Tags: Chloroquine Phosphate

Non-falciparum Malaria (P Vivax, P Ovale, P Malariae)

Patients with nonfalciparum malaria invariably develop fever and chills that may become cyclic. Initially, patients experience chills, which are followed by fever (Box 1). Patients with malaria often manifest many nonspecific symptoms such as weakness, malaise, headache, and myalgias. As the disease progresses, signs of anemia, such as pale conjunctiva, may be seen.

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Chloroquine has a bitter taste, which can deter children from taking it, so a sweet effervescent formulation of chloroquine phosphate has been compared with chloroquine tablets in a pharmacodynamic study. However, sweet-tasting medications carry a risk of accidental overdose in children. If given intravenously, chloroquine should be diluted and infused slowly, since rapid injection causes toxic concentrations.

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Chloroquine and its congeners can cause two typical effects in the eye, a keratopathy and a specific retinopathy. Both of these effects are associated with the administration of the drug over longer periods of time. Chloroquine-induced keratopathy is limited to the corneal epithelium, where high concentrations of the drug are readily demonstrable. Slit lamp examination shows a series of punctate opacities scattered diffusely over the cornea; these are sometimes seen as lines just below the center of the cornea, while thicker yellow lines may be seen in the stroma.

Parasitic Infections

Most infectious agents fulfill the definition of a parasite: an organism that grows, feeds, and shelters on or in a different organism and contributes nothing to the host. However, medical science has created the classification “parasite” to include a complex group of nonfungal eukaryotic human pathogens. Unlike fungi, parasites have no cell wall and are often motile.

Erythrocytic asexual phase

This begins with penetration into red blood cells by merozoites arising from the exoerythrocytic schizonts in the liver cells. The parasites grow rapidly, and a large central vacuole forms in the cytoplasm leading to the so-called ring form.