Malaria Management Flashcards
(17 cards)
Mefloquine
- begin ≥2 WEEKS before leaving
- Continue 4 WEEKS after returning
- CI: Psych disorders (depression)
PTx: Regions w/ chloroquine-sensitive malaria
- Chloroquine or Hydroxychloroquine
Chloroquine/Hydroxychloroquine
- start 1-2 WEEKS before leaving
- continue 4 WEEKS after returning
- qweekly
PTx: regions primarly w/ P. Vivax
Primaquine
Primaquine
- begin 1-2 days before leaving
- continue 7 days after returning
- P. Vivax areas only
- CI: G6PD deficient or pregnancy
PTx: ALL malaria-endemic regions
- Atovaquone/Proguanil (DOC)
- Doxy
- Tafenoquine
Malaria S/Sx
- FEVER
- Night Sweats
- HA
- Weakness
- Insomnia
Severe Malaria Dx
Pt has AT LEAST ONE:
- Impaired consciousness/coma
- HgB<7
- AKI (inc SCr)
- ARDS
- Shock
- Acidosis
- Parasite Density ≥ 5%
Tafenoquine
- begin 3 days before leaving
- continue 1 WEEK after returning
- CI: G6PD deficient, Pregnancy, Kids, or Psych Disorder
P. Vivax or P. Ovale Tx
Anti-Relapse Tx
- Primaquine (DOC)
- Tafenoquine (only w/ chloro)
- ADD to other Malaria Tx (Art-Lum, or Chloro if sensitive)
Doxycycline
- begin 1-2 days before leaving
- continue 4 WEEKS after returning
- can prevent other infxns
Atovaquone/Proguanil
- Start 1-2days before leaving
- Continue for 7 days after returning
- CI: CrCl <30 or pregnancy
PTx: regions w/ mefloquine-sensitive malaria
Mefloquine
Uncomp Malaria - Chloroquine Sensitive Region
Chloroquine or Hydroxychloroquine (always DOC if area is sensitive)
Uncomp Malaria - Region w/ chloroquine Resistance or unknown Resistance
- Artemether-lumefantrine x 3d (DOC)
- Atovaquone/Proguanil
- Quinine +Doxy/Tetra/or Clinda
Severe Malaria Tx
- IV Artesunate (up to 7days)
- transition to ORAL Tx (Art-Lum DOC) after IV Tx
- NEVER Chloro/Hyrdro for severe!!
P. Knowlesi or P. Marariae in ANY region
- Chloroquine/Hydroxy (DOC)
- Alt: any other agent
