Malaria Treatment (United States)

        Malaria attack can vary from mild to severe. Severe malaria can be very deadly especially if the parasite is Plasmodium falciparum.
        Route of medication administration is usually orally or IV (if not tolerated by mouth or faster onset is desired).

Drugs used against parasites in the blood:

• Chloroquine
• Atovaquone-proguanil 
• Artemether-lumefantrine
• Mefloquine
• Quinine
• Quinidine
• Doxycycline (used in combination w/ Quinine)
• Clindamycin (used in combination w/ Quinine)
• Artesunate (not licensed for use in the US, but available through the CDC malaria hotline)

Primaquine is active against parasites that lies dormant in the liver called hypnozoites. This medicine prevents reemergence of malaria. Primaquine SHOULD NOT be taken by pregnant women and by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase).  

What is G6PD Deficiency? 

It is a hereditary condition which causes the destruction of red blood cells when the body is facing an infection or exposed to certain drugs. 

*Malaria-infected people should only take Primaquine once G6PD deficiency after the person is screened and no deficiency is found. 

Treatment of Malaria depends on the following factors: 

• Type of Species of the infecting parasite
• The area where the infection was acquired and its drug-resistance status
• The clinical status of the patient
• Any accompanying illness or condition
• Pregnancy
• Drug allergies, or other medications taken by the patient

Visit this website to find out more about treatment guideline of Malaria among pregnant women:

CDC: Alternative Treatment of Malaria for Pregnant Women 

Let us examine the side effects of some of the drugs used against parasites in the blood. 

1. Chloroquine

Side Effects: 

Central Nervous System: SEIZURES, anxiety, agitation, confusion, delirium, depression, hallucinations

Heart: cardiomyopathy, hypotension

Gastrointestinal Tract: abdominal cramps, anorexia, diarrhea, hepatitis, increased liver enzyme

Skin: STEVENS-JOHNSON SYNDROME, TOPICAL EPIDERMAL NECROLYSIS, alopecia, dermatoses, itchiness, hives, 

CAPITALS indicate life-threatening. It is important to note that these side effects are not common. Talk to your provider about contraindications and adverse side effects of the drug. 

2. Quinine

Side Effects: 

Heart: TORSADES DE POINTES

Gastrointestinal Tract: abdominal cramps/pain, diarrhea, nausea, vomiting, hepatotoxicity

Skin: rash

Endocrine System: Hypoglycemia (increased in pregnancy)

Circulation: bleeding

Other: ANAPHYLAXIS due to hypersensitivity (allergic reaction), HEMOLYTIC UREMIC SYNDROME, STEVENS-JOHNSON SYNDROME

CAPITALS indicate life threatening. 

Italics indicate most frequent. 

Any evidence of allergy (flushing, itching, rash, fever, facial swelling, stomach pain, difficulty breathing, ringing in the ears, visual problems) or rash indicate hypersensitivity. It is advisable to stop the drug and notify healthcare provider right away. Talk to your provider first about side effects and symptoms to watch out for before starting therapy. 

Bibliography: 

DrugGuide.com|Davis' Drug Guide Online Powered by Unbound Medicine. (n.d.). Retrieved May

     5, 2015, from http://www.drugguide.com/ddo

Malaria Treatment (United States). (2012, November 9.). Retrieved May 5, 2015, from http://www.

     cdc.gov/malaria/diagnosis_treatment/treatment.html