Question
All of the following drugs are used in the management of uncomplicated Plasmodium falciparum malaria, except:
| A. |
Artemether |
| B. |
Primaquine |
| C. |
Chloroquine |
| D. |
Sulphadoxine/pyrimethamine |
Show Answer
|
Correct Answer » C Explanation |
 |
Management of Uncomplicated Plasmodium falciparum Malaria- High Yield Points:
First-Line Drugs for P. falciparum Malaria
Plasmodium falciparum is often resistant to chloroquine, so it is not the drug of choice unless confirmed sensitive. Standard treatment involves artemisinin-based combination therapies (ACTs)such as:
-
Artemether-Lumefantrine (AL)
- Dosage: Twice daily for 3 days.
- Well-tolerated and widely used.
-
Artesunate + Amodiaquine (AS + AQ)
- Dosage: Daily for 3 days.
- Effective in regions without amodiaquine resistance.
-
Artesunate + Sulfadoxine-Pyrimethamine (AS + SP)
- Single-dose SP with daily artesunate for 3 days.
- Requires folate supplementation if used.
-
Dihydroartemisinin-Piperaquine (DHA-PPQ)
- Dosage: Daily for 3 days.
- Provides a long post-treatment prophylactic effect.
Role of Primaquine- Gametocytocidal Use:
A single low dose of primaquine (0.25 mg/kg) is recommended after ACT to eliminate P. falciparum gametocytes, reducing transmission.
Not used for acute parasite clearance.
Alternative Therapies
For areas with ACT unavailability or confirmed drug resistance:
- Quinine + Doxycycline/Clindamycin: Given for 7 days.
- Atovaquone-Proguanil: Effective in multidrug-resistant areas.
Special Populations
Pregnant Women
- First Trimester: Quinine + Clindamycin for 7 days.
- Second/Third Trimester: ACTs (e.g., AL or AS + SP).
Infants and Children : ACTs are safe and effective when dosed appropriately based on weight.
