Mechanism of Action: Chloroquine and hydroxychloroquine increase pH within intracellular vacuoles

and alter processes such as protein degradation by acidic hydrolases in the lysosome, assembly of
macromolecules in the endosomes, and posttranslational modification of proteins in the Golgi
apparatus.

Indication: used in the treatment of arthritis to help relieve inflammation, swelling, stiffness, and joint
pain.  This medicine was originally used to prevent and to treat malaria.

Contraindication: low blood sugar. glucose-6- phosphate dehydrogenase (G6PD) deficiency. low amount
of magnesium in the blood. low amount of potassium in the blood. porphyria. anemia. low levels of a
type of white blood cell called neutrophils. alcoholism.

Adverse Effect: headache. dizziness. loss of appetite. nausea. diarrhea. stomach pain. vomiting. Rash

Nursing Responsibility:

-Monitor ECG for cardiomyopathy and QT prolongation periodically during therapy.

-Monitor for signs and symptoms of DRESS.

-Discontinue therapy if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters.
-Assess for suicidal tendencies, depression, or changes in behavior periodically during therapy

-Assess patient for improvement in signs and symptoms of condition daily throughout the course of
therapy.