malaria

How is malaria transmitted?

By the Anopheles mosquito

Which malaria species is the most deadly?

P. falciparum

Which malaria species is the most common?

P. vivax

When does quick start prophylaxis need to be initiated?

1-2 days before travel

What medications can be used for quick start prophylaxis?

Doxycycline, Malarone, Primaquine

Doryx

Doxycycline

Vibramycin

Doxycycline

Malarone

Atovaquone/Proguanil

Doxycycline dosing in malaria

100 mg PO QD

Malarone dosing in malaria

250 mg/100 mg PO QD

Primaquine dosing in malaria

30 mg PO QD

When should you discontinue doxycycline for quick start prophylaxis?

4 weeks after travel

What are some important counseling tips for doxycycline?

Can cause photosensitivity. Wear at least SPF 30.

When is doxycycline preferred for quick start prophylaxis?

If the patient will be hiking or camping

When should you stop Malarone for quick start prophylaxis?

1 week after travel

Can Malarone be used while breastfeeding?

No

Can Malarone be used if the patient has severe renal impairment?

No

When should you stop Primaquine for quick start prophylaxis?

1 week after travel

Which medication for quick start prophylaxis is most effective against P. vivax?

Primaquine

A patient cannot use Primaquine if they have which deficiency?

G6PD

Can Primaquine be used while breastfeeding?

No, unless the infant is tested for G6PD deficiency

Can any of the medications for quick start prophylaxis be used in pregnancy?

No

Medications used for quick start prophylaxis can cause nausea. What should you recommend to patients who need to take them?

Take with food, milk or water

When should advanced start prophylaxis be initiated?

1-2 weeks before travel

What medications can be used for advanced start prophylaxis?

Chloroquine, Mefloquine

Aralen

Chloroquine

Lariam

Mefloquine

When should you stop taking Aralen for advanced start prophylaxis?

4 weeks after travel

Chloroquine dosing

500 mg PO weekly

What is a major side effect commonly seen with long-term use of Aralen?

Retinal toxicity/visual changes

Aralen has resistance issues with which malaria species?

P. falciparum and P. vivax

Are those who are chronically taking hydroxychloroquine covered for advanced start prophylaxis?

Yes

When should you start taking Lariam for advanced start prophylaxis?

at least 2 weeks before travel

When should you stop taking Lariam for advanced start prophylaxis?

4 weeks after travel

Lariam should not be used if you have...

Psychiatric conditions, seizures, arrhythmias

Mefloquine dosing

250 mg PO weekly

Are the medications used for advanced start prophylaxis safe in pregnancy?

Yes

Are the medications used for advanced start prophylaxis safe to use in children?

Yes

Arakoda

Tafenoquine

Arakoda dosing

Loading dose 3 days before travel

Arakoda cannot be used if a patient has…

G6PD deficiency, pregnancy, breastfeeding, or any underlying psychiatric conditions