Chloroquine:
Use: Chloroquine is a 4-aminoquinoline that has marked and repaid schizonticidal activity against Chloroquine sensitive infection of P. falciparum and P. vivax. It is also gametocytocidal against P. vivax and immature gametocytes of P. falciparum. It is not effective against tissue stages (intrahepatic forms) of P. vivax and should therefore, be used with Primaquine to effect remedial cure of P. vivax. According to WHO Chloroquine can be given throughout pregnancy and to children of all ages if there is no specific contra-indication for it.
Dose: 25 mg of Chloroquine base per Kg body weight given over a period of 03 days. This consists of 10 mg per Kg body weight on the first and second day and 05 mg per Kg body weight on the third day.
Side effects: According to WHO, serious adverse reaction to Chloroquine are rare at the usual Anti-Malarial dosage, but some people may feel itchy after taking Chloroquine and you may see them scratching. Occasionally Chloroquine may cause transient headaches, nausea, vomiting, gastrointestinal symptoms and blurred vision. This may be avoided by taking the dose after meals. These effects are not dangerous, and they will disappear soon after the 03-day treatment.
Contra-indication: Chloroquine should not be used in persons with known hypersensitivity to Chloroquine, with a known history of epilepsy or suffering from skin disease like psoriasis.
Over-dosage: Chloroquine has a low safety margin. Acute Chloroquine poisoning is extremely dangerous and death may occur within a few hours. Symptoms and signs of poisoning include headache, nausea, diarrhea, dizziness, muscular weakness and blurred vision. The main effects in on the cardio-vascular system leading to hypotension and cardiac arrhythmias progressing to cardio-vascular collapse, convulsions, cardiac and respiratory arrest and death. If a patient is seen within few hours of administration of the event, emesis must be induced or gastric lavage undertaken as rapidly as possible. If not, treatment is symptomatic and directed particularly to sustaining cardiovascular and respiratory function.
Precautions: There is very little difference between the therapeutic and toxic doses. Oral ingestion of 2-3 times the daily dose can be dangerous. All medicines, especially Chloroquine should be kept out of the reach of children. Intramuscular Chloroquine should be avoided if the patient is able to take medicines orally (as this may result in cardiac arrest).
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