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 of pregnancy quinine should be used as first line treatment.
· After the first trimester ALu tablets is first line medicine.
Use of Artemether-lumefantrine (ALu) in Lactation
· Due to the long elimination half-life of Lumefantrine (up to 10 days), it is not recommended in mothers breast-feeding children below 5kgs.
· In this case quinine should be used.
Management of Severe Malaria:
· Parenteral artesunate Dosage: 2.4 mg/kg in body weight. IV or IM given on admission (time = 0 hour), then at 12 hours and 24 hours for a minimum of 3 injections in 24 hours regardless of patient’s recovery
· Alternatively; Injectable Artemether should be administered in a dose of 3.2mg/kg body weight loading dose IM stat then 1.6mg/kg bwt (time= 0 hrs, then 24hrs then 48 hrs)
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 ed): New York, NY: McGraw-Hill.
Katz M D., Matthias KR., Chisholm-Burns M A., Pharmacotherapy(2011) Principles & Practice Study Guide: A Case-Based Care Plan Approach: New York, NY: McGraw-Hill.
Schwinghammer TL, Koehler JM (2009) Pharmacotherapy Casebook: A Patient-Focused Approach (7th ed): New York, NY: McGraw-Hill.
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