Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D02448 (Fansidar)
 243 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the North Fly region of the Western Province of Papua New Guinea 491 cases of Plasmodium falciparum infection were monitored in vivo for sensitivity to chloroquine and amodiaquine over a 2-year period; 41% resistance was detected. The RI type accounted for 74% of the resistant strains detected; 43% of these recrudesced on day 28 or shortly thereafter. 22% of resistant strains were RII type and 4% R III. The infections were categorized as imported or locally acquired. Imported infections accounted for 58% of the cases monitored and showed a resistance rate of 49%. Resistance was detected in 24% of the cases indigenous to the North Fly region (13% in the Kiunga-Ningerum area and 38% in the Ok Tedi-Star Mountains area). Linguistic groups immediate to the Ok Tedi mining operation, the Wopkaimin and Kamfaiwolmin, showed an increase in resistance from 28% in 1986 to 55% the following year. This increase was associated with renewed construction activity within the mine's development area. Two falciparum malaria outbreaks were experienced during this study, the second being attributed to introduced strains. The study showed the impact of age and variation of malaria endemicity in suppressing resistance. The study also demonstrated a possible cross-resistance problem between imported cases of P. falciparum treated with amodiaquine and chloroquine, with resistance rates of 58% and 60%, respectively, demonstrated in children under 10 years of age. The 61% amodiaquine resistance rate in locally acquired infection in children was attributed to drug pressure, since chloroquine resistance in the same group was reported at 19%. RIII-type resistance in children was only detected in those treated with amodiaquine. The efficacy of amodiaquine in clearing only 41% of the P. falciparum infections in children was a major concern. All 201 resistant P. falciparum infections detected over the 24-month monitoring period responded to treatment with quinine and Fansidar.
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PMID:Resistance of Plasmodium falciparum to chemotherapy with 4-aminoquinolines in the Ok Tedi area of Papua New Guinea. 266 76

The sulfadoxine-pyrimethamine combination has not been recommended for the prophylaxis of malaria since 1985 following serious accidents in the USA. However, this drug is worth considering for treatment since it has the advantage over mefloquine of being cheaper, having fewer side effects and it avoids using mefloquine. A study of Plasmodium falciparum resistance to Fansidar should be carried out on cases imported to France to determine an adapted utilisation of this drug. This would be an appreciable advantage for tropical Africa.
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PMID:[Plasmodium falciparum drug resistance and sulfadoxine-pyrimethamine in Africa]. 267 Feb 91

From March 1981 until August 1985, 79 children suffering from falciparum malaria were treated with chloroquine upon admission to the Department of Child Health, Medical School Sam Ratulangi University/Gunung Wenang General Hospital, Manado. Twenty-one out of 79 patients were within range of the criteria of resistance as established by WHO: Standard field test or 7 days test. Six (28.6%) out of 21 patients belonged to resistance II (R II) to chloroquine. The duration of fever in the 6 patients with R II to chloroquine was 2-7 days, with the average of 3.3 days. Patients with R II to chloroquine were treated with Fansidar, and all of them were cured.
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PMID:Chloroquine resistant falciparum malaria in children. 267 20

Patients with Plasmodium falciparum infections in northern KwaZulu adjacent to the Mozambique border were treated with chloroquine 25 mg/kg. Persistent parasitaemias increased from nil in 1983 to 21.2% and 16.1% for hospital and field treatments respectively in 1987. After a change to sulfadoxine-pyrimethamine (Fansidar; Roche) treatment (adults 1,500 mg and 75 mg respectively) these rates fell in March 1988 to 6.9% and 0.4%.
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PMID:Chloroquine resistance in Plasmodium falciparum in KwaZulu, 1983-1988. 268 47

Congenital ocular toxoplasmosis with recurrences must be treated by Spiramycin destroys trophozoites when they escape from the true cysts. Fansidar (Pyrimethamine + Sulfadoxine) seems to have less efficacity than Pyrimethamine with Sulfadiazine.
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PMID:[Treatment of recurrent congenital ocular toxoplasmosis. Our initial experience with Fansidar]. 268 44

In the treatment of severe Plasmodium falciparum infection antimalarial drugs should, ideally, be given by controlled rate intravenous infusion until the patient is able to swallow tablets. In cases where infection has been acquired in a chloroquine resistant area, and where it has broken through chloroquine prophylaxis or where the geographical origin or species are uncertain, quinine is the treatment of choice. When access to parenteral quinine is likely to be delayed, parenteral quinidine is an effective alternative. A loading dose of quinine is recommended in order to achieve therapeutic plasma concentrations as quickly as possible. In the case of chloroquine sensitive P. falciparum infection, chloroquine, which can be given safely by slow intravenous infusion, may be more rapidly effective and has fewer toxic effects than quinine. There is limited experience with parenteral administration of pyrimethamine sulphonamide combinations such as Fansidar, and resistance to these drugs has developed in South East Asia and elsewhere. Mefloquine and halofantrine cannot be given parenterally. Qinghaosu derivatives are not readily available and have not been adequately tested outside China. Supportive treatment includes the prevention or early detection and treatment of complications, strict attention to fluid balance, provision of adequate nursing for unconscious patients and avoidance of harmful ancillary treatments. Anaemia is inevitable and out of proportion to detectable parasitaemia. Hypotension and shock ('algid malaria') are often attributable to secondary gram-negative septicaemia requiring appropriate antimicrobial therapy and haemodynamic resuscitation. Many patients with severe falciparum malaria are hypovolaemic on admission to hospital and require cautious fluid replacement. Failure to rehydrate these patients may lead to circulatory collapse, lactic acidosis, renal failure and severe hyponatraemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of severe malaria. 269 26

Thirty-nine percent (36 of 92) of children in Limbe, Cameroon, treated with chloroquine (10 mg/kg body weight on days 1 and 2, and 5 mg/kg on day 3) for falciparum malaria failed to respond within 7 d of treatment. Twenty-two of these children with chloroquine-resistant malaria were successfully treated with Fansidar [one-half tablet (250 mg sulfadoxine and 25 mg pyrimethamine) per 10 kg body weight], while the other 14 children were cured with mefloquine (25 mg/kg body weight). In vitro, a combination of verapamil at 1.0 x 10(-6) M with chloroquine or desethylchloroquine reversed resistance to the antimalarial drug and its primary metabolite in each of the 2 isolates successfully adapted and maintained in continuous culture. Similar combinations had no effect on susceptibilities of a sensitive reference clone, D6, used as control. Both chloroquine-resistant isolates from Cameroon were significantly more susceptible to mefloquine and halofantrine in vitro than the chloroquine-sensitive reference clone. Clinical observation, and in vitro confirmation, of chloroquine-resistant falciparum malaria in these indigenous children from Cameroon, and the current socio-economic condition in West Africa, underscore the need for pragmatic health management policies for efficient use of alternative antimalarial drugs in controlling drug resistant Plasmodium falciparum in the region. This observation of reversal of chloroquine resistance in isolates of P. falciparum obtained from West Africa, and a previous report on clones obtained from south-east Asia and South America, suggest that the mechanism(s) of resistance to chloroquine may be identical in resistant parasites from the 3 continents.
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PMID:Chloroquine resistant Plasmodium falciparum in indigenous residents of Cameroon. 269 61

The susceptibilities of 27 Plasmodium falciparum strains to chloroquine and mefloquine were studied in the area of Puerto Ayacucho, Amazonas Federal Territory of Venezuela, to determine their levels of resistance in vivo and in vitro. 50% of these strains showed chloroquine resistance in vivo. No grade III chloroquine resistance was found. 25% of the strains were resistant to chloroquine in vitro and 9% were resistant to mefloquine in vitro. Preliminary results suggest that strains resistant to Fansidar may also be found.
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PMID:Susceptibility of Plasmodium falciparum strains to chloroquine and mefloquine in the Amazonas Federal Territory of Venezuela. 269 96

Malaria, particularly that due to chloroquine-resistant Plasmodium falciparum, which requires management with antimalarial drugs capable of protecting against multiresistant strains, has emerged in Malaysia. A study was carried out to assess the efficacy and tolerability of 2 dosages of mefloquine/sulfadoxine/pyrimethamine (MSP; RO 13-5112) compared to Fansidar in a malaria endemic area. 914 subjects in 3 random groups were studied. Occurrence of malaria was assessed both clinically as well as by blood films. Plasma drug levels were also measured. The results showed that the low dose of MSP was completely effective in suppressing parasitaemia. 2.7% of the study population reported adverse drug reactions, the lowest incidence being in subjects on the low dose; their blood chemical profiles were also the least affected. The plasma levels of pyrimethamine and sulfadoxine achieved in the low dose group were slightly higher than expected, but there was no significant difference in bioavailability. The study showed that, for chemoprophylaxis, a low dose of MSP provided effective protection with minimal side effects.
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PMID:Chemosuppression of malaria by the triple combination mefloquine/sulfadoxine/pyrimethamine: a field trial in an endemic area in Malaysia. 269 9

A protocol of monitoring and treatment in toxoplasmosis is suggested by the authors. During pregnancy, the administration of spiramycine at a 9 m UI daily dose remains the basic preventive treatment when a seroconversion occurs after a 4 week post-conception period. In the fetus, the antenatal diagnosis is made by ultrasound started on the 18th week after conception and repeated every 4 weeks, amniocentesis and eventually umbilical cord puncture associated with a pyrimethamine-sulfamide drug treatment in case of positive diagnosis. A therapeutic pregnancy termination is considered when lesions have been detected by ultrasound. In the newborn (neonatal or post-natal period), the diagnosis is made by transfontanel ultrasonography, ocular fundi and spinal fluid examination, detection of specific IgM antibodies in cord blood and the evolution and importance of serum antibodies response requiring a drug treatment during 15-18 months with spiramycine and pyrimethamine + sulfadoxine (Fansidar).
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PMID:[Monitoring and treatment of toxoplasmosis in the pregnant woman, fetus and newborn]. 269 91


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