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Pharmacology (5th year) > Malaria > Flashcards

Flashcards in Malaria Deck (16):
1

Categories of malaria

- severe
- moderately severe
- uncomplicated malaria

2

Non-drug measures to prevent malaria

- remain indoors
- wear long-sleeved clothing
- screen doorways and windows
- apply a DEET-containing repellent
- use mosquito mats and coils
- use insecticide-treated bed nets
- spray aerosol insecticide
- use ceiling fans/air conditioner

3

Options for malaria chemoprophylaxis

- doxycycline
- mefloquine
- atovaquone-proguanil

4

Management problems of malaria in Cape Town

- delay in presentation
- delay in diagnosis
- underassessment of disease severity
- choice of antimalarial

5

Symptoms of uncomplicated malaria

- fever
- headache, lassitude, fatigue
- abdominal discomfort
- muscle and joint aches
- chills and perspiration
- anorexia and vomiting
- worsening malaise

6

Symptoms of malaria in young children

- lethargy
- poor feeding
- vomiting, diarrhoea
- seizures
- sleepiness
- cough
- rapid respiration

7

Choice of anti-malarial in uncomplicated malaria

Arthemisinin-based combination
- artemether + Lumefantrine = Coartem

8

Contraindications for Coartem

- allergic
- <5kg
- pregnant in 1st trimester
- severe malaria

9

Instructions for taking Coartem

- take all 6 doses over 3 days
- take with food or milk containing >1.2g of fat
- take fluids and paracetamol if needed
- expect response in 24-48 hours
- return if temp not settled y day 3
- return if vomiting or deteriorating

10

Clinical features of severe malaria

- impaired consciousness
- severe weakness
- convulsions
- low BP
- resp distress
- visible jaundice
- macroscopic haematuria
- abnormal bleeding

11

Laboratory features of severe malaria

- severe anaemia
- hypoglycaemia
- acidosis
- renal impairment
- hyperlactataemia
- hyperparasitaemia
- elevated BR

12

Management of severe malaria

- rapid clinical assessment
- empiric glucose if LOC decreased
- urgent bloods
- parenteral Artesunate (preferred)/ Quinine
- transfer to highest level of care
- monitor constantly
- support failing organs

13

Problems associated with quinine use

- needs a loading dose
- infusion rate often not controlled
- hypoglcaemia

14

Dosing of IV quinine

- loading dose of 20mg/kg by slow IV infusion over 4 hours
- then 10mg/kg by slow intravenous infusion over 4 hours, repeated every 8 hours
- follow with coartem

15

Organism that can cause severe malaria

P. falciparum

16

Organisms that can cause uncomplicated malaria

- p falciparum
- p malariae
- p knowlesi