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A Pharmacological Appraisal of Antimalarial Plant Species
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Mahwahwatse J. Bapela, Precious B. Ramontja, Mcebisi J. Mabuza
Antimalarial drugs are used to prevent the infection caused by Plasmodium species, treat the disease, eliminate latent parasites and prevent the transmission of malaria. The major purpose of antimalarial treatment in severe malaria is to prevent death, whereas in uncomplicated malaria it is to cure and to avoid the development of severe disease (Conroy et al., 2019). While insecticides are aptly credited for much of the success in reducing the burden of malaria, treatment and prevention with drugs have always been the essential components of all successful malaria elimination programs. Similarly, while many diseases have been eradicated primarily through the use of vaccines, it is very unlikely that malaria could be eradicated with a vaccine alone without the integration of antivector methods and drugs (Molyneux, 2020; The malERA Group, 2017).
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The two major antimalarial drugs are chloroquine and quinine. Chloroquine is the primary drug used for the treatment of malaria, as well as for chemoprophylaxis in pregnant women who must travel to endemic areas (Diro and Beydoun, 1982). Although there have been no studies of infants whose mothers were treated for malaria during pregnancy with chloroquine, one study reported no increased frequency of congenital anomalies among 169 infants whose mothers received weekly low doses of the drug for malaria prophylaxis during pregnancy (Wolfe and Cordero, 1985). Quinine is used primarily for chloroquine-resistant falciparum malaria. Although there are no large studies regarding its use during pregnancy, increased malformations have been reported when large doses were used to attempt abortion (Nishimura and Tanimura, 1976). Quinine sulfate tablets have also been utilized for leg cramps, but their efficacy is unproven. Although not recommended for the treatment of leg cramps during pregnancy, the antimalarial quinines should not be withheld in the seriously ill pregnant woman with chloroquine-resistant malaria.
Heterocyclic Drug Design and Development
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Garima Verma, Mohammad Shaquiquzzaman, Mohammad Mumtaz Alam
Malaria is a mosquito-borne disease affecting humans caused by Plasmodium. Symptoms of this disease include vomiting, fever, tiredness, and headaches. Antimalarial drugs are used for curing malaria. Those procured from the natural origin are documented in Table 9.27.
Review of the mechanism underlying mefloquine-induced neurotoxicity
Published in Critical Reviews in Toxicology, 2021
Airton C. Martins, Monica M. B. Paoliello, Anca O. Docea, Abel Santamaria, Alexey A. Tinkov, Anatoly V. Skalny, Michael Aschner
Mefloquine was developed by the United States military in the 1970s to treat malaria in soldiers shortly after the Vietnam War, and subsequently marketed worldwide. Mefloquine was the drug of choice for both therapy (1250 mg/as a single dose) and chemoprophylaxis (250 mg/week) for U.S. military service members until about 2013, when the military stopped using this drug given the growing concerns related to the neuropsychiatric side-effects of mefloquine. Considering the more than 2.7 million US military and veterans who served in Southeast Asia and other countries with malaria endemic diseases, attention has been given to the significance and impact of possible side effects of antimalarial drugs for this group (Schneiderman et al. 2018). Mefloquine remains the choice for malaria treatment in children of different ages and those weighing >5 kg. Mefloquine pharmacokinetic models in children demonstrated large variability in exposure and suggest that children’s body-weight should be considered in dosing recommendations to assure similar efficacy in children and adults (Bourahla et al. 1996; Guidi et al. 2019). Moreover, in pregnant women the treatment of malaria may be adjust based on the gestational age and severity of disease (Moore and Davis 2020). In addition, pharmacokinetic studies showed that pregnant women have lower peak plasma concentration of mefloquine and that the elimination half-life is longer than in non-pregnant controls (Nosten et al. 1990; Na Bangchang et al. 1994).
The preclinical discovery and development of rectal artesunate for the treatment of malaria in young children: a review of the evidence
Published in Expert Opinion on Drug Discovery, 2021
Laís Pessanha de Carvalho, Andrea Kreidenweiss, Jana Held
Artemisinin derivatives as artesunate are used efficiently as combination therapy to treat uncomplicated falciparum malaria in Africa and are a fundamental pillar for managing and controlling the disease. The fast onset of action and rapid parasite reduction of this drug class is exceptional amongst current antimalarial treatment options. Owing to its unique chemical properties, intramuscular and intravenous artesunate injections were developed to treat life-threatening severe malaria, but the requirement of appropriate facilities and knowledge impairs its implementation in remote settings. This is of particular concern to children under 5 years who suffer the most from malaria complications that results in hundreds of thousands of deaths annually. To overcome this problem, a rectal formulation of artesunate was developed as a pre-referral treatment to be administered already at home as soon as severe malaria is suspected. This emergency treatment rapidly decreases parasitemia and provides time to the patient to be transported to health-care facilities for adequate parenteral treatment.
Malaria vaccines in the eradication era: current status and future perspectives
Published in Expert Review of Vaccines, 2019
K. L. Wilson, K. L. Flanagan, M. D. Prakash, M. Plebanski
The agenda has been set to not just control, but to eradicate malaria from the world; a lofty goal fraught with challenges. Despite this aim, malaria continues to present a significant global heath burden, with an estimated 216 million cases occurring worldwide in 2016, resulting in 445,000 deaths [1]. Treatment for malaria relies on antimalarial drugs, but drug resistance develops to each newly introduced antimalarial agent [1]. Malaria control measures include the wide deployment of impregnated bed nets and insecticide spraying, which contribute to an overall reduced incidence of malaria. These measures are not sufficient alone, due in part to their incomplete use in malaria-endemic regions, as well as the development of resistance to insecticides. Therefore, a long-lasting malaria vaccine is urgently needed. However, despite decades of intensive research only one candidate vaccine has been licensed for use in humans, the recombinant pre-erythrocytic vaccine RTS, S/AS01 [2]. In the present review we will offer a general updated overview of the malaria vaccine field and discuss in some detail the issues associated with trying to provide effective, eradication capable, potentially multistage vaccines from an immunological viewpoint. The review focuses on human vaccine trials, with a major emphasis on cell mediated immune mechanisms that might be harnessed to achieve effective long-lasting immunity. The role of vaccine-induced antibodies has been comprehensively reviewed in two recent publications [3,4] and will not be discussed.