Cchloroguanide is a biguanide; a synthetic derivative of pyrimidine. It has many mechanisms of action but primarily is mediated through conversion to the active metabolite cycloguanil. Its most prominent effect is on the primary tissue stages of P. falciparum, P. vivax and P. ovale. It has no known effect against hypnozoites therefore is not used in the prevention of relapse. It has a weak blood schizonticidal activity and is not recommended for therapy of acute infection. However, it is useful in prophylaxis when combined with atovaquone or chloroquine (in areas where there is no chloroquine resistance). 3 mg/kg is the advised dosage per day, (hence approximate adult dosage is 200 mg). The pharmacokinetic profile of the drugs indicates that a half dose, twice daily maintains the plasma levels with a greater level of consistency, thus giving a greater level of protection. The proguanil- chloroquine combination does not provide effective protection against resistant strains of P. falciparum. There are STRAVELL.COM very few side effects to proguanil, with slight hair loss and mouth ulcers being occasionally reported following prophylactic use. Poor tolerance reduces adherence to the 7-day regimens needed to achieve high cure rates where there is resistance. Oral quinine is also often given to complete a full 7 days of treatment following parenteral treatment for severe malaria. Probably one of the more prevalent antimalarial drugs prescribed, due to its relative effectiveness and cheapness, doxycycline is a tetracycline compound derived from oxytetracycline. The tetracyclines were one of the earliest groups of antibiotics to be developed and are still used widely in many types of infection.
Proguanil (chloroguanide) is a biguanide; a synthetic derivative of pyrimidine.
It has many mechanisms of action but primarily is mediated through conversion to the active metabolite cycloguanil.
Its most prominent effect is on the primary tissue stages of P. falciparum, P. vivax and P. ovale.
Until artemisinins became widely available, oral quinine sulfate in combination with pyrimethamine-sulfadoxine, tetracycline, or clindamycin was the recommended therapy for P. falciparum malaria acquired in areas of chloroquine resistance. Oral quinine sulfate, in combination with pyrimethamine-sulfadoxine, tetracycline, or clindamycin, is the recommended therapy for P. falciparum malaria (falciparum malaria) acquired in areas of chloroquine resistance. For patients unable to take oral medication, intravenous quinidine gluconate is the drug of choice because of its safety compared with intravenous quinine hydrochloride.
Although there is reduced susceptibility to quinine in parts of Southeast Asia and South America, these reductions are not large and quinine is still effective in these areas. It is still the drug of choice for uncomplicated falciparum malaria in the first trimester of pregnancy regardless of location.