Asyah Shareef

20191389
 DRUG RESISTANCE
▪ The ability of the parasite to survive & multiply despite administration of the drug.
▪ The drug resistance most commonly with P. Falciparum.
▪ Resistance to chloroquine is most prevalent.
▪ The emergence resistance depend on several factors:
1. The mutation rate of the parasite.
2. The overall parasite load.
3. The strength of drug selection.
4. The treatment compliance.
5. Host immunity.
 PREVENTION OF RESISTANCE
▪ Resistance develop most rapidly when a population of the parasite encounters
subtherapeutic concentration of anti-malaria drug.
▪ How to reduce it;
➢ Selection of the drug.
➢ Ensure compliance.
➢ Avoid basic antimalaria for non-malarial indications e.g., chloroquine.
➢ Monitor resistance & early treatment of these cases to prevent their spread.
➢ Combinations.
SIDE EFFECTS OF ANTI-MALARIAL DRUGS
 Chloroquine Primaquine

• Low doses: GI irritation, skin • GI distress, pruritus, headaches,

rash, headaches and methemoglobinemia.
• High doses: severe skin lesions, • Hemolysis in G6PD-deficient
peripheral neuropathies, patients (tafenoquine single dose
myocardial depression, retinal preferred alternative).
damage, auditory impairment, • Contraindicated in pregnancy.
and toxic psychosis.
• Long-term use of high doses of
chloroquine for rheumatologic
diseases can result in irreversible
ototoxicity, retinopathy, myopathy,
and peripheral neuropathy