Management Review MyAAPCR疟疾和管理审查课件.ppt

Diaminopyrimidines: Trimethoprim, Pyrimethamine Blood schizonticide Pyrimethamine also sporonticide Biguanides: Proguanil, Chlorguanide, Chlorproguanil Blood schizonticide Proguanil also sporonticide Sulfonamides Sulfadoxine, Sulfadiazine, Sulfamethoxazole Blood schizonticide Sulfones Dapsone Blood schizonticide Cinchona Alkaloids Quinine, Quinidine Blood schizonticide 4-quinoline-carbinolamines Mefloquine Blood schizonticide Antibiotics Tetracycline Vibramycine Clindamycin Blood schizonticides Others HalofantrinArtemisinin (quinghaosu) Atovaquone Blood schizonticides Combination Fansidar (Pyrimethamine + Sulfadoxine) Maloprim (Pyrimethamine + Dapsone) Malarone (Atovaquone + Proguanil) Blood schizonticides and sporonticides Atovaquone (also tissue schizonticide for P. falcip) Selected Drugs Chloroquine: Indications- Chloroquine sensitive all forms except resistant P. falciparum and P. Vivax Dosage: Oral-25mg/kg base in divided doses: typical 600mg start, 300mg after 6-8 hours, 300mg every day for 2 more days IM or slow IV-10mg/kg over 8 hours, then 5mg/kg q 8 hours x 3 doses then oral dosing until a total of 25mg/kg is given Chloroquine---- Side effects: Impaired hearing, psychosis, convulsions, blood dyscrasias, skin allergy, hypotension, haemolysis in G6PD. Long term use may cause dose dependent retinopathy, ototoxicity and myopathy. Pregnancy: not contraindicated Children: not contraindicated Mefloquine hydrochloride Indications-Chloroquine resistant malaria (Treatment) Dosage: Oral-20-25mg/kg base single dose or in divide doses Typical 750mg start, then 500mg after 6- 12 hours Side effects: Cardiac conduction problems (prolongation of QT interval), liver effect, ophthalmopathy, neuropsychiatric symptoms (rare) Mefloquine----- Contraindications: Cardiac conduction problems, Neuropsychiatric problems (including epilepsy, depression, psychosis etc), Liver dysfunction, Concurrent use of quinine, quinidin