Antimalarial Drugs and their clinical uses.pptx

Brief introduction to Malaria and its drugs
What is Malaia
Its Smptoms
Life Cycle of Plasmodium
Anti Malarial drugs and their mechanism of action with adverse effects and clincal uses
Chemoprophylaxis and its uses
How malaria affects a person. how does chloroquine quinine and mefloquine act on Cells. what's blood and tissue schintocide. what is Cinconism. What is Blackwater fever

1. Antimalarial Drugs Dr Shahrukh zaman

2. Introduction to Malaria Malaria is one of the most common diseases worldwide and a leading cause of death. Caused by Plasmodium species ( P. falciparum, P. malariae , P. ovale , P. vivax ). Symptoms : Fever, chills, headache, nausea, vomiting, fatigue, and in severe cases, seizures, coma, or death .

3. Life Cycle of Plasmodium Infection starts when a mosquito injects Plasmodium sporozoites into the bloodstream. Sporozoites travel to the liver, where they multiply. (Tissue Schizontes ) They are released into the bloodstream, infecting red blood cells (Blood Schizontes ). Dormant stages ( P. vivax , P. ovale ) in the liver cause relapses ( Hypnozytes ) Drugs target different life cycle stages: liver (primary schizonticides ) and blood (blood schizonticides ).

4. Chloroquine Mechanism of Action (MOA) : Prevents polymerization of heme into hemozoin , causing toxic heme buildup in the parasite. Clinical Use : Drug of choice for acute non-falciparum and sensitive falciparum malaria. Adverse Effects : GI irritation, skin rash, headache. At high doses: retinal damage, Auditory damage, cardiac issues, neuropsychiatric symptoms

5. Artemisinin Derivatives MOA : Forms free radicals in the parasite's food vacuole. Clinical Use : First-line for chloroquine-resistant malaria ( P. falciparum ). Adverse Effects : Nausea, vomiting, diarrhea. No significant pregnancy risks.

6. Quinine/Quinidine MOA : Complexes with parasite DNA, blocking replication and transcription. Clinical Use : Used for chloroquine-resistant P. falciparum and in combination therapy (e.g., with doxycycline or clindamycin). Adverse Effects : Cinchonism (GI issues, headache, tinnitus, vertigo, blurred vision ), hemolysis in G6PD-deficient patients, cardiac toxicity, Blackwater fever.

7. Mefloquine MOA : Unknown. Clinical Use : Prophylaxis in chloroquine-resistant regions. An alternative for acute attacks. Adverse Effects : GI distress, psychiatric disturbances (e.g., vivid dreams, anxiety), seizures, and cardiac issues at high doses.

8. Primaquine MOA : Forms redox-active metabolites, which are toxic to liver-stage parasites and gametocytes. Clinical Use : Eradicates liver stages of P. vivax and P. ovale and is used for terminal prophylaxis. Adverse Effects : GI distress, headaches, methemoglobinemia , hemolysis in G6PD-deficient individuals. Contraindicated in pregnancy.

9. Antifolates Drugs : Pyrimethamine , Proguanil , Sulfadoxine . MOA : Inhibit folic acid synthesis, blocking DNA synthesis in the parasite. Clinical Use : Used for multidrug-resistant P. falciparum . Adverse Effects : GI distress, folate deficiency, renal dysfunction, skin rashes .

10. Doxycycline & Other Antimalarials Doxycycline : Used for chemoprophylaxis in multidrug-resistant areas. Atovaquone : Disrupts mitochondrial function, used for treatment and prophylaxis ( P. falciparum ). Lumefantrine : Used in combination with artemether ( Coartem ).

11. Drug Prophylaxis Use Duration Chloroquine Areas without P. falciparum resistance Weekly Mefloquine Chloroquine-resistant areas Weekly Doxycycline Multidrug-resistant areas daily Malarone (Atovaquone + Proguanil) Multidrug-resistant areas daily Primaquine Terminal prophylaxis for P. vivax & P. ovale daily (14 days)