Management of uncomplicated Malaria: Drug of choice for treatment of uncomplicated malaria is Artemether-Lumefantrine (AL), which is a fixed formulation of artemether 20mg and lumefantrine 120mg or dispersible tablets for paediatric use Use of Artemether-lumefantrine (ALu) in Pregnancy ·         Presently, Artemisinin compounds cannot be recommended for treatment of malaria in the first trimester of pregnancy. ·         In the first trimester ...

·         Parasite-based diagnosis is recommended for all patients presenting with signs and symptoms of malaria. ·         The recommended investigations are: malaria microscopy and malaria rapid diagnostic tests (mRDTs) ·        In severe malaria, blood slide (BS) is a recommended malaria test as it quantifies parasitemia. References Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill. ...

·         Extreme weakness ·         Impaired consciousness ·         Change of behaviour ( hallucinations, delusions, agitation, and acute state of confusion) ·         Respiratory distress ·         Bleeding tendency ·         Jaundice ·         Circulatory collapse/ shock ·         Vomiting everything ·         Inability to drink or breastfeed References Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill. DiPiro JT, Talbert RL, ...

·         Fever ·         Headache ·         Malaise  ·         Joint pains ·         Vomiting /diarrhoea ·         Body ache ·         Poor appetite ·         Body weakness ·         Pallor  ·         Enlarged spleen References Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML, (2008): Pharmacotherapy: A Pathophysiologic Approach (7th ...

·         The Plasmodiumspecies that infect humans are P. falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi (rarely). The basic elements of the life cycle are the same for all Plasmodium sp ·         Transmission begins when a female Anopheles mosquito feeds on a person with malaria and ingests blood containing gametocytes. ·         During the following 1 to 2 wk, ...

·         Uncomplicated malaria: defined as symptomatic malaria without signs of severity or evidence (clinical or laboratory) of vital organ dysfunction. It has the following features; fever, headache, joint pains, malaise, vomiting, diarrhoea, body ache, body weakness, poor appetite, pallor, enlarged spleen  ·         Severe malaria: In a patient with P. falciparum asexual parasitaemia and no other obvious cause of symptoms the ...

·         There may be some factors that may lead to incorrect interpretation of plasma drug levels such as; o   Non-compliance of patient leading to low plasma drug levels o   Low dose administered which leads to subtharapapeutic concentrations o   Patient suffer from mal-absorption o   Drug with low bioavailability may also lead to subtherapeutic concentrations o   Concomitant drugs that could affect the ...

The following are drugs that qualifies for TDM ·         Cardio active drugs o   amiodarone, o   digoxin, o   digitoxin o   disopyramide, o   lignocaine, o   procainamide, o   propranolol and o   quinidine ·         Aminoglycoside o   gentamycin, o   amikacin o   tobramycin ·         Antidepressants : o   lithium o   tricyclic antidepressants ·         Antiepileptic drugs o   Phenytoin, o   phenobarbitone o   benzodiazepines, o   carbamazepine, o   Valproic acid and ...

·         The drug in question has a narrow therapeutic range, eg: Lithium, phenytoin, and digoxin ·         A direct relationship exists between the drug or drug metabolite levels in plasma and the pharmacological or toxic effects, ·         The therapeutic effect can not be readily assessed by the clinical observation, ·         Large individual variability in steady state plasma concentration exits at any ...

·         Therapeutic drug monitoring (TDM) is defined as the use of drug concentration measurements in plasma as an aid to the management of drug therapy for the cure, alleviation or prevention of disease. ·         TDM enables the assessment of the efficacy and safety of a particular medication in a variety of clinical settings. ·         Therapeutic Drug Monitoring aims to individualize ...

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