The Musculoskeletal System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Systemic lupus erythematosus is diagnosed by presentation of a number of clinical symptoms, most commonly arthralgia (arth = joint, algia = pain) and arthritis. Laboratory tests show abnormal ANA titer, positive LE cell test. Several different drugs are utilized in the treatment of systemic lupus erythematosus. Aspirin and the NSAIDs are used to manage arthralgias or synovitis (inflammation of the synovium), pleurisy, headache, and low-grade fever. The antimalarial agent hydroxychloroquine is effective in treating arthralgias, arthritis, and skin disease. Corticosteroids are used to control the inflammatory response. Connective tissue disorders are treated by rest and exercise, physical and occupational therapy, heat, supportive or rehabilitative devices, education, nutrition, and orthopedic surgery.
Artemisinins
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Artemisinin, also known as Qinghaosu, is the active principle extract of Qinghao (Artemisia annua L.), a plant that has been used for centuries in traditional Chinese medicine. The antimalarial properties of artemisinin were first reported in the Western literature in 1979 (Jiang et al., 1982). Extensive clinical studies have demonstrated that these drugs have a highly potent antimalarial activity, which, combined with a broad stage specificity of action, results in a faster clinical and parasitologic response than any other antimalarial agent in clinical use (Hien and White, 1993). Artemisinin drugs are structurally distinct from all other classes of antimalarials (China Cooperative Research Group, 1982), consisting of a peroxide within a 1,2,4-trioxane configuration. The unique feature of these compounds is the presence of a sesquiterpene lactone ring with an endoperoxide bridge that is essential for their antimalarial activity (Cumming et al., 1997) (see Figure 169.1).
Giardia lamblia
Peter D. Walzer, Robert M. Genta in Parasitic Infections in the Compromised Host, 2020
The previous use of quinacrine as an antimalarial agent has provided considerable information on the drug's side effects and toxicity. Adverse side effects are infrequent but may include gastrointestinal symptoms such as nausea, vomiting, abdominal cramps, and diarrhea; dermatological changes including rashes and skin discoloration; and constitutional symptoms such as malaise, myalgia, headache, and fever. Toxic reactions to the drug are even less frequent and include exacerbation of preexisting psoriasis or its progression to exfoliative dermatitis and the development of acute toxic psychosis. For these reasons the drug is contraindicated in persons with psoriasis or a history of psychosis. Quinacrine also should not be given to persons receiving primaquine for malaria prophylaxis, because it may induce an increase in the serum primaquine concentration to a toxic level. The currently recommended dosage for adults is 100 mg three times per day for 5 days and for children 2 mg/kg in three divided doses per day for 5 days (217).
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.
How worthwhile is methylene blue as a treatment of malaria?
Published in Expert Review of Anti-infective Therapy, 2019
Olaf Müller, Guangyu Lu, Albrecht Jahn, Frank-Peter Mockenhaupt
In conclusion, the findings from the existing studies clearly demonstrate the efficacy and safety of MB in the treatment of malaria. While there is a need to conduct more clinical studies on the effects of MB in P. vivax malaria, there is already high evidence for strong effects of the drug against the parasites of P. falciparum, in particular against the gametocytes. MB can thus be considered as an alternative to PQ in the combination therapy of falciparum malaria, in particular where the goal of malaria programmes is elimination. Moreover, adding MB to existing ACT regimens is potentially useful to reduce P. falciparum transmission intensity, to increase treatment efficacy, and to reduce the risk for development and spread of malaria parasites resistant against artemisinins and ACT. However, there is a need to further modify the MB formulation to improve its taste and acceptability and to conduct a multi-country phase III study in different endemic areas and populations to confirm current findings on the efficacy and safety of MB-ACT combination schemes. This is in particular important as there are very different types of G6PD deficiency in malaria endemic areas, and MB has so far only been shown to be safe in the A- type of SSA. Finally, given the time needed and the high costs for the development of new antimalarial medication, the further development of MB-based combination therapy should be considered as highly cost-effective by the Global Health community.
Antimalarial drugs: what’s new in the patents?
Published in Expert Opinion on Therapeutic Patents, 2023
Elizabeth A. Lopes, Maria M. M. Santos, Mattia Mori
Overall, the development of new chemotherapies to overcome malaria drug resistance is a health emergency. According to the WHO guidelines, the new generation of antimalarials that are being developed should target more than one stage of the malaria parasite life cycle, be chemoprotective, act as hypnozoites anti-relapse agent, be effective in all drug-resistant parasites, be safe in humans, have an easy administration, and have low cost [18]. Given the large number of requisites, the ideal antimalarial agent is still far from development and clinical use. Nevertheless, more than 150 partners are working in collaboration with MMV to eradicate malaria worldwide, resulting in some compounds that are currently in clinical development [19].
Related Knowledge Centers
- Artesunate
- Malaria
- Quinine
- Retinopathy
- Antiparasitic
- Natural Product
- Route of Administration
- Artemisinin
- Drug of Last Resort
- Side Effect