3.16 Antimalarials
Malaria is a prevalent protozoal disease impacting individuals globally. According to the Centers for Disease Control, approximately 1,700 cases of malaria are diagnosed in the United States each year.[1]
Mechanism of Action: Antimalarial agents work by targeting specific intracellular processes that impact cell development.[2]
Indications: Antimalarials are used for the prevention or treatment of malaria.
Nursing Considerations: Antimalarial medications may impact hearing and vision, so clients should be monitored carefully for adverse effects. Additionally, antimalarial medications may cause GI upset, so clients should be instructed to take these medications with food.
Side Effects/Adverse Effects: Individuals who receive antimalarial medications should be monitored for changes in vision and hearing. Additionally, renal impairment may occur so renal function should be carefully monitored. Adverse effects and signs of toxicity include headache, drowsiness, visual disturbances, nausea and vomiting, cardiovascular collapse, shock, and convulsions.
Health Teaching & Health Promotion: Clients should receive instruction to take medications as prescribed and adhere to the full prescription regimen. Clients should minimize additional exposure to mosquitoes (i.e., the mode of transmission) and use preventative measures such as repellents, protective clothing, bed nets, etc. Clients on chloroquine therapy should also avoid alcohol. Chloroquine can be extremely toxic to children and should be safely stored and out of reach. Clients receiving antimalarial therapy may have increased sensitivity to light and should be counseled to wear protective glasses to prevent ocular damage. Treatment often requires sustained regimens of six months or greater so clients should be monitored carefully for adherence and compliance.[3]
Now let’s take a closer look at the medication grid on chloroquine in Table 3.16.[4]
Table 3.16 Chloroquine Medication Grid
| Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/Adverse Effects |
|---|---|---|---|---|
| Antimalarials | chloroquine | Check for allergies
Contraindicated in clients hypersensitive to drug and in those with retinal or visual field changes Use cautiously in clients with severe GI, neurologic, or blood disorders; hepatic disease or alcoholism; or G6PD deficiency or psoriasis Take with food to prevent GI upset In severe or resistant cases, artesunate IV may be prescribed |
Prevention of malaria or improvement of an acute attack of malaria
For malaria prevention, the CDC recommends that clients take the drug for four weeks after leaving a malaria-infected area. |
Changes in vision
Changes in hearing Monitor renal function closely Monitor client for overdose, which can quickly lead to toxic symptoms: Headache, drowsiness, visual disturbances, nausea and vomiting, cardiovascular collapse, shock, and convulsions |
Critical Thinking Activity 3.16
Using the above grid information, consider the following clinical scenario question:
A nurse is providing medication teaching to a client who is planning on visiting a country with high rates of malaria to do mission work. The client states, “I’m glad I only have to take this medication for a week. The side effects sound horrific!” What is the nurse’s best response regarding the length of therapy?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” section at the end of the book.
- Centers for Disease Control and Prevention. (2018, November 15). Choosing a drug to prevent malaria. https://www.cdc.gov/malaria/travelers/drugs.html ↵
- Achieng, A., Rawat, M., Ogutu, B., Guyah, B., Ong'echa, J. M., Perkins, D., & Kempaiah, P. (2017). Antimalarials: Molecular drug targets and mechanism of action. Current Topics in Medicinal Chemistry, 17, 1-15. https://doi.org/10.2174/1568026617666170130115323 ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵