Antimalarial drugs. Antimalarials: classification

Malaria is an infectious disease that can be contracted by the bite of an infected female Anopheles mosquito. After a bite, symptoms of malaria usually develop within 10-15 days. The disease is accompanied by severe paroxysmal fever, chills, anemia, and enlarged liver and spleen. Sometimes the symptoms can be mild and mimic ARVI. However, if treatment is not started within the first 24 hours after infection, death is possible.

Malaria is caused by protozoa of the genus Plasmodium. Five species of Plasmodium are dangerous to humans: P. vivax, P. ovale, P. malariae, P. falciparum and P. knowlesi. Each type of plasmodium is characteristic of a specific area.

Every year, about half of the world's inhabitants are at risk of contracting malaria. The majority of the population is living in dangerous areas. However, travelers visiting malaria-prone countries can also become infected. Malaria is a very serious disease, but it is highly preventable and treatable.

Plasmodium requires a very hot and humid climate to reproduce. Before visiting tropical and subtropical regions, you should familiarize yourself with the Map of Malaria Risk Zones and the Effectiveness of Antimalarial Drugs. If you decide to visit a dangerous region, you must have a malaria test and a supply of an effective drug with you. Plasmodium in some regions is absolutely not sensitive to certain medicinal substances, so it is important to competently approach the choice of preventive and medicinal drugs.

How to prevent and treat malaria?

Personal prevention of malaria comes down to four methods.

Early use of chemotherapy drugs.
Protecting your home from mosquitoes.
Wearing clothing that covers as much skin as possible.
Using mosquito repellents.

Antimalarial drugs begin to be taken 1-2 weeks before departure to a dangerous region, continue throughout the entire period of stay in the malaria focus and 3-4 weeks after return. Today, there are many drugs for malaria based on quinine, chloroquine, mefloquine, fansidar, metakelfin, proguanil and artemisin. Some of these drugs are used only for treatment, others can also be used for prevention.

Quinine is a chemical compound obtained from the bark of the cinchona tree. Historically, it was the first substance that was used to fight malaria.

Chloroquine is a synthetic analogue of quinine. In some regions, malarial plasmodia are resistant to drugs based on chloroquine (for example, Delagil, Rezoquin, Khingamine, Arequin). Today, pharmacologists have already obtained drugs that have a more pronounced therapeutic effect than quinine and chloroquine.

Prevention with Fansidar is carried out according to the standard scheme. And for treatment, Fansidar is usually taken together with quinine for greatest effectiveness. This effectively prevents relapses that occur with quinine monotherapy.

Mefloquine (Lariam) is a fairly convenient and effective remedy. For prevention, it is taken once a week according to the standard regimen. Treatment with Lariam is carried out within 1 day after detection of infection, since the drug maintains a therapeutic concentration in the blood for a long time and continues its powerful work for several more days. A pleasant bonus of this drug is its property of not damaging liver cells.

Prevention with metakelfin lasts quite a long time - it must be continued for six months after returning from a region dangerous for malaria. Treatment is carried out with a single dose of the drug.

Proguanil (Malarone) for prevention must be taken more often than other drugs - 2 times a week. Treatment is carried out for 4-7 days. However, strains resistant to proguanil have not yet been identified.

Today, the most popular anti-malaria drug is Riamet (Coartem), which contains an artemisin derivative. This is a fairly new drug that is used only to treat malaria. Riamet (Coartem) is taken orally for 3 days from the moment of infection. Thanks to its excellent therapeutic effect, this drug has earned universal recognition.

Malaria belongs to, its carriers are blood-sucking insects belonging to a certain species. It is precisely because of the high mortality rate that the disease poses a serious danger to humans, and when the first symptoms appear, a medicine for malaria and timely treatment are required.

Medicines for malaria can be divided into several groups:

Unfortunately, scientists have not yet developed drugs that can destroy sporozoites that have entered the blood.

Before starting treatment for malaria, you should consult with an infectious disease specialist. Drug therapy can be classified as a protective agent that protects, treats, and prevents the spread of the disease.

Description of drugs

You can use both ointments and tablets. Let's take a closer look at the most common drugs that help fight the disease.

Mefloquine

If it is not possible to go to a medical facility, doctors advise using the drug as emergency aid in case of malaria infection. One of the contraindications is an allergic reaction to the constituent components, mental illness, pregnancy or the age of the patient. Do not give to children under two years of age.

The essence of the treatment is that the product is used once in strict accordance with the instructions. If the patient begins to vomit 30 minutes after taking the medicine, it must be taken again, observing the dosage.

Quinocid

The action of this drug is to destroy the infectious agent. In addition to the main purpose of use, it can be used to prevent relapse and as a prophylactic agent. Allowed for children whose infection occurred at birth. In this case, the dosage is determined by the attending physician.

There are side effects:

nausea;
vomit;
headache;
lips turn blue;
sudden changes in temperature in the patient.

The drug cannot be used if a course of treatment with other drugs aimed at combating malaria has been started. This medicine is not used for people with kidney disease or heart and blood vessel problems.

Bigumal

The drug is often used for prevention. After using Bigumal, you must drink at least 50 ml of liquid, it is best to use water.

In powder form, the product can be given to babies under one year of age. For severe malaria, Bigumal solution is administered intravenously. The great advantage of the medication is that the body does not give any adverse reactions to it.

Primaquin

This anti-malaria drug has the ability to stop the reproduction of infection carriers. Can be used for any type of disease. A positive effect was noted as a prophylactic agent, as well as as a drug that can prevent relapse.

There are several side effects:

headache;
pain in the abdomen;
cardiac dysfunction;
blue lips;
Iron-deficiency anemia.

Cannot be used for diseases of the circulatory system and kidney ailments.

Doxycycline

Belongs to the tetracycline group and is a group of antibiotics with a wide spectrum of effects. It is used when an infection occurs that is caused by microorganisms sensitive to the product. The medicine is used after meals and should be taken with plenty of water.

The ointment of the same name has a good effect. It acts as a therapeutic and prophylactic agent. Apply to skin areas with insect bites. Cannot be used by children under nine years of age and women during breastfeeding. The product can be used up to 4 months of pregnancy, but first it is recommended to consult a specialist.

Fansidar

The medicine is taken with food and washed down with liquid, it is best to use water. It can be given to children whose weight is more than 5 kg, but you should consult a specialist about the dosage.

The product is used as a prophylactic. As soon as the course of treatment is completed, tests are required for research.

Acyclovir

The drug is aimed at combating viruses.

Available in the following forms:

pills;
ointment;
powder for solutions.

The ointment has no side effects after use, unlike tablets. The patient may experience nausea, vomiting, and weakness. After using the powder solution, liver enzymes are often activated, which leads to changes in blood tests.

Cannot be used during pregnancy or breastfeeding.

Chloridine

Very often this drug is used to combat malaria. When toxoplasmosis occurs, it has the greatest effect. A good result is achieved by combining chloridine with sulfanilamide and chingamine. The medicine is used once a day.

The dosage and time of taking the drug are prescribed by the doctor, who makes a conclusion about the general well-being of the patient and how severe the disease is.

Chloridine is used to treat children; the doctor calculates the amount of the drug based on the child’s weight.

Chloroquine

The drug is dosed depending on the severity of the case. Duration of administration is three days for acute form.

It is used as a prophylactic for a week, but a long course can provoke the appearance of dermatitis. If the latter is detected, the dosage should be reduced or discontinued.

The attending physician regularly monitors liver function and takes blood and urine tests. The medicine should not be used for heart disease.

How to treat children

Most often they use Rezoquine, Chloroquine, Delagil. Along with the general therapeutic course, children are prescribed medications that enhance the functioning of the immune system and relieve symptoms of the disease.

About preventive measures

Prevention of malaria requires measures aimed at preventing the disease in disadvantaged areas.

This includes:

use of medications for prevention;
ointments that help kill blood-sucking insects;
products that can prevent mosquito attacks.

Today, scientists are developing a vaccine against this disease, and many studies are being conducted on this matter. So far, anti-malaria drugs are used as the most effective means of prevention.

At the same time, you need to try to create maximum protection from blood-sucking insects:

use the developed tools;
use electric fumigators indoors.

In areas unfavorable for the disease, you cannot wear open clothing; a person must be protected as much as possible. The body is treated with repellents before going outside.

If there is a large concentration of insects before going to bed, you need to lower the canopy, which is pre-treated with an insecticidal agent.

The following are used as comprehensive preventive measures:

therapeutic treatment of patients;
active methods of combating the spread of the disease;
protection from bloodsuckers;
prevention using chemicals.

After recovery, a person must register with a dispensary. People should be checked if their body temperature suddenly rises.

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Bigumal occupies a special position in terms of the nature of its antimalarial action. This drug is effective against the causative agent of tropical malaria. It affects both erythrocyte and sexual forms of Plasmodium falciparum.

To prevent relapses of malaria, quinocide is mainly used, which is especially effective against paraerythrocytic forms of plasmodium. Quinocid is prescribed following a course of treatment with hematoschizotropic drugs. This ensures a radical cure for the patient.

For public prevention of malaria, drugs that affect the sexual forms of plasmodium are used - plasmocide and bigumal. These antimalarial drugs prevent mosquitoes from infecting mosquitoes with malaria and thus prevent the further spread of the disease. The main means of public chemoprophylaxis is plasmocide. It is prescribed together with hematoschizotropic antimalarials to achieve both clinical and preventive effects.

When using antimalarial drugs, the development of drug resistance of malarial plasmodium is observed. It develops especially easily with bigumal and chloridine.

Antimalarials are used not only to treat malaria, but also for some other diseases caused by worms. Thus, akriquin is used to treat amebiasis, giardiasis, leishmaniasis,; Chloridine is used for...

Antimalarials are drugs used for chemotherapy and chemoprophylaxis of malaria. The activity of antimalarial drugs manifests itself differently in relation to different stages of development of malarial plasmodium in the human body. Sometimes the effect is most pronounced in relation to one or more stages. Depending on the nature of the effect, antimalarial drugs are divided into a number of groups. Schizontocides are drugs that are active against asexual forms of development of malarial plasmodium (schizonts); blood schizontocides - drugs that suppress the development of schizonts in erythrocytes; Primary tissue schizontocides are active against primary, and secondary tissue schizontocides are active against secondary exoerythrocytic forms. In accordance with this, blood schizontocides are used to prevent and relieve attacks of malaria. By reducing the number of plasmodia in the blood, blood schizontocides also cause a decrease in sexual forms. In tropical malaria they radically cure the disease. Primary tissue schizontocides are used for causal prevention. They prevent the development of erythrocyte schizogony. Only in isolated cases can late attacks of malaria occur. Secondary tissue schizontocides are indicated for the radical cure of malaria in patients who have had three- and four-day malaria.

Drugs that act on gamonts - gamontocides - cause the disappearance of sexual forms of malarial plasmodium from the blood or disrupt the cycle of its sexual development in the mosquito. The latter can interrupt the sexual development cycle of Plasmodium in the mosquito body at the exflagellation stage. Drugs that interrupt the development cycle at the ookinete stage are called sporontocides.

Antimalarial activity has been found in many classes of chemical compounds. The most widely used derivatives of 4-aminoquinoline are hingamine (see), haloquin, etc. These blood schizontocides have the highest effectiveness among other antimalarials. The derivatives of 9-aminoacridine - quinine (see) and quinine (see) have a similar effect. 8-aminoquinoline derivatives - plasmocide (see), quinocide (see) - have a wide spectrum of action. They are active against both sexual and tissue forms of malarial plasmodium. As blood schizontocides they are relatively inactive. Quinocide is more active than plasmocide against secondary tissue forms.

Phenylbiguanide derivatives - bigumal (see) and others - have the effect of blood and primary tissue schizontocides, as well as sporontocidal activity. Derivatives of 2,4-diamino-5-phenyl-pyrimidine - chloridine (see) and others - are active against blood schizonts (the effect on tissue schizonts is less pronounced) and have a sporontocidal effect.

To relieve attacks of malaria, blood schizontocides are used: hingamine, haloquine, quinine, quinine. To radically cure malaria after treatment with blood schizonticides, quinocide is used.

Prevention of malaria is carried out depending on the indications with various antimalarial drugs. Spring anti-relapse treatment - blood schizontocides. For the purpose of public chemoprophylaxis, i.e., to interrupt the epidemiological chain of humans and mosquitoes, gamontocides are prescribed in combination with blood schizontocides. For individual prevention, blood and primary tissue schizontocides are prescribed. Pre-epidemic chemoprophylaxis is carried out using quinocide.

When using antimalarial drugs, the development of drug resistance of malarial plasmodium is observed. It develops especially easily with bigumal and chloridine. Cases of resistance to quinine, quinine and quinamine have been described.

Traveling to tropical countries is often dangerous due to many complex infections, including malaria. To reduce the risk of infection and prevent possible consequences, before traveling to India or Africa you should purchase antimalarial drugs and learn about preventive measures to prevent the disease.

The information prepared by our specialists will help you with this.

How to eliminate the disease?

Statistics on the incidence of malaria look depressing - up to 500 million people annually become victims of the bite of the malaria mosquito of the genus Anopheles. The lack of prevention and medications for malaria leads to the fact that people with weakened immune systems - children, pregnant women, and patients with other diseases - are exposed to infection.

But this does not mean that healthy and strong men are not at risk of infection - a mosquito bite is equally dangerous for all categories of the population who have not taken preventive measures to prevent the attack of infectious insects.

You can quickly cure malarial fever if you diagnose the disease at the very beginning of its development and undergo a course of treatment, taking adequate antimalarial drugs.

Doctors will tell you what to treat.

The causative agent of the pathology, malarial plasmodium, differs according to the type of strain; accordingly, their effect on the human body and the course of the disease are different.

Therefore, the choice of medication depends on the type of disease, its symptoms, degree of development and the presence of complications.

Doctors insist that malaria treatment should not be started until the diagnosis is clarified. Only after laboratory test results confirm the presence of infection and the doctor determines the type of pathology can specific antimalarial therapy be prescribed.

The main method of getting rid of malaria is drug treatment aimed at eliminating the pathogen, preventing the development of complications and the spread of infection.

It is important to diagnose the disease on time.

Classification of medications

When prescribing drugs against malaria, doctors are obliged to ensure that they influence different phases of the development of infectious agents - single-celled microorganisms Plasmodium. The existing classification of antimalarial drugs allows us to accurately determine the medicine for malaria that is adequate to the degree of pathological processes. Group funds:

Schizontocides are destroyed by tissue schizonts that infect the liver.
Hematoschizotropes contribute to the death of plasmodia that have penetrated into erythrocytes.
Gametocides help neutralize hematocytes. Indicated for acute forms of the disease.
Hypnozoiticides help prevent re-infection.
Sporontocides interrupt the development of plasmodium in the stomach of the malaria mosquito.

To eliminate the symptoms of the disease, medications are prescribed for clinical attacks of malaria. For the purpose of suppressive prophylaxis, to prevent the occurrence or recurrence of fever characteristic of the disease, hematoschizotropic drugs are used.

To suppress strains of Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, drugs of the 4-aminoquinoline group are used.

To prevent the processes of reproduction of plasmodia in the liver, causal prophylactic agents are prescribed - histoschizotropic drugs that suppress the vital activity of pre-erythrocyte forms of plasmodia and inhibit the activity of erythrocyte schizonts.

Features of etiotropic therapy

To suppress Plasmodium, etiotropic therapy is used. The main drugs of treatment are tablets against the causative agent of malaria and intravenous drip injections.

Chloroquine (Delagil, Hingamine) is one of the most popular drugs in the quinolylmethanol group. It has hematoschizotropic and gametocidal effects. It is used as a means to suppress the immune system of the infectious agent, as well as to prevent malaria infection in persons planning to travel to the tropics. Especially if the trip will take place in remote regions of endemic countries where there is no access to necessary medicines.

Chloroquine is used in the treatment of malaria.

Release form: tablets, injection solution. The dosage of the drug depends on the task at hand - to eliminate the symptoms of the disease, the drug is taken for three days, while the course of prevention of malaria infection is seven days.

Side effects of Chloroquine include dizziness and nausea, possible headaches and hearing impairment. The drug is contraindicated in patients with heart pathologies.

Quinine (Quinine sulfate, Hexaquin, Quinine hydrochloride) is a hematoschizotropic antimalarial drug that prevents the penetration of plasmodium cells into erythrocytes. As a hematocidal agent, it affects the sexual forms of the pathogen.

The medicine is effective against all types of Plasmodium, including forms resistant to Chloroquine. Not recommended for use by pregnant and lactating women. The main contraindications are middle ear diseases, malarial hemoglobunaria.

Mefloquine (Lariam) - tablets from the group of quinolylmethanols. They have a hematoschizotropic effect in tropical fever and forms of the disease resistant to Quinine and Chloroquine. It is also used to prevent malaria as a prophylactic measure.

To treat an infection, the drug is taken in two doses with an interval of 12 hours. For prevention, the drug should be taken 4 weeks before the trip and continued for a month after the trip.

Artemether + Lumefantrine is a combined semi-synthetic antimalarial drug of a new generation. Effective against all types of plasmodia.

Traditional methods of eliminating pathology

Some infected people prefer home treatment when they do not know how to quickly get rid of an attack. This approach is only partially justified - if urgent help is needed and there is no way to see a doctor.

Traditional methods of treatment include the preparation of medicinal decoctions:

There are folk remedies for the treatment of malaria.

Steam the hop cones with boiling water and leave for 1.5 hours. Take two tablespoons of the infusion during an attack or twice a day between attacks.
Fresh lilac leaves, wormwood and eucalyptus oil are infused in vodka and taken a tablespoon before meals.
Pour half a teaspoon of mustard into a glass of wine, add a pinch of salt. The product is thoroughly mixed and taken three times a day.
Take a quarter teaspoon of crushed orange peel three times a day.
Pour a teaspoon of willow bark into 400 ml of boiling water and simmer over low heat for 15 minutes. Take every morning on an empty stomach.

It is almost impossible to completely cure malaria at home.

Alternative medicine methods help alleviate the patient’s condition during attacks of fever and help prevent the development of complications.

However, even with a visible improvement in the well-being of an infected person, folk remedies cannot guarantee that after some time a relapse will not occur and attacks will not recur.

How to prevent the disease?

At high risk are tourists, seasonal workers, and refugees from endemic regions. Therefore, every person temporarily residing in a tropical country needs to undergo a medical examination, even if he does not have symptoms of malaria.

The disease develops gradually and may appear within a month. If pathogen cells are detected in the blood in time, they can be eliminated before pathological processes begin, and thus avoid the severe consequences of malaria.