Malaria pills

In summer, when the holiday season is in full swing, the flow of tourists to exotic countries increases significantly. A trip to a country located in a tropical climate zone promises, of course, exciting experiences. In order not to spoil your vacation, remember the preventive measures for the most common diseases in these latitudes and dangerous to health, the pathogens of which you may encounter. If you decide to go to the countries of Asia, South and Central America, the Pacific Ocean, your travel first aid kit should definitely have room for malaria pills.

Carriers of the malaria pathogen are mosquitoes of the genus Anopheles. Malaria is characterized by focal outbreaks of spread. Due to the climate features, stable foci have formed in countries with a warm and humid climate. The fact is that the maturation of the malaria plasmodium in the body of a mosquito occurs at a temperature of 16°C - 30°C. Mosquitoes need slow-flowing bodies of water with clean and warm water to reproduce.

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How can one recognize the disease?

Malaria is caused by parasites of the genus Plasmodium. The disease can be acute or protracted, accompanied by fever, enlarged liver, and anemia.

Attacks of fever in malaria are periodically repeated. In some patients who have not received treatment or have not completely cured the disease, the fever returns in a week or two or even 2-3 months after the first attack has subsided.

The incubation period lasts 7-45 days. Then, in patients who do not have immunity from the disease, a period may appear, accompanied by chills, headaches, fever, poor health, muscle aches, and sometimes diarrhea. Sometimes the incubation period can last up to 14 months due to the pathogens "sleeping" in hepatocytes.

The attack goes through the following stages: chills, fever, sweating. The chill stage is characterized by pale and cool "goose" skin with a bluish tint. After a time that ranges from 10 minutes to 3 hours, the body temperature rises rapidly (up to 40°C and even higher). Muscle pains become stronger, the head hurts more, you want to drink, vomiting may occur. During the fever, the skin becomes dry and hot, there is a rapid heartbeat. After a few hours, sweat appears, the temperature drops to subnormal numbers, and the state of health temporarily improves.

The attack lasts from 6 to 24 hours or longer. After it, malaria does not manifest itself in any way for two or three days, until the next attack. In patients with tropical malaria, fever attacks may occur more often, up to 2 times a day, since their blood may contain several generations of pathogens, each developing according to its own "schedule". After 2-3 attacks, an increase in the size and some soreness of the spleen and liver can be detected. The rapid death of red blood cells causes anemia and an increase in the concentration of bilirubin. Because of this, the epidermis and mucous membranes acquire a yellowish tint.

In the presence of all these signs, a thick film microscopy and blood test can finally confirm the diagnosis.

How not to get confused in the names of malaria pills? It's not that complicated. Pills are divided into those that fight tissue forms of the pathogen (schizontocides) and those that are intended to fight erythrocyte forms - hematocides. The effectiveness of therapy depends on the timeliness and correct choice of medications. In acute malaria, hematocides are used. If parasites of the P.vivax, P.ovale, P.malariae groups are detected, drugs of the 4-aminoquinoline group are used.

Chloroquine

Chloroquine is the most popular of them. Its analogues are Delagil, Hingamin. The pharmacodynamics of chloroquine is that the drug inhibits the replication of the pathogen's DNA, suppresses the immune system, and has an anti-inflammatory effect. Indications for the use of chloroquine:

• treatment of acute malaria,
• prevention of malaria in those traveling to areas where the disease is common;
• therapy of extraintestinal amoebic dysentery;
• as part of the therapy of rheumatoid arthritis, systemic lupus erythematosus, photodermatoses.

The method of administration and dosage of malaria tablets depend on whether it is necessary to combat the symptoms of malaria or to prevent infection when traveling to an area where this disease is common. The course of treatment with chloroquine lasts three days. In case of signs of fever, take 1 g at the first dose, 6-8 hours later - 500 mg; on the second and third days - 500 mg of chloroquine. To prevent the disease, take 500 mg weekly, strictly every 7 days. The prophylactic course begins 1-2 weeks before the expected trip and continues for up to 6 weeks after arrival.

Long-term use of chloroquine can cause dermatitis. If this happens, the dosage is reduced or the drug is stopped altogether. In some cases, side effects of malaria tablets such as dizziness, headaches, nausea, vomiting, and hearing loss occur. They go away on their own. Chloroquine therapy requires constant monitoring of liver function, blood and urine tests. Contraindications for use: diseases of the heart, kidneys, liver, and hematopoietic organs.

Can pregnant women take chloroquine? There is no clear answer. The safety of using malaria tablets during pregnancy has not been confirmed, so they are prescribed only if the expected benefit to the expectant mother outweighs the possible risk to the development of the baby. The pharmacokinetics of chloroquine is such that its metabolites enter breast milk. This must be taken into account when taking the drug during breastfeeding.

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Quinine sulfate

Quinine sulfate (or quinine hydrochloride) also inhibits the growth of erythrocytic types of malaria. Its mechanism of action is similar to chloroquine, but is inferior in activity. Today, quinine is used when the malaria pathogen is resistant to quinamine or other antimalarial drugs: in some cases, the pathogen is neutralized by the action of quinine. The drug suppresses the centers responsible for maintaining normal body temperature, and also - at a significant dosage - affects the centers of the brain responsible for hearing and vision. Quinine sulfate reduces the heart rate, excites smooth muscle cells of internal organs, and increases uterine tone. The drug is not prescribed to pregnant and lactating women.

The drug is contraindicated if there are signs of deficiency of the enzyme glucose-6-phosphate dehydrogenase, malarial hemoglobinuria, diseases of the middle and inner ear. The drug is prescribed with caution in case of heart disorders and during pregnancy. For pregnant women, to avoid termination of pregnancy, the maximum daily dosage should be up to 1 g. This dose should be divided into 4-5 doses.

Chloridine

Effective against malaria plasmodia, toxoplasmosis and leishmania. Inhibits the growth of asexual erythrocyte forms of all types of plasmodia, but its effect is slower than chloroquine. Pharmacokinetics of the drug: quickly absorbed into the blood and remains in the blood for a long time, finally excreted only a week after the last dose. When taking chloridine in combination with chloroquine, its effectiveness increases. Chloridine is taken in 2-3 courses with an interval of 1-2 months.

May cause headaches, dizziness, heart pain, digestive disorders, visual impairment, hair loss. Contraindicated in diseases of the hematopoietic organs and kidneys. The drug is not prescribed during pregnancy.

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Mefloquine

Mefloquine is an antiprotozoal, antimalarial drug. It is taken once in a dosage of 15-25 mg / kg of the base, if urgent treatment is necessary in case of suspected malaria and the inability to receive qualified medical care. For prophylaxis, 5 mg / kg is prescribed weekly 2-3 weeks before arrival in the area of malaria. The prophylactic course is completed 4 weeks after leaving the danger zone. The tablets must be washed down with a large amount of water. Women of reproductive age should be especially careful when prescribing these antimalarial tablets. If a woman does take the drug, then it is necessary to refrain from pregnancy for this period and until 2 months have passed since the last intake of mefloquine.
The drug is contraindicated in epilepsy and other types of seizures, in acute psychosis. The drug is prescribed with special caution to people with liver dysfunction.

Primaquine

To prevent relapses of the disease after the course of hematocides is completed, a course of tissue schizontocide is recommended - primaquine (proguanil, primetamine). These antimalarial tablets destroy exoerythrocytic pathogens in the liver. Primaquine also neutralizes sexual forms of parasites in red blood cells and destroys "sleeping" parasites in the liver.

Primaquine is taken for 14 days at 0.25 mg per kilogram of weight per day. Strains resistant to the drug are found on the Pacific coast and in Asian countries. Then it is necessary to take primaquine at 0.25 mg / kg per day for 21 days.

Primaquine is well tolerated, but in some cases abdominal pain, indigestion, heart pain, weakness occur. All these ailments disappear after the end of the course of treatment with primaquine. If the patient has reason to suspect anemia or anomaly of red blood cells, the drug should be prescribed with caution. Primaquine is contraindicated if other acute infections are detected or during an exacerbation of rheumatism. The drug should be taken together with drugs that suppress hematopoiesis.

Quinocide

Helps to avoid remote relapses, neutralizing sexual forms of all types of malarial plasmodia. When taking the drug, nausea, headache, drug fever sometimes appear, lips and nails acquire a bluish tint, kidney and bladder function may be impaired. All these side effects disappear after the end of the course of treatment with quinocide. The drug is not prescribed simultaneously with other drugs for malaria, as its toxicity increases.

Bigumal

The effect of Bigumal is similar to Chloridin, but lasts less. The effect of treatment does not occur as quickly as when using chloroquine. Bigumal is used sparingly because the drug acts more slowly, is quickly eliminated from the body, and pathogens quickly develop resistance to it. Bigumal is taken in a course of 4-5 days. If the disease is severe, therapy can last up to 7 days. The drug is usually well tolerated.

Fansidar

Fansidar is used for forms of malaria resistant to chloroquines and is prescribed in combination with quinine. Therapy begins on the third day of the quinine course. For prophylaxis, weekly intake is prescribed.

Overdose of antimalarial drugs causes nausea, vomiting, dizziness, signs of nervous and cardiovascular system activity. In these cases, it is necessary to wash out the stomach. After an overdose, long-term monitoring of hemodynamic parameters, ECG, and the state of the nervous system is necessary.

Along with the prescription of antimalarial drugs, patients with severe forms of malaria are prescribed drugs that reduce intoxication and drugs that improve blood circulation, as well as vitamins and agents to normalize blood clotting.

All of the listed drugs not only have a strong effect on malaria plasmodia, but also affect the human body. Carefully read the instructions before taking malaria tablets, as they can interact with other drugs, in some cases critically weakening or enhancing their effect. It is necessary to adhere to the regimen and treatment or prevention scheme, do not use drugs with an expired shelf life or violated storage conditions. Even if you have long left the region where malaria is common, if you have signs of fever, urgently seek medical help - malaria can manifest itself even after several months.

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