Quinine:
According to WHO, Quinine should only be used for uncomplicated malaria if alternatives are not available e.g. in areas of multi drug resistance and where P. falciparum does not respond to Chloroquine, sulphadoxine - pyremethamine etc. Quinine could be used as first line treatment for patients who fail to respond to Chloroquine and are hypersensitive to sulpha drugs.
Artesunate:
Use: Artesunate is a water soluble hemisuccinate derivative of dihydroartemisinin and is most widely used member of this family of dugs. It is effective against P. falciparum resistant to other operationally used anti-malarial drugs. It does not have hypnozonticidal activity. It also reduces gametocytes carriage rate. Artesunate is used for treatment of uncomplicated P. falciparum malaria. It should always be administered in combination with another effective blood Schizonticide to prevent recrudescence and delay the selection of resistant strains. The use of artesunate as monotherapy should be limited to specific indications, such as patient with a history of adverse reactions to the combination drug. WHO does not recommended Artesunate for the treatment of vivax malaria since other effective anti-malarial drugs are available for this purpose.
Dose: for treatment of uncomplicated P. falciparum malaria, Artesunate should be used combination with other effective schizonticide. The recommended dose is: 4 mg/Kg body weight once a day for 03 days, plus sulphadoxine- pyremethamine as single adult dose of 1500 mg of sulpha drug + 75 mg of pyremethamine on first day (25 mg Sulphadoxine and 1.25 mg of pyremethamine per Kg body weight, as a single dose).
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