Antimalarial - Pharmacology

Malaria is still one of the most prevalent protozoan diseases in the world. The mosquito infects the human and the parasite passes through two phases. The tissue phase causes no clinical symptoms in the human and the erythrocytic phase invades red blood cells and causes chills, fever, and sweating, In the United States the 1000 cases reported annually are almost all from international travel. Quinine was the only antimalarial drug from 1820 to the early 1940s when synthetic antimalarial drugs were developed. Chloroquine is commonly prescribed. If drug resistance develops quinine is used in combination with an antibiotic such as tetracycline.

Nursing process related to treating patients who have malaria.

  • Assessment
    • Assess patient’s hearing (drugs may affect 8th cranial nerve)
    • Assess for visual changes (should have frequent ophthalmic examinations)
  • Nursing diagnoses
    • Risk of infection
    • Risk for impaired tissue integrity
    • Risk for sensory disturbances (auditory and visual)
  • Planning
    • Patient will be free of malarial symptoms
  • Nursing interventions
    • Monitor urinary output (600 mL/d) and liver function (liver enzymes)
    • Report if serum liver enzymes are elevated
  • Client teaching
    • Advise patients traveling to malaria-infested countries to take prophylactic doses of antimalarial drugs before leaving, during the visit, and upon return.
    • Instruct patient to take oral antimalarial drugs with food or at mealtime if GI upset occurs.
    • Monitor patients returning from international travel for malarial symptoms.
    • Instruct the client to report vision or hearing changes immediately.
    • Advise the patient to avoid consuming large quantities of alcohol.
  • Evaluation
    • Evaluate effectiveness of drug by determining the patient is free of symptoms
  • Side effects and adverse reactions
    • General side effects include GI upset, 8th cranial nerve involvement (quinine and chloroquine), renal impairment (quinine) and cardiovascular effects (quinine)

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