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Medical Care




Microsoft word - malaria_all_meds

history of epilepsy. Pregnant women should seek MALARIAL PREVENTION
medical advice regarding malarial prevention. Malaria can be fatal. It is essential to take medical Prolonged administration of Chloroquine may advice on which antimalarial drugs are rarely lead to eye damage. If any problems occur appropriate. No medication can be guaranteed to with the eyes you should seek medical advice. protect against malaria in every case. Any traveller becoming ill when visiting a malarious Side effects of Chloroquine
region or up to one year after returning home Headache, stomach upsets, hair loss and visual should seek medical advice. disturbances may occur. May also provoke psoriasis. Seek medical advice should these GENERAL MEASURES
In addition to taking antimalarial drugs, it is essential to take other measures to reduce your 3. MALARONE (Atovaquone
exposure to the mosquito: 250mg/Proguanil100mg per tablet) Prescription from doctor required Protect against mosquito bites by wearing This medication has been developed relatively long-sleeved clothing. recently and is generally considered a great Use insect repellent creams containing DEET advance. It is known to be very effective for prevention and treatment of Malaria, particularly Spray your room or tent before going to bed the resistant forms of chloroquine-resistant with a knockdown spray (fly-spray). malaria eg P. Falciparum. Sleep in a properly screened room or under a Malarone has a low risk of side effects with the great advantage that it can be started at short Use a plug-in electric insecticide vaporiser and if available use air conditioning as this notice, only 24 hours prior to travel. Also It need helps eliminate mosquitoes in sleeping areas. only be taken for 7 days after a travellers return unlike other prophylactics which must be MEDICATIONS IN USE
continued for 28 days. It is therefore
Various different Antimalarials are in use and are particularly useful for the short term business
described below. Different ones are traveller.
recommended for different areas and it is Malarones main disadvantage presently is that it essential you get clear advice about this. Some is very expensive. useful information can be found on the internet at
Dosage for prophylaxis against malaria: Take
one Malarone tablet daily starting 24 hours before travel and continuing for 7 days after leaving the 1. PROGUANIL HYDROCHLORIDE 100mg
Malaria risk area. Ideally it should be taken with a (Paludrine)
fat rich meal (or at least a glass of milk or a Available from pharmacist without prescription yoghourt) as this improves absorption from the Dosage for prophylaxis against malaria:
Take 2 tablets of Proguanil daily. Starting one week prior to departure and continuing for four Side effects of Malarone
weeks after return. This medicine is most When Malarone is used for malaria prevention in commonly taken in conjunction with Chloroquine. general side effects are uncommon and minor. When higher doses of the drug are used for Precautions
treatment of malaria, headache, nausea, vomiting, Proguanil should be used with caution in patients mouth ulcers, abdominal pain, diarrhoea, and with kidney problems. coughing can occur though are still quite Pregnant women should seek medical advice uncommon. Convulsions and rash have rarely regarding malaria prevention. Side effects of Proguanil
Mild gastric upset and diarrhoea. Mouth ulceration has been reported. Not suitable for women during pregnancy. Travellers with a known allergy to Atovaquone or Proguanil should use an alternative. 2. CHLOROQUINE 250mg (Avoclor)
Available from pharmacist without prescription
Malarone should not be taken at the same Dosage for prophylaxis against malaria:
time as preparations containing either Take 2 tablets of Chloroquine once a week on the Tetracycline, Rifampicin or Metoclopramide, same day. Starting one week prior to departure since such combinations can significantly and continuing for four weeks after return. reduce the effectiveness of Malarone. It may not be suitable for persons with Kidney Precautions
Chloroquine should be used with precaution if you suffer from liver or kidney problems or if there is a 4. DOXYCYCLINE 100mg daily
Prescription from doctor required (Lariam) Prescription from doctor required
Dosage for prophylaxis against malaria: Take
Dosage for prophylaxis against malaria: Take
one doxycycline capsule daily with food. Start 2 to one Mefloquine tablet once a week on the same 3 days prior to departure and continuing for four day, starting two to three weeks prior to
weeks after return. departure and continuing for four weeks after Precautions
• Drink sufficient fluid to ensure capsule is Precautions
washed into the stomach. Lariam should not be taken if • Do not lie down for 30 minutes after You have kidney or severe liver problems swallowing the capsule. Heart conduction abnormalities • Doxycycline interferes with absorption of the If you are allergic to quinine contraceptive pill with initial use. Hence you
If you are taking other anti-malarial must not rely on your pill alone for the first
3 weeks of doxycycline use. ie use condoms
If you have had fits, a strong family history of epilepsy or severe psychiatric complaints • Not suitable for children under 12 years, or Reliable contraceptive precautions should be during pregnancy. used to prevent pregnancy whilst taking • Travellers with a known allergy to Doxycycline. Lariam and for three months afterwards. Side effects of Doxycycline
Side effects of Mefloquine
Possible side effects can rarely include skin Dizziness, visual disturbance, nausea, vomiting, photosensitivity that may result in an exaggerated diarrhoea, abdominal pain, changes in mood, sunburn reaction. This risk can be minimised by sleep disturbance. Very rarely Lariam can cause wearing a hat and using good quality sunscreens. blood disorders and skin rashes. You should Fortunately this only affects approximately 5% of avoid carrying out tasks requiring a high degree of people who use doxycycline. co-ordination while taking Lariam as it can cause Women who take doxycycline for long periods dizziness and a disturbed sense of balance. may develop vaginal thrush and may wish to Ensure you are not affected in this way before discuss this with their doctor before using doxycycline.

Psychiatric effects of Mefloquine
Travelers are always very concerned about the risk of psychiatric disturbance that they have heard can occur with Lariam. Although undoubtedly this does occur the risk is small and Very Approximate Costs of Medications.
fortunately effects do reverse quickly when the Different Pharmacies will vary in price. drug is stopped. About 1 in 140 people taking mefloquine will experience temporary mild
psychiatric side effects. More serious side effects Medication
can be expected in only 1 in 10,000 people taking this drug. Most people who get side effects will Proguanil &
develop them after the first 2 to 3 doses. Doctors Chloroquine
therefore now advise you to start taking mefloquine 2 or 3 weeks before you travel. Then Malarone
if you do develop early side effects an alternative can be found. Doxycycline
For most countries (but not all) where mefloquine is advised a suitable alternative is Malarone. Mefloquine
There is no doubt that the risks from developing resistant malaria vastly outweigh the very small risk of psychiatric disturbance from Mefloquine.



Volume XX, Number 4 April 2012 Protect Against Sun Exposure ave you ever been cooked like a that you can't see through when held up According to the American lobster? Lobsters turn bright red Academy of Dermatology, the threemost common forms of skin cancer Has they cook and so do people when Use sunscreen with a sun protection they're exposed to the burning rays of the