Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mefloquine hydrochloride [WR 142,490; alpha-(2-piperidyl)-2,8-bis(trifluoromethyl)-4-quinolinemethanol hydrochloride] was tested for suppressive effect on sporozoite-induced malaria in nonimmune volunteers living in an area where malaria is not naturally transmitted. Single doses of 250 mg were given at weekly intervals, 500 mg at intervals of 2 weeks and 1,000 mg at intervals of 4 weeks, to men bitten by 10 to 15 mosquitoes heavily infected with a chloroquine- and pyrimethamine-resistant strain of Plasmodium falciparum. None of the individuals so treated developed infections during the period of drug delivery or during the follow-up period of 60 days. Doses of 250 or 500 mg produced no adverse reactions; mild epigastric discomfort occurred in all three men given 1,000 mg. Sporozoite-induced P. vivax infections were suppressed by single doses of 250 mg of mefloquine given at weekly intervals, but malaria developed after completion of the course. At treatment intervals longer than 1 week, vivax malaria was not suppressed.
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PMID:Suppressive activity of mefloquine in sporozoite-induced human malaria. 76 78

Mefloquine hydrochloride, a new 4-quinolinemethanol, was administered as a single oral dose to 47 volunteers infected with malaria. Treatment resulted in rapid clearence of fever and parasitemia. No recrudescence of parasites was observed after treatment of chloroquine-sensitive infections of Plasmodium falciparum. More significantly, in nonimmune persons with chloroquine-resistant infections, 1 gram of mefloquine cured 10 of 12 patients and 1.5 grams cured all 8 patients who received this dose of the drug. The marked activity of a single dose of mefloquine against chloroquine-resistant strains of Plasmodium falciparum suggests that this agent may be more useful than currently available drugs are for the treatment of drug-resistant malaria.
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PMID:Mefloquine (WR 142,490) in the treatment of human malaria. 110 87

At a time when Fansimef, the fixed combination of mefloquine, sulfadoxine and pyrimethamine was considered for prophylaxis of falciparum malaria, a randomized double-blind study comparing the efficacy and tolerability of Fansimef with that of Lariam (mefloquine), Fansidar, chloroquine and placebo in malaria prophylaxis was performed in Thailand from July 1987 to January 1988. The study population of 602 adult males was recruited in Pak Tongchai District, some 360 km North-East of Bangkok, where multiresistant P. falciparum is endemic. All active treatments and placebo were given once weekly for 24 weeks with doses as follows: Fansimef: 125 mg mefloquine + 250 mg sulfadoxine + 12.5 mg pyrimethamine (1 half-strength tablet); Lariam: 125 mg mefloquine (1 half-strength tablet); Fansidar: 500 mg sulfadoxine + 25 mg pyrimethamine; chloroquine; 300 mg. A loading dose of 2 half-strength tablets was given in the Fansimef group in weeks 1 and 2 and in the Lariam group in weeks 1 to 4. The incidence of acute episodes of P. falciparum per 100 person months of prophylaxis was 0.17 each in the Fansimef and the Lariam groups, 1.18 in the Fansidar group, 0.69 in the chloroquine group and 0.64 in the placebo group (differences statistically not significant). Clinically adverse events were reported by 170 subjects (Fansimef 28, Lariam 29, Fansidar 41, choroquine 43, placebo 29; differences statistically not significant). The most frequent adverse events in all groups were headache, sleepiness, dizziness and weakness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fansimef for prophylaxis of malaria: a double-blind randomized placebo controlled trial. 129 89

From July 1987 to June 1988 a randomized, double-blind, comparative placebo-controlled field trial was conducted in a group of villages near Ibadan, Nigeria. The aim of the study was to assess the suppressive tolerability and efficacy of four antimalarials (Fansimef, Lariam, Fansidar, chloroquine) given for 24 weeks. Fansimef and Lariam were given with loading and maintenance doses, Fansidar and chloroquine as one tablet per week for 24 weeks. Of 567 enrolled subjects, 114 (20%) had parasitaemia on entry. Eight episodes of symptomatic falciparum malaria occurred during the trial, seven in the placebo group, and one in the Fansimef group. Compared with placebo, parasitaemia was effectively suppressed by all four drug regimens. Adverse event data were not significantly different between groups: six adverse events per 114 participants in the Fansimef group, six/113 in the mefloquine group, five/111 in the Fansidar group, 17/115 in the chloroquine group and eight/114 in the placebo group. Safety of Fansimef for 24 weeks in endemic areas was comparable for standard antimalarials in this trial and provides support for the use of this drug for the treatment of resistant malaria in indigenous African populations.
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PMID:Mefloquine-sulphadoxine-pyrimethamine (Fansimef, Roche) in the prophylaxis of Plasmodium falciparum malaria: a double-blind, comparative, placebo-controlled study. 130 98

Malaria is largely preventable, so travelers should be taught general protective measures and given appropriate chemoprophylaxis before they leave on their trip. Chloroquine phosphate (Aralen) is still the drug of choice in locations where malaria remains chloroquine-sensitive. However, chloroquine-resistant areas infested with Plasmodium falciparum are becoming more numerous. In such areas, mefloquine hydrochloride (Lariam), doxycycline, or proguanil (Paludrine) (obtainable outside the United States) may be used. A single dose of pyrimethamine-sulfadoxine (Fansidar) may be used to treat presumptive malarial infection if medical care is not immediately available. For prevention of relapse of Plasmodium vivax and Plasmodium ovale infection, primaquine phosphate is recommended for the final 2 weeks of chemoprophylaxis on return from a malarious area.
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PMID:Prophylaxis for malaria. Helping world travelers come home healthy. 151 52

Since the time of its introduction in 1985, mefloquine (Lariam) has been used extensively for malaria prophylaxis. The international Drug Safety Department of the manufacturer gathered all spontaneous adverse drug reactions reported in association with this drug from all available sources and monitored the literature on a world-wide basis. The serious neurologic and psychiatric adverse events reported in association with Lariam prophylaxis from the time of introduction until May 1991 were reviewed. During this time, 59 serious neurologic and psychiatric adverse reactions were reported as follows: 26 convulsions, 12 depressions, 20 psychotic episodes, and one toxic encephalopathy; none were fatal. While spontaneous reporting systems are biased by under-reporting, they provide useful instruments for analysis of clinical risks factors. The neurologic and psychiatric adverse events reported in association with mefloquine prophylaxis were of the same types as those reported with other quinine derivative antimalarials. The precise mechanism of serious neurologic and psychiatric reactions is unknown. The only patient population identified at this time as having an increased risk of developing these serious reactions to mefloquine are persons with a history of seizures or manic-depressive illness. Mefloquine prophylaxis should not be prescribed to such patients.
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PMID:Mefloquine prophylaxis: an overview of spontaneous reports of severe psychiatric reactions and convulsions. 159 72

A double-blind comparative study of Fanismef-mefloquine/sulfadoxine/pyrimethamine (MSP) and Lariam-mefloquine (MEF) for the treatment of falciparum malaria, was carried out at malaria clinics in Kanchanaburi, in western Thailand, in the years 1987 and 1988. The cure rates obtained were 96% for the MSP group and 93% for the MEF and there was no significant difference. Vomiting and diarrhea were common side effects in both the MSP and MEF groups. Less common side effects were epigastric pain, minor skin rashes and dizziness. Significant differences in vomiting and epigastric pain only occurred in the patients who did not have these symptoms before treatment: vomiting MSP 23%, MEF 8%, epigastric pain MSP 22% and MEF 11%.
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PMID:Phase III double-blind comparative study of Fansimef and Lariam for the curative treatment of Plasmodium falciparum infections in Thailand. 207 82

Twenty eight adult male patients with acute uncomplicated falciparum malaria which showed RI or RII responses to quinine sulfate at the dosage of 600 mg 8 hourly for 7, 10 or 14 days were treated with a single dose of mefloquine (Lariam); 25 patients received 1000 mg, 2 received 750 mg and 1 received 500 mg. The initial response was good; there was no RII or RIII response. Three patients were lost to followup. Of 25 patients who stayed in the Bangkok Hospital for Tropical Diseases where there was no malaria transmission for 28-65 days, only one patient in the 1000 mg group had recrudescence on day 21. The cure rate was 96%. Our prospective study suggests that mefloquine was effective in the treatment of quinine resistant falciparum malaria and the risk of cross-resistance between quinine and mefloquine in P. falciparum in vivo is very low.
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PMID:Quinine resistant falciparum malaria treated with mefloquine. 209 15

Recommendations for the prevention of malaria among travelers have been developed by CDC in consultation with representatives from the Offices of Medical Services of the Department of State and the Peace Corps; the Division of Experimental Therapeutics of the Walter Reed Army Institute of Research; the Office of the Surgeon General, U.S. Army; the Office of the Surgeon General, U.S. Air Force; and the Bureau of Medicine and Surgery, U.S. Navy. Resistance of Plasmodium falciparum to chloroquine has spread to most areas with malaria. Alternative drugs to chloroquine are either associated with adverse reactions, are of limited efficacy, or require complex and detailed instructions for use that reduce compliance. These factors have contributed to a threefold increase in the number of reported P. falciparum infections among U.S. travelers to malarious areas since 1980. A new drug, mefloquine (Lariam), is expected to be highly effective against both chloroquine-resistant and Fansidar-resistant P. falciparum infections. Mefloquine is now recommended as the drug of choice for travelers at risk of infection with chloroquine-resistant P. falciparum. Alternative drugs for travelers who cannot take mefloquine include 1) doxycycline alone or 2) chloroquine alone, with Fansidar available for standby treatment while medical care is sought for evaluation of febrile illness when travelers are in a malarious area. Prospective travelers and health-care providers are advised to call the CDC Malaria Hotline at (404) 332-4555 for detailed recommendations for the prevention of malaria.
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PMID:Recommendations for the prevention of malaria among travelers. 215 46

Recommendations for the prevention of malaria among travelers have been developed by CDC in consultation with representatives from the Offices of Medical Services of the Department of State and the Peace Corps; the Division of Experimental Therapeutics of the Walter Reed Army Institute of Research; the Office of the Surgeon General, U.S. Army; the Office of the Surgeon General, U.S. Air Force; and the Bureau of Medicine and Surgery, U.S. Navy. Resistance of Plasmodium falciparum to chloroquine has spread to most areas with malaria. Alternative drugs to chloroquine are either associated with adverse reactions, are of limited efficacy, or require complex and detailed instructions for use that reduce compliance. These factors have contributed to a threefold increase in the number of reported P. falciparum infections among U.S. travelers to malarious areas since 1980. A new drug, mefloquine (Lariam), is expected to be highly effective against both chloroquine-resistant and Fansidar-resistant P. falciparum infections. Mefloquine is now recommended as the drug of choice for travelers at risk of infection with chloroquine-resistant P. falciparum. Alternative drugs for travelers who cannot take mefloquine include 1) doxycycline alone or 2) chloroquine alone, with Fansidar available for standby treatment while medical care is sought for evaluation of febrile illness when travelers are in a malarious area. Prospective travelers and health-care providers are advised to call the CDC Malaria Hotline at (404) 332-4555 for detailed recommendations for the prevention of malaria.
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PMID:From the Centers for Disease Control. Recommendations for the prevention of malaria among travelers. 215 78


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