Malaria drugs (Antimalarials)

Malaria infection during pregnancy brings substantial risks for the pregnant woman and her foetus along with the new-born child. So, it is advisable not to travel to places where malaria is spread while you are pregnant. Even if you have to go there, it is good to speak to your doctor who is looking after you right now. In any case, you should not take any anti-malarial medicine without consulting your doctor. In this articleMalaria during PregnancyPyrimethamineChloroquineQuininePyrimethamine with SulfadoxineTaking Anti-Malarial Drugs during PregnancyCombination of Chloroquine and ProguanilTips to Avoid Malaria during PregnancyMalaria during Pregnancy Malaria is a very serious illness especially when it comes to pregnant women because it results in severe discomfort and is sometimes fatal too. It affects both, the mother and the child. So, it is always good to avoid mosquitoes because malaria is caused by infected mosquito bite. If you have to travel to any malaria prone area and you are pregnant, take advice from your doctor.Anti-Malarial Drugs and Their Effects on Pregnancy Have a quick look at the anti-malarial drugs and their effects on pregnancy. PyrimethaminePyrimethamine may interfere with folic acid metabolism. Animal experiments have shown that administration of very high doses during the babys organ development may give rise to birth defects typical of folic acid antagonism. If pyrimethamine is given during pregnancy, folic acid supplementation may be required.ChloroquineChloroquine is useful in the suppression and treatment of malaria. It has a rapid schizonticidal effect. Chloroquine and related substances may cause neurological disturbances in the foetus and interference with hearing, balance and vision. The use of these drugs in the prophylaxis of malaria is accepted because the small risk to the foetus with the low doses used is outweighed by the benefits to the mother and foetus. The use of higher doses in the treatment of malaria and in the second line treatment of liver amoebiasis is accepted because the lifesaving benefits of the treatment to the mother and the foetus outweigh the risk.QuinineQuinine, a highly active blood schizonticide also suppresses the asexual cycle of development of malarial parasites in the erythrocytes (red blood cells). Quinine (and quinidine) in high doses causes foetal injuries in the form of deafness, developmental disturbances and malformations of the extremities and cranium. Its ability to induce uterine contractions also causes a risk of miscarriage.Pyrimethamine with SulfadoxinePyrimethamine may interfere with folic acid metabolism. Sulfadoxine may cause jaundice in babies during the first month of life by displacing bilirubin from plasma albumin. Sulfadoxine should therefore be avoided as far as possible during the last month of pregnancy. Products: Chloroquine, Quinine For Children: Reduced dose necessary For Pregnant Women: High doses may affect the baby For Breastfeeding Mothers: Caution Contra-indications*: Renal and liver impairment, epilepsy Caution: --------- Taking Anti-Malarial Drugs during PregnancyYour obstetrician will advise you which anti-malarial drugs you should take. Make sure you take the medicine as and when prescribed. The type of medication is prescribed considering the place where you are going. The parasites causing malaria are different and have different effects in various parts of the world. Your doctor will have proper and updated knowledge of the kind of medicine that would be effective in the part of the world you are going.There are some medicines which are safe during pregnancy which can be taken only if they are prescribed by an obstetrician. For example: Combination of Chloroquine and ProguanilCombination of chloroquine and proguanil is usually recommended during pregnancy. The only thing is that this does not give much protection against malaria in many regions. Such medicines should be taken only if they are prescribed by an obstetrician. Avoid mefloquine during first trimester of pregnancy. Avoid taking doxycycline completely during pregnancy.Atovaquone lacks any evidence of whether it is safe to be taken during pregnancy or not. So, you should avoid it as far as possible. Tips to Avoid Malaria during PregnancyThe best thing is to avoid mosquito bite. For this you can take following steps.Cover your arms and legs after sunset by wearing full sleeves and trousers.Use mosquito repellent on your skin. Make sure you choose the one that is specially recommended to be used during pregnancy.It is safe and good to sleep under a mosquito net.Ideally pregnant women should stay indoors especially between dusk to dawn.Keep your house and surroundings clean.Mosquitoes thrive in stagnant water so do not let the water get stagnated in your surroundings. Finding effects of anti-malarial medicines to cure malaria on pregnant women is difficult because these women are usually not tested and are excluded from clinical trials fearing potential damages to the woman and the foetus. Since pregnant women are more susceptible to the disease, it is good to avoid the circumstances in the first place. It is not just that a woman who is pregnant might get infected with malaria. She can be susceptible to re-occurrence of malaria and develop severe complications during this period. One can even die due to complications because malaria contributes significantly to foetal and maternal mortality. The history of travels done by the pregnant woman should be taken under consideration especially if it includes unexplained fever or anaemia. No matter whether the fever was high or of low-grade or even if it is absent, a visit to the doctor is recommended before and after the journey. Some of the symptoms may include cough, headache and diarrhoea. However, anaemia is a common symptom and sometimes the only clue especially in endemic areas. Treatment of malaria during pregnancy becomes difficult because of the restrictions on anti-malarial agents. So, take preventive measures and stay cautious and safe throughout the pregnancy period.