MEFLOQUINE
| A | Halofantrine | |
| B |
Lumefantrine |
|
| C |
Artemisinin derivatives |
|
| D |
Mefloquine |
Which of the following antimalarial drug cause neruopsychiatric reactions and convulsions?
| A |
Halofantrine |
|
| B |
Lumefantrine |
|
| C |
Artemisinin derivatives |
|
| D |
Mefloquine |
Neuropsychiatric reactions, convulsions and encephalopathy are the major side effects of mefloquine.
Halofantrine is associated with cardiac conduction defects and and aretmesinin derivatves occassionally cause anaphylaxis.
Lumefantrine is usually well tolerated.
Ref: Harrisons principles of internal medicine, 18th edition, Page: 1700
A 28 weeks pregnant primigravida, presented with intermittent fever with chills, headache and myalgia. Peripheral smear shows malarial parasites. All of the following medicines can be given to this patient, EXCEPT:
| A |
Chloroquine |
|
| B |
Primaquine |
|
| C |
Mefloquine |
|
| D |
Quinine |
Chloroquine is the treatment of choice for malaria caused by all sensitive Plasmodium species.
For the woman with chloroquine-resistant infection, which constitutes the majority of falciparum infections, quinine plus clindamycin is currently recommended. Quinine may induce hyperinsulinemia and thus, possible maternal and fetal hypoglycemia.
Mefloquine is generally considered safe in young children and pregnant women.
Primaquine and doxycycline are contraindicated in pregnancy.
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 58. Infectious Diseases. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
Mefloquine is contraindicated with –
| A |
Quinine |
|
| B |
Atenolol |
|
| C |
Enalapril |
|
| D |
Verapamil |
Ans. is ‘a’ i.e., Quinine
o Halofantrine or quinidine/quinine given to patients who have received mefloquine cause QTc lengthening -cardiac arrest may occur.
| A |
Chloroquine |
|
| B |
Quinine |
|
| C |
Mefloquine |
|
| D |
Primaquine |
Ans. is ‘c’ i.e., Mefloquine
o Amongst the antimalarial drugs, quinine, primaquine and occasionally chloroquine can cause hemolysis in patients with G6PD deficiency.
| A |
Primaquine |
|
| B |
Doxycycline |
|
| C |
Amodiaquine |
|
| D |
Hydroxychloroquine |
Ans. is ‘b’ i.e., Doxycycline
A person wants to visit a malaria endemic area of low level chloroquine resistant falciparum malaria. The best chemoprophylaxis is –
| A |
Chloroquine |
|
| B |
Proguanil + Pyrimethamine |
|
| C |
Sulfadoxine + Pyrimethamine |
|
| D |
Mefloquine |
Ans. is ‘d’ i.e., Mefloquine
Chemoprophylaxis of malaria
o Chemoprophylaxis is recommended for travellers from non-endemic areas, and as a short term measure for soldiers, police and labour forces serving in highly endemic areas.
o Chemoprophylaxis should begin a week before arrival in malarious area and continued for at least 4 weeks or preferably 6 weeks after leaving malarious area.
o Drugs used are : ‑
1. Chloroquine –> DOC for chemoprophylaxis in chloroquine sensitive P. falciparum areas.
2. Atovaquone/Proguanil —-> Used in areas with chloroquine or mefloquine resistant P. falciparum.
3. Doxycycline —> Used in areas with chloroquine or mefloquine resistant P. falciarum.
4. Mefloquine —> Used in areas with chloroquine resistant P. falciparum
5. Hydroxychloroquine —> Alternative to chloroquine in areas with chloroquine sensitive P. falciparum.
| A |
Mefloquine |
|
| B |
Quinine |
|
| C |
Halofantrine |
|
| D |
Artesunate |
Ans. is ‘a’ i.e., Mefloquine
Chemoprophylaxis of malaria
- Chemoprophylaxis is recommended for travellers from non-endemic areas, and as a short term measure for soldiers, police and labour forces serving in highly endemic areas.
- Chemoprophylaxis should begin a week before arrival in malarious area and continued for at least 4 weeks or preferably 6 weeks after leaving malarious area.
- Drugs used are : ‑
Chloroquine → DOC for chemoprophylaxis in chloroquine sensitive P. falciparum areas.
Atovaquone/Proguanil → Used in areas with chloroquine or mefloquine resistant P. falciparum.
Doxycycline → Used in areas with chloroquine or mefloquine resistant P. falciparum.
Mefloquine → Used in areas with chloroquine resistant P. falciparum
Hydroxychloroquine → Alternative to chloroquine in areas with chloroquine sensitive P. falciparum
