These drugs target various stages of the malaria parasite life cycle.
It raises the pH of parasite vacuoles inhibiting haem-polymerase
– This stops the parasite feeding in RBCs stopping the life cycle
– It is taken weekly and used in malaria prophylaxis and attacks
– It is also used an anti-inflammatory in autoimmune disorders
• Headache + Contraindicated in epilepsy
• Unfortunately, resistance to chloroquine is emerging in many species of P. Falciparum.
This acts similarly to chloroquine and is used for prophylaxis and treatment of chloroquine-resistance strains
• Dizziness + Psychiatric signs (suicidal thoughts)
This interferes with the erythrocytic stage of the parasite by inhibiting its ability metabolise haem
– Quinine is used in the management of P. Falciparum that has become resistant to chloroquine.
• Produces curare-like effects on skeletal muscle + tinnitus + visual disturbances
• Blackwater fever –> a haemolytic crisis that occasionally complicates malaria infection.
• Large numbers of red blood cells undergo haemolysis releasing haemoglobin into the bloodstream
• This can cause an AKI.
e.g. Dihydroartemisin + Artensuante
These are semi-synthetic drugs which are used in combination therapy to treat P. Falciparum
– They are broken down to dihydroartemisinin which generates free radicals to kill the parasite
• GI upset
This is Pyrimethamine (inhibits dihydrofolate reductase) + Sulfadoxine (inhibits dihydropteroate synthase)
– Acts to prevent folic acid synthesis prevent DNA synthesis –> used to treat P. Falciparum
• Megaloblastic anaemia
• Folate deficiency
This is a prodrug whose active metabolite inhibits dihydrofolate reductase to stop parasite DNA synthesis
– It is commonly used in combination with chloroquine or atovaquone (electron transport chain inhibitor)
Drugs against other parasites
This drug is used to treat many parasitic worm infections including threadworms, hookworms and giardia
– It inhibits the synthesis of microtubules which stops uptake of glucose and nutrients killing the helminth
• GI upset
This drug is most famous for treating schistosomiasis arguably by increasing cell permeability to Ca2+
• GI upset
• CNS disturbance (dizziness, headache)
Used against parasites like head lice, scabies. It opens Cl– channels causing cell hyperpolarization and death
• CNS depression