Antimalarials
Many malaria prophylaxis options, but none perfect - Stacey Butterfield
image by: Cell & Molecular Biology
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Malaria: Targets and Drugs for All Stages
Unfortunately, resistance frequently arises to any widely-used single drug. In the last five years, strong gains were made through combinations such as artemisinin-combination therapies (ACTs) where artemisinins were combined with a partner to which resistance had emerged. But now there are signs of resistance to artemisinins, the spread of which would wipe out recent gains. However in HIV, three drug combinations and first, second and third line combinations are being used to win the fight against AIDS. Malaria has proved a challenge, but there is hope; compared to viruses, the parasites’ mutation rate is lower and disease management is relatively straightforward. Thus expanding the existing…
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Chemoprophylaxis and Treatment
Several classes of antimalarial drugs are available (Table 52–1 and Figure 52–2). Drugs that eliminate developing or dormant liver forms are called tissue schizonticides; those that act on erythrocytic parasites are blood schizonticides; and those that kill sexual stages and prevent transmission to mosquitoes are gametocides. No single available agent can reliably effect a radical cure, ie, eliminate both hepatic and erythrocytic stages. Few available agents are causal prophylactic drugs, ie, capable of preventing erythrocytic infection. However, all effective chemoprophylactic agents kill erythrocytic parasites before they increase sufficiently in number to cause clinical disease.
An ancient foe and a modern arms race
Our immune systems mount responses to kill or supress invading bacteria, viruses or parasites. Over time, the pathogens develop ways to evade our responses. We are often aided by drugs or vaccines, though these too may be overcome, and the cycle continues. Malaria, a disease that has been with humans for over 50,000 years, is no different.
Monoclonal antibody could prevent malaria, study shows
Based on recent research, a “potential game changer” approach could offer a practical way to use monoclonal antibody therapies for malaria in Africa.
Triple Artemisinin-Based Combination Therapies for Malaria – A New Paradigm?
Triple ACTs (TACTs), combining an artemisinin and two existing partner drugs, could be a stop-gap therapy for treating multidrug-resistant malaria until new antimalarials are available. Where resistance is not established, deployment of TACTs could delay or prevent emergence of resistance and could prolong the longevity of antimalarial compounds used in any triple-drug combination.
Dosing Recommendations for Prevention and Treatment of Malaria
For Travel to Chloroquine-Resistant Areas: Atovaquone/proguanil once daily started 1–2 days before travel, for duration of stay, and then for 1 week after returning home.
History of antimalarials drugs
MMV is developing next-generation medicines to address drug resistance and improve compliance.
Are antimalarial drugs still effective?
Studies reveal emerging resistance to first–line treatments
Artemisinin resistance and malaria elimination: Where are we now?
The emergence of artemisinin resistance is a major obstacle to the global malaria eradication/elimination programs. Artemisinin is a very fast-acting antimalarial drug and is the most important drug in the treatment of severe and uncomplicated malaria. For the treatment of acute uncomplicated falciparum malaria, artemisinin derivatives are combined with long half-life partner drugs and widely used as artemisinin-based combination therapies (ACTs).
Artemisinins: their growing importance in medicine
Artemisinins are derived from extracts of sweet wormwood (Artemisia annua) and are well established for the treatment of malaria, including highly drug-resistant strains. Their efficacy also extends to phylogenetically unrelated parasitic infections such as schistosomiasis.
At Long Last, Can Malaria Be Eradicated?
Two new vaccines may finally turn back an ancient plague. But in unexpected ways, their arrival also complicates the path to ending the disease.
Drug-resistant malaria is emerging in Africa. Doctors are worried — yet hopeful
So far, the ACTs still work. But in an experimental setting, as drug resistance sets in, it can lengthen treatment by three or four days. That may not sound like much, said Timothy Wells, chief scientific officer of the nonprofit Medicines for Malaria Venture. But "the more days of therapy you need," he says, "then the more there is the risk that people don't finish their course of therapy."
Experience: my anti-malaria drugs made me psychotic
Looking back, I can see the effects started before I left for Ghana, but at the time I blamed it on the stress of the trip ahead. My mind became chaotic, and I couldn’t make any decisions. I tried to pack, but would take something in each hand and stare at them in confusion. In the end, I had to ask my mum to help.
Herbs And Empires: A Brief History Of Malaria Drugs
What do Jesuit priests, gin and tonics, and ancient Chinese scrolls have in common? They all show up in our animated history of malaria. It's a story of geopolitical struggles, traditional medicine, and above all, a war of escalation between scientists and a tiny parasite. Malaria has proved to be a wily foe: Every time we think we have it backed into a corner, it somehow escapes.
Malaria medication: your questions answered
The female Anopheles mosquito bites from dusk to dawn and does not hum or leave a welt at the site of the bite, so you won’t know if you have been bitten or not. Antimalarial medication works by killing the malaria parasites during their development stage in the liver and red blood cells. You need to begin taking your antimalarial before you enter the risk area to give it time to establish in your system.
Malaria Prophylaxis
It must be remembered that no chemoprophylaxis regime provides 100% protection. Therefore it is essential to prevent mosquito bites as well as to comply with chemoprophylaxis. A possibility of malaria should be considered if a febrile illness develops after a week of entering a malarious area as well as up to over a year after visiting such an area, although it is more likely within the first 3 months of return.
Malaria Prophylaxis: A Comprehensive Review
Drug chemoprophylaxis has proved to be an effective preventive strategy in travellers to malaria- endemic areas [41], both for P. falciparum and non-falciparum malaria, despite it does not usually prevent the later relapses that can occur with P. vivax and P. ovale.
Prevention and Prophylaxis of Malaria in Older Travelers
Fixed-dose combination atovaquone/proguanil is well tolerated and convenient, making it a commonly prescribed agent for malaria prophylaxis. The effectiveness of atovaquone/proguanil against chloroquine-resistant and mefloquine-resistant P. falciparum also makes it an attractive option in areas where multidrug-resistant P. falciparum is endemic.
Ready to beat malaria: prospects for new interventions
A sobering thought is that a malaria parasite mutation causing drug resistance can arise during the course of infection in a single malaria patient, but it takes us more than 10 years from discovery to bring a new drug to the clinic - David Baker, LSHTM.
The past, present and future of anti-malarial medicines
With the recent emergence of resistance to current front-line artemisinin-based combination therapy, the need for the discovery of new anti-malarials that can act through novel mechanisms of action has been pushed firmly to the top of the development agenda.
What is the most effective and safe malaria prophylaxis during pregnancy?
Chloroquine and mefloquine have superior safety profiles in pregnancy, though all antimalarials are effective for prophylaxis. Antimalarials will decrease the severity of maternal malaria infection and malariaassociated anemia, while decreasing the incidence of low birth weight and perinatal death in women having their first or second baby (strength of recommendation.
Which malaria tablets should I take?
With many different options available when it comes to antimalarial medication, it can be confusing working out which one is best for you.
Malaria: Targets and Drugs for All Stages
Malaria is an ancient enemy. Its treatments predate modern drug discovery, most notably the use of the Qinghao plant in ancient China (2nd century BC to 340 CE) and Peruvian bark in the early 17th century, the medicines from which are now known to be artemisinin and quinine respectively.
Chloroquine, Past and Present
Chloroquine's fame is as an antimalarial drug, and the history of antimalarials starts of course with quinine. That's the active compound in cinchona bark, whose medicinal properties had long been known among the natives of South America in the tropical parts of the Andes - the Incas and the people(s) that the Incas absorbed into their empire. It doesn't seem to have been used by them as a malaria treatment per se, but rather was known as a treatment for shivering, brought on by either low temperatures or by malaria itself.
Medicines for Malaria Venture
Our mission is to reduce the burden of malaria in disease-endemic countries by discovering, developing and facilitating delivery of new, effective and affordable antimalarial drugs.
Push Health
Malaria prophylaxis, sometimes referred to as malaria prevention medication, consists of specific medications that reduce the risk that one will contract malaria if exposed to it while traveling. Push Health can connect people in need of a malaria medication prescription with local medical providers who can prescribe malaria pills if it is safe and appropriate to do so.
CDC
No antimalarial drug is 100% protective and must be combined with the use of personal protective measures, (i.e., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet).
StatPearls
Malarial chemoprophylaxis functions by targeting the liver schizont, blood schizont, or hypnozoite stages of the plasmodium life cycle. The three most commonly prescribed medications for chemoprophylaxis are atovaquone-proguanil, doxycycline, and mefloquine.
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