Malaria Prophylaxis Flashcards
(27 cards)
What non-pharmacological methods can be taken to prevent mosquito bites?
Long sleeves and trousers after dusk, mosquito nets impregnated with permethrin, mats and vapourised insecticides.
Diethyltoluamide (DEET) preparations of 20-50% are safe in which patient groups?
When applied to the skin of adults and children over 2 months, as well as pregnant and breastfeeding women.
What effect does DEET have on sun cream and how should this be treated?
DEET can reduce the SPF of sun cream, a high SPF cream should be used, DEET should be applied after the sun cream.
When should use of mefloquine for malaria prophylaxis be started?
2-3 weeks before travel to the endemic area.
When should use of Malarone or doxycycline for malaria prophylaxis be started?
1-2 days before travel to the endemic area.
For how long should malaria prophylaxis be continued after return from the endemic area?
For 4 weeks after leaving the endemic area, except for Malarone which should be stopped after 1 week.
After return from an area where there may be a risk of malaria, for how long could illness potentially be malaria?
Any illness withing one year and especially within three months of return. Travellers should immediately go to the doctors.
Which antimalarial drugs are unsuitable in epileptic patients?
Chloroquine and mefloquine.
Describe the relationship between asplenia and malaria.
Asplenic patients have an increased risk of severe malaria. They should take special care to not contract malaria.
Can proguanil for malarial prophylaxis be used in patients with renal impairment?
No.
What is the eGFR which prevents the use of Malarone for malaria prophylaxis?
Less than 30.
Do breastfed infants require their own malaria prophylaxis?
Yes, the amount of antimalarial medication present in breastmilk is too variable to be relied on.
How long before travel should patients on warfarin start malaria prophylaxis?
2-3 weeks prior to travel.
With regards to malaria prophylaxis, when should a warfarin patient’s INR be monitored?
Before chemoprophylaxis, seven days after starting, and after completing the course. INR should be stable prior to travel.
What specific toxicity has been observed with use of chloroquine (Avloclor)?
Ocular toxicity, screening is recommended.
Ocular toxicity with chloroquine is uncommon when the dose is under what?
4mg/kg.
In which patient is use of mefloquine contraindicated?
Those with a history of psychiatric disorders.
What side effects occur commonly with mefloquine use?
Abnormal dreams, insomnia, anxiety, depression.
What less common side effects have been reported with mefloquine use?
Psychosis, suicidal ideation, and suicide.
Which signs should be regarded as a sign of a more serious even if they occur when a patient is taking mefloquine for malaria prophylaxis?
Nightmares, anxiety, depression, restlessness, confusion.
What should patients on mefloquine do if they experience any psychiatric side effects?
Discontinue treatment and seek medical attention. Side effects can last a long time due to the long half-life of the drug.
How can driving be affected by mefloquine use?
Dizziness or a disturbed sense of balance may affect the performance of skilled tasks such as driving. Effects may occur and persist up to several months after stopping mefloquine.
How much quinine bisulphate is equivalent to 100mg of quinine base?
169mg.
How much quinine dihydrochloride is equivalent to 100mg of quinine base?
122mg.
