THIS PRESENTATION IS FOR TEACHING AND LEARNING PURPOSE.

1. MALARIA ,RECENT ADVANCE AND
NEW ANTI MALARIAL DRUGS
DR MUKESH KUMAR SAMOTA
MD(INTERNAL MEDICINE)
GOVT. MEDICAL COLLEGE AND HOSPITAL, JHALAWAR
RAJASTHAN (INDIA).

2. INTODUCTION
• M A L A R I A I S A P R O TO Z O A N D I S E A S E
T R A N S M I T T E D B Y F E M A L E A N A P H E L E S
M O S Q U I TO E S
• H E AV Y B U R D E N I N T R O P I C A L C O U N T R I E S
• M O S T I M P O RTA N T PA R A S I T I C D I S E A S E
O F H U M A N T R A N S M I T T E D I N 3 B I L L I O N
P E O P L E W O R D W I D E A N D A P P R O X 2 0 0 0
D E AT H / D AY W O R D W I D E .
• 6 S P E C I E S O F G E N U S P L A S M O D I U N
C A U S E N E A R LY A L L M A L A R I A
I N F E C T I O N S I N H U M A N S

4. LIFE CYCLE

6. PATHOPHYSIOLOGY
After invading RBC growing parasites consume intracellular proteins principally
Hb and
Potentially toxic heme is converted to biologically inert hemozoin (malaria
pigment).
Parasites alters RBC membrane by changing its transport property and
expososing cryptic surface antigens.
In erythrocytic cycle RBC ruptures and release malarial pigments and other
proteins which stimulate host immune system
Stimulation of macrophages and cells occur which release proinflammatory
mediators and it cause clinical features .
In case of Pf there is cyto adherence, agglutination, rosette formation of infected
RBC leads to occludes capillaries and vessels which is responsible for sever
and complicated malaria

8. CLINICAL FEATURES

13. DIAGNOSIS

26. CHQ RESISTANCE

29. ANTI MALARIAL TARGET SITE

36. OTHERS
MEFLOQUINE
250 mg weekly for adults
used in area of chq resist Pf
DOXYCUCLINE
100 mg daily start 2 days before to 4week after
C/I For pregnancy and chldren <8 yrs of age
PRIMAQUINE
0.5mg/kg daily

37. Atorvaquinone (250mg)+proguanil(100mg)
Used in usa
Not used in india

38. TREATMENT OF MALARIA
UNCOMPLICATED MALARIA
(A) CHQ SENSITIVE PL. VIVAX
1.CHQ 10 mg/kg PO stat then5mg/kg@12h
then 5mg/kg @24 and 36 h
OR
10 mg/kg BW stat then 10 mg/kg BW @24 hrs and
5mg/kg BW48 hrs
PLUS
Primaquin 0.25mg/kg for 14 days

39. (B)CHQ RESISTENT PL. VIVAX
1.QUININE 600MG(10MG/DAY) 8H FOR7DAY
PLUS
DOXYCYCLINE100MG DAILY FOR 7 DAYS PLUS
PRIMAQUINE15MG FOR 14 DAYS
2. ACT PLUS PRIMAQUINE

40. CHQ RESISTENT MALARIA (PF)