Atovaquone: A hydroxynaphthoquinone that has antimicrobial activity and is being used in antimalarial protocols.Naphthoquinones: Naphthalene rings which contain two ketone moieties in any position. They can be substituted in any position except at the ketone groups.Proguanil: A biguanide compound which metabolizes in the body to form cycloguanil, an anti-malaria agent.Sulfadiazine: One of the short-acting SULFONAMIDES used in combination with PYRIMETHAMINE to treat toxoplasmosis in patients with acquired immunodeficiency syndrome and in newborns with congenital infections.Cytochromes b: Cytochromes of the b group that have alpha-band absorption of 563-564 nm. They occur as subunits in MITOCHONDRIAL ELECTRON TRANSPORT COMPLEX III.Antimalarials: Agents used in the treatment of malaria. They are usually classified on the basis of their action against plasmodia at different stages in their life cycle in the human. (From AMA, Drug Evaluations Annual, 1992, p1585)Pneumocystis: A genus of ascomycetous FUNGI, family Pneumocystidaceae, order Pneumocystidales. It includes various host-specific species causing PNEUMOCYSTIS PNEUMONIA in humans and other MAMMALS.Propyl Gallate: Antioxidant for foods, fats, oils, ethers, emulsions, waxes, and transformer oils.Parasitic Sensitivity Tests: Tests that demonstrate the relative effectiveness of chemotherapeutic agents against specific parasites.Pneumonia, Pneumocystis: A pulmonary disease in humans occurring in immunodeficient or malnourished patients or infants, characterized by DYSPNEA, tachypnea, and HYPOXEMIA. Pneumocystis pneumonia is a frequently seen opportunistic infection in AIDS. It is caused by the fungus PNEUMOCYSTIS JIROVECII. The disease is also found in other MAMMALS where it is caused by related species of Pneumocystis.Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (AEROSOLS) and other colloidal systems; water-insoluble drugs may be given as suspensions.Plasmodium falciparum: A species of protozoa that is the causal agent of falciparum malaria (MALARIA, FALCIPARUM). It is most prevalent in the tropics and subtropics.Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from DRUG TOLERANCE which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration.Trimethoprim-Sulfamethoxazole Combination: This drug combination has proved to be an effective therapeutic agent with broad-spectrum antibacterial activity against both gram-positive and gram-negative organisms. It is effective in the treatment of many infections, including PNEUMOCYSTIS PNEUMONIA in AIDS.Coccidiostats: Agents useful in the treatment or prevention of COCCIDIOSIS in man or animals.Toxoplasmosis, Cerebral: Infections of the BRAIN caused by the protozoan TOXOPLASMA gondii that primarily arise in individuals with IMMUNOLOGIC DEFICIENCY SYNDROMES (see also AIDS-RELATED OPPORTUNISTIC INFECTIONS). The infection may involve the brain diffusely or form discrete abscesses. Clinical manifestations include SEIZURES, altered mentation, headache, focal neurologic deficits, and INTRACRANIAL HYPERTENSION. (From Joynt, Clinical Neurology, 1998, Ch27, pp41-3)Malaria, Falciparum: Malaria caused by PLASMODIUM FALCIPARUM. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations.Electron Transport Complex III: A multisubunit enzyme complex that contains CYTOCHROME B GROUP; CYTOCHROME C1; and iron-sulfur centers. It catalyzes the oxidation of ubiquinol to UBIQUINONE, and transfers the electrons to CYTOCHROME C. In MITOCHONDRIA the redox reaction is coupled to the transport of PROTONS across the inner mitochondrial membrane.Dapsone: A sulfone active against a wide range of bacteria but mainly employed for its actions against MYCOBACTERIUM LEPRAE. Its mechanism of action is probably similar to that of the SULFONAMIDES which involves inhibition of folic acid synthesis in susceptible organisms. It is also used with PYRIMETHAMINE in the treatment of malaria. (From Martindale, The Extra Pharmacopoeia, 30th ed, p157-8)Piroplasmida: An order of protozoa comprising heteroxenous tick-borne blood parasites. Representative genera include BABESIA, Dactylosoma, and THEILERIA.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues.Polarography: An electrochemical technique for measuring the current that flows in solution as a function of an applied voltage. The observed polarographic wave, resulting from the electrochemical response, depends on the way voltage is applied (linear sweep or differential pulse) and the type of electrode used. Usually a mercury drop electrode is used.Citalopram: A furancarbonitrile that is one of the SEROTONIN UPTAKE INHIBITORS used as an antidepressant. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia in preference to tricyclic antidepressants, which aggravate this condition.Malaria: A protozoan disease caused in humans by four species of the PLASMODIUM genus: PLASMODIUM FALCIPARUM; PLASMODIUM VIVAX; PLASMODIUM OVALE; and PLASMODIUM MALARIAE; and transmitted by the bite of an infected female mosquito of the genus ANOPHELES. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high FEVER; SWEATING; shaking CHILLS; and ANEMIA. Malaria in ANIMALS is caused by other species of plasmodia.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Product Labeling: Use of written, printed, or graphic materials upon or accompanying a product or its container or wrapper. It includes purpose, effect, description, directions, hazards, warnings, and other relevant information.Tablets: Solid dosage forms, of varying weight, size, and shape, which may be molded or compressed, and which contain a medicinal substance in pure or diluted form. (Dorland, 28th ed)Pharmaceutical Services, Online: Pharmacy services accessed via electronic means.Investigational New Drug Application: An application that must be submitted to a regulatory agency (the FDA in the United States) before a drug can be studied in humans. This application includes results of previous experiments; how, where, and by whom the new studies will be conducted; the chemical structure of the compound; how it is thought to work in the body; any toxic effects found in animal studies; and how the compound is manufactured. (From the "New Medicines in Development" Series produced by the Pharmaceutical Manufacturers Association and published irregularly.)Drugs, Investigational: Drugs which have received FDA approval for human testing but have yet to be approved for commercial marketing. This includes drugs used for treatment while they still are undergoing clinical trials (Treatment IND). The main heading includes drugs under investigation in foreign countries.Clarithromycin: A semisynthetic macrolide antibiotic derived from ERYTHROMYCIN that is active against a variety of microorganisms. It can inhibit PROTEIN SYNTHESIS in BACTERIA by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation.Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man.Toxoplasma: A genus of protozoa parasitic to birds and mammals. T. gondii is one of the most common infectious pathogenic animal parasites of man.Toxoplasmosis, Congenital: Prenatal protozoal infection with TOXOPLASMA gondii which is associated with injury to the developing fetal nervous system. The severity of this condition is related to the stage of pregnancy during which the infection occurs; first trimester infections are associated with a greater degree of neurologic dysfunction. Clinical features include HYDROCEPHALUS; MICROCEPHALY; deafness; cerebral calcifications; SEIZURES; and psychomotor retardation. Signs of a systemic infection may also be present at birth, including fever, rash, and hepatosplenomegaly. (From Adams et al., Principles of Neurology, 6th ed, p735)Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. It also inhibits CYTOCHROME P-450 CYP3A.Travel: Aspects of health and disease related to travel.Bacterial Infections: Infections by bacteria, general or unspecified.Pneumocystis jirovecii: A species of PNEUMOCYSTIS infecting humans and causing PNEUMOCYSTIS PNEUMONIA. It also occasionally causes extrapulmonary disease in immunocompromised patients. Its former name was Pneumocystis carinii f. sp. hominis.Rehabilitation: Restoration of human functions to the maximum degree possible in a person or persons suffering from disease or injury.Occupational Therapy: Skilled treatment that helps individuals achieve independence in all facets of their lives. It assists in the development of skills needed for independent living.Physical Therapy Specialty: The auxiliary health profession which makes use of PHYSICAL THERAPY MODALITIES to prevent, correct, and alleviate movement dysfunction of anatomic or physiological origin.Auscultation: Act of listening for sounds within the body.HIV Infections: Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).Didanosine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. Didanosine is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA by binding to reverse transcriptase; ddI is then metabolized to dideoxyadenosine triphosphate, its putative active metabolite.Amoxicillin-Potassium Clavulanate Combination: A fixed-ratio combination of amoxicillin trihydrate and potassium clavulanate.Pharmacies: Facilities for the preparation and dispensing of drugs.Government PublicationsBooksGovernment Publications as Topic: Discussion of documents issued by local, regional, or national governments or by their agencies or subdivisions.Travel Medicine: Multidisciplinary field focusing on prevention of infectious diseases and patient safety during international TRAVEL. Key element of patient's pre-travel visit to the physician is a health risk assessment.Organic Chemicals: A broad class of substances containing carbon and its derivatives. Many of these chemicals will frequently contain hydrogen with or without oxygen, nitrogen, sulfur, phosphorus, and other elements. They exist in either carbon chain or carbon ring form.Water Pollutants, Chemical: Chemical compounds which pollute the water of rivers, streams, lakes, the sea, reservoirs, or other bodies of water.Azoles: Five membered rings containing a NITROGEN atom.Chemistry, Organic: The study of the structure, preparation, properties, and reactions of carbon compounds. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)Protein-Losing Enteropathies: Pathological conditions in the INTESTINES that are characterized by the gastrointestinal loss of serum proteins, including SERUM ALBUMIN; IMMUNOGLOBULINS; and at times LYMPHOCYTES. Severe condition can result in HYPOGAMMAGLOBULINEMIA or LYMPHOPENIA. Protein-losing enteropathies are associated with a number of diseases including INTESTINAL LYMPHANGIECTASIS; WHIPPLE'S DISEASE; and NEOPLASMS of the SMALL INTESTINE.Unconscious (Psychology): Those forces and content of the mind which are not ordinarily available to conscious awareness or to immediate recall.IrelandJaundice: A clinical manifestation of HYPERBILIRUBINEMIA, characterized by the yellowish staining of the SKIN; MUCOUS MEMBRANE; and SCLERA. Clinical jaundice usually is a sign of LIVER dysfunction.Blood Vessels: Any of the tubular vessels conveying the blood (arteries, arterioles, capillaries, venules, and veins).Nonprescription Drugs: Medicines that can be sold legally without a DRUG PRESCRIPTION.Drug Information Services: Services providing pharmaceutic and therapeutic drug information and consultation.Self Medication: The self administration of medication not prescribed by a physician or in a manner not directed by a physician.Directories as Topic: Lists of persons or organizations, systematically arranged, usually in alphabetic or classed order, giving address, affiliations, etc., for individuals, and giving address, officers, functions, and similar data for organizations. (ALA Glossary of Library and Information Science, 1983)Syringes: Instruments used for injecting or withdrawing fluids. (Stedman, 25th ed)Patents as Topic: Exclusive legal rights or privileges applied to inventions, plants, etc.Foramen Ovale, Patent: A condition in which the FORAMEN OVALE in the ATRIAL SEPTUM fails to close shortly after birth. This results in abnormal communications between the two upper chambers of the heart. An isolated patent ovale foramen without other structural heart defects is usually of no hemodynamic significance.Search Engine: Software used to locate data or information stored in machine-readable form locally or at a distance such as an INTERNET site.Device Approval: Process that is gone through in order for a device to receive approval by a government regulatory agency. This includes any required preclinical or clinical testing, review, submission, and evaluation of the applications and test results, and post-marketing surveillance. It is not restricted to FDA.Substance-Related Disorders: Disorders related to substance abuse.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Cell Line, Tumor: A cell line derived from cultured tumor cells.Apoptosis: One of the mechanisms by which CELL DEATH occurs (compare with NECROSIS and AUTOPHAGOCYTOSIS). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA; (DNA FRAGMENTATION); at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth.Antineoplastic Agents: Substances that inhibit or prevent the proliferation of NEOPLASMS.Oncolytic Virotherapy: Use of attenuated VIRUSES as ANTINEOPLASTIC AGENTS to selectively kill CANCER cells.
Alternative oxidase inhibitors potentiate the activity of atovaquone against Plasmodium falciparum. (1/172)Recent evidence suggests that the malaria parasite Plasmodium falciparum utilizes a branched respiratory pathway including both a cytochrome chain and an alternative oxidase. This branched respiratory pathway model has been used as a basis for examining the mechanism of action of two antimalarial agents, atovaquone and proguanil. In polarographic assays, atovaquone immediately reduced the parasite oxygen consumption rate in a concentration-dependent manner. This is consistent with its previously described role as an inhibitor of the cytochrome bc1 complex. Atovaquone maximally inhibited the rate of P. falciparum oxygen consumption by 73% +/- 10%. At all atovaquone concentrations tested, the addition of the alternative oxidase inhibitor, salicylhydroxamic acid, resulted in a further decrease in the rate of parasite oxygen consumption. At the highest concentrations of atovaquone tested, the activities of salicylhydroxamic acid and atovaquone appear to overlap, suggesting that at these concentrations, atovaquone partially inhibits the alternative oxidase as well as the cytochrome chain. Drug interaction studies with atovaquone and salicylhydroxamic acid indicate atovaquone's activity against P. falciparum in vitro is potentiated by this alternative oxidase inhibitor, with a sum fractional inhibitory concentration of 0.6. Propyl gallate, another alternative oxidase inhibitor, also potentiated atovaquone's activity, with a sum fractional inhibitory concentration of 0.7. Proguanil, which potentiates atovaquone activity in vitro and in vivo, had a small effect on parasite oxygen consumption in polarographic assays when used alone or in the presence of atovaquone or salicylhydroxamic acid. This suggests that proguanil does not potentiate atovaquone by direct inhibition of either branch of the parasite respiratory chain. (+info)
Atovaquone-proguanil compared with chloroquine and chloroquine-sulfadoxine-pyrimethamine for treatment of acute Plasmodium falciparum malaria in the Philippines. (2/172)This randomized, open-label clinical trial compared a fixed-dose combination of atovaquone and proguanil (n=55) with chloroquine (n=23) or a combination of chloroquine, sulfadoxine, and pyrimethamine (n=32) for treatment of acute falciparum malaria in the Philippines. Patients were hospitalized for 28 days to ensure medication compliance and prevent reinfection. Atovaquone-proguanil produced a significantly higher cure rate (100%) compared with that for chloroquine (30.4%; P<.0001) or chloroquine-sulfadoxine-pyrimethamine (87.5%; P<.05). Treatments did not differ significantly with respect to parasite clearance time (mean: 46.7 h for atovaquone-proguanil, 60.0 h for chloroquine, and 42.8 h for chloroquine-sulfadoxine-pyrimethamine) or fever clearance time (mean, 38.8, 46.8, and 34.5 h, respectively). Adverse events were typical of malaria symptoms; the most frequently reported events were vomiting (18% for atovaquone-proguanil, 17% for chloroquine, and 9% for chloroquine-sulfadoxine-pyrimethamine), abdominal pain (15%, 17%, and 3%, respectively), anorexia (11%, 13%, and 0%, respectively), and headache (6%, 17%, and 3%, respectively). Atovaquone-proguanil was well tolerated and more effective than chloroquine or chloroquine-sulfadoxine-pyrimethamine for treatment of multidrug-resistant falciparum malaria in the Philippines. (+info)
Prophylactic activity of atovaquone against Plasmodium falciparum in humans. (3/172)The prophylactic antimalarial activity of atovaquone was determined in a randomized, double-blind, placebo-controlled study of healthy volunteers who were challenged by the bite of Plasmodium falciparum-infected Anopheles stephensi. Subjects were randomly assigned to one of three groups: six received seven daily doses of 750 mg of atovaquone, starting the day before challenge; six received a single dose of 250 mg of atovaquone the day before challenge; and four received placebo. Polymerase chain reaction- and culture-confirmed parasitemia developed in all four placebo recipients, but in none of the drug recipients, indicating that either of the atovaquone regimens provides effective prophylaxis (P = 0.005). However, in low-dose recipients, the drug levels by day 6.5 were profoundly subtherapeutic, indicating that parasites were eliminated prior to the establishment of erythrocytic infection. Atovaquone thus protects non-immune subjects against mosquito-transmitted falciparum malaria, and has causal prophylactic activity. (+info)
A randomized, double-blind, placebo-controlled field trial to determine the efficacy and safety of Malarone (atovaquone/proguanil) for the prophylaxis of malaria in Zambia. (4/172)Malaria poses a major health risk to people who are exposed to infection in malaria-endemic areas. A randomized, double-blind, placebo-controlled study was conducted to determine the efficacy and safety of Malarone (250 mg of atovaquone/100 mg of proguanil hydrochloride per tablet) for the chemoprophylaxis of Plasmodium falciparum malaria in Zambia. Adult volunteers received a three-day treatment course of Malarone to eliminate pre-existing parasitemia and were then immediately randomized to treatment with either one Malarone tablet daily (n = 136), or one placebo tablet daily (n = 138) for at least 10 weeks. Malaria blood smears were prepared on a weekly basis and a failure of chemoprophylaxis was defined as any subject who had a positive blood smear, or who withdrew from the study due to a treatment-related adverse event. The prophylaxis success rates in the Malarone and placebo groups were 98% and 63%, respectively (P < 0.001). The most commonly reported adverse events with at least a possible causal relationship to study medication were headache and abdominal pain, which occurred with a higher incidence in the placebo group. No subjects were withdrawn from the study due to a treatment-related adverse event. Thus, Malarone appears to have an excellent safety and efficacy profile for the chemoprophylaxis of P. falciparum infection. (+info)
Efficacy and safety of atovaquone/proguanil compared with mefloquine for treatment of acute Plasmodium falciparum malaria in Thailand. (5/172)The increasing frequency of therapeutic failures in falciparum malaria underscores the need for novel, rapidly effective antimalarial drugs or drug combinations. Atovaquone and proguanil are blood schizonticides that demonstrate synergistic activity against multi-drug-resistant Plasmodium falciparum in vitro. In an open-label, randomized, controlled clinical trial conducted in Thailand, adult patients with acute P. falciparum malaria were randomly assigned to treatment with atovaquone and proguanil/hydrochloride (1,000 mg and 400 mg, respectively, administered orally at 24-hr intervals for three doses) or mefloquine (750 mg administered orally, followed 6 hr later by an additional 500-mg dose). Efficacy was assessed by cure rate (the percentage of patients in whom parasitemia was eliminated and did not recur during 28 days of follow-up), parasite clearance time (PCT), and fever clearance time (FCT). Safety was assessed by sequential clinical and laboratory assessments for 28 days. Atovaquone/proguanil was significantly more effective than mefloquine (cure rate 100% [79 of 79] vs. 86% [68 of 79]; P < 0.002). The atovaquone/proguanil and mefloquine treatments did not differ with respect to PCT (mean = 65 hr versus 74 hr) or FCT (mean = 59 hr versus 51 hr). Adverse events were generally typical of malaria symptoms and each occurred in < 10% of the patients in either group, with the exception of increased vomiting found in the atovaquone/proguanil group. Transient elevations of liver enzyme levels occurred more frequently in patients treated with atovaquone/proguanil than with mefloquine, but the differences were not significant and values returned to normal by day 28 in most patients. The combination of atovaquone and proguanil was well tolerated and more effective than mefloquine in the treatment of acute uncomplicated multidrug-resistant falciparum malaria in Thailand. (+info)
Malarone (atovaquone and proguanil hydrochloride): a review of its clinical development for treatment of malaria. Malarone Clinical Trials Study Group. (6/172)The continuing spread of drug-resistant malaria emphasizes the need for new antimalarial drugs. Atovaquone is a broad-spectrum antiprotozoal drug with a novel mechanism of action, via inhibition of parasite mitochondrial electron transport, and a favorable safety profile. Early studies with atovaquone alone for treatment of malaria demonstrated good initial control of parasitemia but an unacceptable rate of recrudescent parasitemia. Parasites isolated during recrudescence after treatment with atovaquone alone were resistant to atovaquone in vitro. The combination of atovaquone and proguanil is synergistic in vitro, and clinical studies demonstrated enhanced efficacy of the combination compared to either drug alone for treatment of malaria. Malarone, a fixed-dose combination of 250 mg of atovaquone and 100 mg of proguanil hydrochloride, is available in many countries for treatment of acute, uncomplicated malaria caused by Plasmodium falciparum. At the recommended dose (in adults, four tablets once a day for three days), the overall cure rate was > 98% in more than 500 patients with falciparum malaria. In four randomized, controlled clinical trials, treatment with atovaquone and proguanil hydrochloride was significantly more effective than mefloquine (Thailand), amodiaquine (Gabon), chloroquine (Peru and the Philippines) or chloroquine plus pyrimethamine/sulfadoxine (Philippines). In clinical trials where the comparator drug was highly effective, treatment with atovaquone and proguanil hydrochloride was equally effective. Parasites isolated during recrudescence after treatment with the combination of atovaquone and proguanil were not resistant to atovaquone in vitro. The most commonly reported adverse events in clinical trials (abdominal pain, anorexia, nausea, vomiting, diarrhea and coughing) occurred with similar frequency in patients treated with a comparator drug. Malarone is a safe and effective new agent for treatment of malaria. (+info)
A mechanism for the synergistic antimalarial action of atovaquone and proguanil. (7/172)A combination of atovaquone and proguanil has been found to be quite effective in treating malaria, with little evidence of the emergence of resistance when atovaquone was used as a single agent. We have examined possible mechanisms for the synergy between these two drugs. While proguanil by itself had no effect on electron transport or mitochondrial membrane potential (DeltaPsim), it significantly enhanced the ability of atovaquone to collapse DeltaPsim when used in combination. This enhancement was observed at pharmacologically achievable doses. Proguanil acted as a biguanide rather than as its metabolite cycloguanil (a parasite dihydrofolate reductase [DHFR] inhibitor) to enhance the atovaquone effect; another DHFR inhibitor, pyrimethamine, also had no enhancing effect. Proguanil-mediated enhancement was specific for atovaquone, since the effects of other mitochondrial electron transport inhibitors, such as myxothiazole and antimycin, were not altered by inclusion of proguanil. Surprisingly, proguanil did not enhance the ability of atovaquone to inhibit mitochondrial electron transport in malaria parasites. These results suggest that proguanil in its prodrug form acts in synergy with atovaquone by lowering the effective concentration at which atovaquone collapses DeltaPsim in malaria parasites. This could explain the paradoxical success of the atovaquone-proguanil combination even in regions where proguanil alone is ineffective due to resistance. The results also suggest that the atovaquone-proguanil combination may act as a site-specific uncoupler of parasite mitochondria in a selective manner. (+info)
Pharmacokinetics of azithromycin administered alone and with atovaquone in human immunodeficiency virus-infected children. The ACTG 254 Team. (8/172)To evaluate if atovaquone (ATQ) interacts pharmacokinetically with azithromycin (AZ) in human immunodeficiency virus-infected children, 10 subjects (ages, 4 to 13 years) were randomized in a crossover study to receive AZ (5 mg/kg/day) alone (ALONE) or AZ (5 mg/kg/day) and ATQ (30 mg/kg/day) simultaneously (SIM) prior to receiving AZ and ATQ staggered by 12 h. Despite a lack of significant difference in the mean AZ pharmacokinetic parameters, the steady-state values of AZ's area under the concentration-time curve from 0 to 24 h and maximum concentration in serum were consistently lower (n = 7 of 7) for the SIM regimen than they were for the ALONE regimen. A larger study will be required to determine if ATQ affects AZ pharmacokinetics and efficacy in a clinically significant manner. (+info)
... (alternative spelling: atavaquone) is a chemical compound that belongs to the class of naphthoquinones. Atovaquone ... Molecular Basis for Atovaquone Resistance in Pneumocystis jirovecii Atovaquone (Meprone) British National Formulary. ... Atovaquone is a medication used to treat or prevent: For pneumocystis pneumonia (PCP), it is used in mild cases, although it is ... However, atovaquone may be used in patients who cannot tolerate, or are allergic to, sulfonamide medications such as TMP-SMX. ...
Atovaquone alone is not indicated for treatment or prevention of malaria as monotherapy (i.e., without proguanil). Atovaquone/ ... Proguanil acts as a mitochondrial sensitiser and synergizes with atovaquone. When atovaquone is used as a sole agent, a high ... Atovaquone/proguanil is not licensed for use in children weighing 10 kg or less. The pediatric tablets are not used in malaria ... Atovaquone/proguanil is not normally used to treat severe malaria, when an injectable drug such as quinine is used instead. ...
Timeline of malaria
"Atovaquone/proguanil". springer.com. Retrieved 22 December 2016. "About MIM". Multilateral Initiative on Malaria. Retrieved May ...
Trevor M. Jones
Atovaquone (PCP/Malaria); Exosurf (infant respiratory distress); Mivacron and Nuromax (neuromuscular blockade); Wellferon ( ...
The addition of proguanil has shown to reduce resistance to atovaquone and increase the ability of atovaquone to trigger a ... "Atovaquone And Proguanil (Oral Route) Side Effects - Mayo Clinic". www.mayoclinic.org. Archived from the original on 2016-11-09 ... "Atovaquone and Proguanil Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 20 ... In the United States and Canada it is only available in combination as atovaquone/proguanil. Proguanil is used for the ...
Coenzyme Q - cytochrome c reductase
... atovaquone). Also propylhexedrine inhibits cytochrome c reductase. A small fraction of electrons leave the electron transport ...
November 2000). "Atovaquone and azithromycin for the treatment of babesiosis". N. Engl. J. Med. 343 (20): 1454-8. doi:10.1056/ ... treatment regimens have been increasingly leaning towards oral atovaquone with oral azithromycin. The latter are preferred, as ...
Doxycycline and atovaquone/proguanil provide protection within one to two days and may be better tolerated. If a person becomes ... In the mefloquine arm, 5% of the users reported severe events requiring medical attention, vs 1.2% in the atovaquone-proguanil ... October 2001). "Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: results from a ... Prophylaxis with mefloquine was compared to prophylaxis with atovaquone-proguanil. Roughly 67% of participants in the ...
... is a hydroxynaphthoquinone antiprotozoal drug related to parvaquone and atovaquone. It is a promising compound for ...
Anina D. Murphy & Naomi Lang-Unnasch (1999). "Alternative Oxidase Inhibitors Potentiate the Activity of Atovaquone against ...
However, more recent work has indicated that, while proguanil is synergistic with the drug atovaquone (as in the combination ... Srivastava IK, Vaidya AB; Vaidya (June 1999). "A mechanism for the synergistic antimalarial action of atovaquone and proguanil ... "Pharmacodynamic interactions among atovaquone, proguanil and cycloguanil against Plasmodium falciparum in vitro". Transactions ... Malarone), cycloguanil is in fact antagonistic to the effects of atovaquone, suggesting that, unlike cycloguanil, proguanil may ...
Atovaquone is available in combination with proguanil under the name Malarone, albeit at a price higher than Lariam. It is ... Atovaquone is recommended to be used only in combination with another anti-malarial compound as the selection of resistant ... A liquid oral suspension of Atovaquone is available under the name Mepron. Primaquine is a highly active 8-aminoquinolone that ... However it is useful in prophylaxis when combined with atovaquone or chloroquine (in areas where there is no chloroquine ...
Cohn, L.A.; Birkenheuer, A.J.; Brunker J.D.; Ratcliff E.R.; Craig, A.W. (2011). "Efficacy of Atovaquone and Azithromycin or ... Cohn, L.A.; Birkenheuer, A.J., Brunker J.D., Ratcliff E.R., Craig, A.W. (2011). "Efficacy of Atovaquone and Azithromycin or ... 60% of sick cats treated with supportive care and the combination of the anti-malarial drug atovaquone and the antibiotic ... The most often used treatments for cytauxzoonosis are imidocarb dipropionate and a combination of atovaquone and azithromycin. ...
In areas where resistance is present, other antimalarials, such as mefloquine or atovaquone, may be used instead. The Centers ...
... and the combination of atovaquone and proguanil hydrochloride (Malarone) is frequently needed. Doxycycline and the atovaquone ... atovaquone/proguanil (Malarone) 1 tablet daily (started one day before travel, and continued for 1 week after returning). Can ...
Other medications that are used, alone or in combination, include pentamidine, trimetrexate, dapsone, atovaquone, primaquine, ... In immunocompromised patients, prophylaxis with co-trimoxazole (trimethoprim/sulfamethoxazole), atovaquone, or regular ...
Dihydrofolate reductase inhibitor
Cycloguanil, a metabolite of proguanil (a component of the oral antimalarial atovaquone-proguanil, or Malarone) Huennekens FM ( ...
The medications prescribed for latent toxoplasmosis are: Atovaquone - an antibiotic that has been used to kill Toxoplasma cysts ... Djurković-Djaković O, Milenković V, Nikolić A, Bobić B, Grujić J (2002). "Efficacy of atovaquone combined with clindamycin ... inside AIDS patients Clindamycin - an antibiotic that, in combination with atovaquone, seemed to optimally kill cysts in mice ...
"Mutation underlying resistance of Plasmodium berghei to atovaquone in the quinone binding domain 2 (Qo(2)) of the cytochrome b ... berghei are associated with resistance to the anti-malarial drug atovaquone. Human genes encoding cytochrome b proteins include ...
Institute for Tropical Medicine Tuebingen
The institute's achievements include contributions to the development of malaria drugs, such as atovaquone-proguanil, ...
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... may refer to: Atovaquone, a chemical compound that belongs to the class of naphthalenes Mepron (rumen-protected ...
These applications include purgative (sennosides), antimicrobial and antiparasitic (rhein- and saprorthoquinone, atovaquone), ...
List of GlaxoSmithKline products
... atovaquone and proguanil hydrochloride) Mepron (atovaquone) Mivacron (mivacurium chloride) Naramig (naratriptan hydrochloride) ... atovaquone) Zantac (ranitidine hydrochloride) Zeffix (lamivudine) Zinacef (cefuroxime) Zinnat (cefuroxime axetil) Zofran ( ...
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Drug Interaction Study Between Atovaquone and Antiretroviral Agents in HIV-1 Infected Patients - Full Text View -...
Malarone® (atovaquone/proguanil) is frequently used in malaria prophylaxis. Unfortunately, there are indications that certain anti-HIV agents may decrease atovaquone plasma levels by induction of atovaquone metabolism.. For travelling HIV patients, the clinical consequences of these possible drug drug interactions are serious, since a diminished exposure to the anti-malarial drug will result in suboptimal prophylaxis of malaria and potential development of drug resistant strains of Plasmodium falciparum.. The purpose of this study is to find out if HIV patients using HAART regimes with either lopinavir/ritonavir, atazanavir/ritonavir or efavirenz have lower atovaquone plasma levels than healthy volunteers after a single dose of atovaquone/proguanil. ...
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To evaluate if atovaquone (ATQ) interacts pharmacokinetically with azithromycin (AZ) in | Selective Inhibitors of Protein...
To evaluate if atovaquone (ATQ) interacts pharmacokinetically with azithromycin (AZ) in human being immunodeficiency virus-infected children, 10 subjects (ages, 4 to 13 years) were randomized inside a crossover study to receive AZ (5 mg/kg/day time) only (ALONE) or AZ (5 mg/kg/day time) and ATQ (30 mg/kg/day time) simultaneously (SIM) prior to receiving AZ and ATQ staggered by 12 h. larger study will be required to determine if ATQ affects AZ pharmacokinetics and effectiveness inside a clinically significant manner. Children infected with human being immunodeficiency computer virus (HIV) have an increased risk of severe and recurrent infections (3, 15, 16, 18, 20), among which the most common is definitely pneumonia (PCP). A new, promising combination, azithromycin (AZ) plus atovaquone (ATQ), is currently under investigation inside a phase II/III medical trial (ACTG 254) to compare its efficiency and protection with those of trimethoprim-sulfamethoxazole in the prophylaxis of multiple ...
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Physician reviewed atovaquone and proguanil patient information - includes atovaquone and proguanil description, dosage and directions.
Information for health care professionals and patients on malaria, its treatment, and prophylaxis using Malarone (atovaquone proguanil HCI) tablets from GlaxoSmithKline. ...
Atovaquone and Proguanil is a very strong oral medication marketed under the brand name Malarone that is intended for the treatment of malaria.
... are medications to treat malaria, a disease caused by parasites. These medicines work by interfering with the growth of parasites in the red blood cells of the human body. Parasites that cause malaria typically enter the body through the bite of a mosquito. Malaria is common in areas such as...
What is in this leaflet?Unless explained differently, the information for Malarone in this leaflet applies to both Malarone Tablets (250/100) and Malarone Junior Tablets (62.5/25) (refer to the Product description section near the end of the leaflet for a description of these two products).Please read this leaflet carefully before you take Malarone.This leaflet answers some common questions about Malarone. It does not contain all of the available information.It does not take the place of talking..
Comparison of Atovaquone and Azithromycin with Trimethoprim-Sulfamethoxazole for the Prevention of Serious Bacterial Infections...
Background. Trimethoprim-sulfamethoxazole (TMP-SMZ) has been used extensively for the prevention of Pneumocystis carinii (also referred to as "Pneumocystis jiroveci") pneumonia (PCP) and other opportunistic infections in human immunodeficiency virus (HIV)-infected children. Because the efficacy of TMP-SMZ for treatment of bacterial infections is limited, it is sometimes poorly tolerated, and there is risk of emergence of drug-resistant strains associated with widespread use, we evaluated a regimen that included atovaquone and azithromycin.. Methods. A randomized, double-blind, placebo-controlled trial was designed to determine whether atovaquone-azithromycin had equivalent efficacy to TMP-SMZ for the prevention of serious bacterial infections and to compare the long-term tolerance, PCP breakthrough rates, and nonserious bacterial infection rates among HIV-infected children aged 3 months to 19 years. Children qualified for PCP prophylaxis (on the basis of Centers for Disease Control and ...
Learn about Mepron (Atovaquone) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications.
Atovaquone - Mechanism, Indication, Contraindications, Dosing, Adverse Effect, Interaction | Drug Index | Pediatric Oncall
Medical information for Atovaquone on Pediatric Oncall including Mechanism, Indication, Contraindications, Dosing, Adverse Effect, Interaction.
No studies have been done on breastfeeding and Malarone (atovaquone/proguanil). However, as this eMedTV page explains, the drug is not likely to pass through breast milk in high amounts. This article offers more details on using Malarone while nursing.
NaTHNaC - Anti-malaria tablets: one brand of atovaquone/proguanil to be available to purchase without prescription
TravelHealthPro is the website comprising the travel health resources of the National Travel Health Network and Centre (NaTHNaC).
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A Study to Compare Different Drugs Used to Prevent Serious Bacterial Infections in HIV-Positive Children - Full Text View -...
Although SMX/TMP remains the drug of choice for PCP prophylaxis, drug sensitivity may limit its use. Atovaquone has demonstrated greater safety than SMX/TMP and thus is suitable as a candidate drug for treatment and prophylaxis of PCP. Azithromycin, with a broad anti-microbial spectrum (including mycoplasma and atypical mycoplasma), is an attractive prophylactic agent for use in children with HIV infection, due to its relative safety and once-daily dosing regimen. Therefore, the combination of atovaquone and azithromycin may offer broader antimicrobial coverage and greater safety than SMX/TMP.. Patients are randomized to receive either SMX/TMP or combination micronized atovaquone/azithromycin. Crossover to the alternative regimen may occur if serious toxicity is observed. Patients are monitored for occurrence of serious bacterial infections or PCP breakthrough, and when a serious bacterial infection occurs, patients are crossed over to the alternative regimen. Treatment continues until 2 years ...
Atovaquone | Davis's Drug Guide for Rehabilitation Professionals | F.A. Davis PT Collection | McGraw-Hill Medical
Assess pulmonary function by measuring lung volumes, breath sounds, respiratory rate, and other symptoms (cough, dyspnea, shortness of breath) (See Appendices I, J, K). Report changes in pulmonary function to help document the effects of drug therapy in treating PCP infections. ...
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In seven controlled trials, 436 adolescents and adults received atovaquone and proguanil hydrochloride for treatment of acute, uncomplicated P. falciparum malaria. The range of mean ages of subjects was 26 to 29 years; 79% of subjects were male. In these studies, 48% of subjects were classified as other racial/ethnic groups, primarily Asian; 42% of subjects were black and the remaining subjects were white. Attributable adverse experiences that occurred in ≥ 5% of patients were abdominal pain (17%), nausea (12%), vomiting (12%), headache (10%), diarrhea (8%), asthenia (8%), anorexia (5%), and dizziness (5%). Treatment was discontinued prematurely due to an adverse experience in 4 of 436 (0.9%) adolescents and adults treated with atovaquone and proguanil hydrochloride.. In two controlled trials, 116 pediatric patients (weighing 11 kg to 40 kg) (mean age 7 years) received atovaquone and proguanil hydrochloride for the treatment of malaria. The majority of subjects were black (72%); 28% were of ...
Clinical experience with atovaquone on a treatment investigational new drug protocol for Pneumocystis carinii pneumonia | RTI
The clinical experience of human immunodeficiency virus (HIV) + patients treated with oral atovaquone for acute Pneumocytstis carinii pneumonia (PCP) under a Treatment Investigational New Drug (IND) protocol (mild or moderate PCP) and an Open-Label Study protocol (severe PCP) was evaluated. A total of 940 patients intolerant of or unresponsive to trimethoprimsulfamethoxazole were enrolled from private practices, clinics, and institutional HIV treatment centers in the United States. Demographics data and the history and severity of PCP were collected at enrollment.
The patent for Malarone, an anti malarial drug ran out last year and you can now buy generic (unbranded, but identical) tablets at a highly reduced price. After shopping around extensively for a weeks worth of the drug being quoted upwards of £50 for the course (16 tablets). I found that ASDA sell it at £1 per tablet, which is less than half the price of any other high street pharmacy and 65p less per tablet than the cheapest online pharmacy I could find. Hope this helps anyone trying to travel on a budget ...
According to the guidelines for India Chemoprophylaxis should be administered only in selective groups in high P.falciparum endemic areas. Use of personal protection measures is encouraged for pregnant women and other vulnerable population including travellers. However, for longer stay of Military and Para-military forces in high Pf endemic areas, the practice of chemoprophylaxis is to be followed wherever appropriate. For Short term chemoprophylaxis (up to 6 weeks) Doxycycline, is the drug of choice. Chemoprophylaxis for longer stay (more than 6 weeks) is with Mefloquine.. Regimens currently recommended for use in South Africa (2009), include Mefloquine, Doxycycline or Atovaquone - proguanil.. Guidelines from the Health Protection Agency Advisory Committee on Malaria Prevention (ACMP) in UK travellers (2007) recommend Mefloquine, or Doxycycline or Atovaquone/Proguanil for travel to high risk areas of Bangladesh and India. Chloroquine plus proguanil is recommended as an alternative. For ...
Antibiotics Manual: A Guide to commonly used antimicrobials | Infectious Disease & Microbiology | Medicine, Nursing & Dentistry...
Preface xvi. Abacacavir (Ziagen) 435. Abacavir + Lamivudine + Dolutegravir (Triumeq) 381. Acyclovir (Zovirax) 442. Adefovir (Hepsera) 187. Albendazole (Albenza) 3. Amikacin (Amikin) 9. Amoxicillan 11. Amoxicillin-Clavulanate (Augmentin, Augmentin 600ES, Augmentin XR) 32. Amphotericin B (Fungizone) 169. Amphotericin B Colloidal Dispersion - ABCD (Amphotec) 13. Amphotericin B Lipid Complex (Abelcet) 1. Ampicillin 15. Ampicillin-Sulbactam (Unasyn) 394. Anidulafungin (Eraxis) 149. Artemether/Lumefantrine (Coartem) 92. Artesunate 27. Atazanavir (Reyataz) 317. Atazanavir + Cobicistat (Evotaz) 152. Atovaquone (Mepron) 240. Atovaquone/Proguanil (Malarone) 230. Azithromycin (Zithromax, Zmax) 437. Aztreonam (Azactam) 40. Bedaquiline (Sirturo) 337. Benznidazole 51. Bithionol (Bitin) 57. Capreomycin (Capastat) 62. Caspofungin (Cancidas) 60. Cefaclor 66. Cefadroxil (Duricef) 135. Cefamandole (Mandol) 232. Cefazolin (Ancef) 18. Cefdinir (Omnicef) 270. Cefditoren Pivoxil (Spectracef) 343. Cefepime (Maxipime) ...
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A 50-year-old Nigerian man was admitted for generalized non febrile seizures. Two weeks before his GP prescribed antimalaric prophilaxis with clorochine for a planned trip in his home country. He suffered of a minor stroke 2 years before with no residual disability. He had also history of arterial hypertension treated with ace inhibitors and aspirin. At admission he was treated with lorazepam i.v. for a second generalized crisis at admission, and started carbamazepine 1000 per day. No other critical events were found during in hospital staying. A CT scan demonstrated the known subcortical right hemispheric hypodensity with no sulcal effacement or swelling features. Three months later carbamazepine was gradually intterrupted. After few months a new trip to Lagos was planned and chosen an antimalaric prophilaxis with Proguanil/Atovaquone (Malarone). The drug was well tolerated and no side effects were detected.. Take home message ...
Proguanil is an anti malarial drug which is given orally. Proguanil is also known as schizonticide. Proguanil is useful as a chemoprophylaxis against malaria.
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Doxycycline. There is no evidence for human teratogenicity with doxycycline use during pregnancy. 8 Despite this, the main concern with doxycycline, like tetracycline, is the risk to the fetus of inhibition of bone growth and discoloration and dysplasia of the teeth, 3 which can occur during the period of calcification beyond the fourth month of gestational age. 4 Because of the potential harm, doxycycline is not recommended during pregnancy. However, keeping in mind that treatment is continued for 4 weeks after leaving the malaria-endemic area, 9 doxycycline can be considered as long as treatment is completed by the fourth month of pregnancy.. Atovaquone-proguanil. Proguanil has been used as a malarial prophylactic agent for decades, with no known toxic effects on the fetus. 10 Four small 3-day treatment studies with the atovaquone-proguanil combination in the second and third trimesters of pregnancy did not identify any adverse effects in the fetuses or newborns. 11-14 In a recent ...
Learn about The ABCD of malaria prophylaxis and the awareness of risk in Malaria Prophylaxis. Learn more about Malaria Prophylaxis.
I am pleased to announce our latest research project: my staff and I are participating in the following very important initiative.. 3 Day Malarone Acceptability and Tolerability research project (3MAT). Malaria is one of the most common causes of fever in Australian travellers, with approximately 400 cases reported each year in Australia. Most travellers who develop malaria did not take anti-malarial medications, or did not take the medications properly (e.g. forgot to take tablets). Malaria is a serious illness and can potentially be fatal.. A research project is being conducted with the aim to make it easier and cheaper to take malaria pills and thus reduce the risk of malaria in travellers. Malarone is a safe and effective anti-malarial medication. The standard dosage of Malarone for prevention of malaria is one tablet per day, starting 2 days before travelling to a malaria area, daily while in a malaria area, and continuing until 7 days after leaving the malaria area.. Research has shown ...
JCI Insight - cGAS-mediated control of blood-stage malaria promotes Plasmodium-specific germinal center responses
Our investigations reveal that cGAS contributes to parasite control, which is essential for the formation of GC-derived humoral immunity. The ability to simultaneously identify and analyze endogenous polyclonal antigen-specific CD4+ T cells and B cells responding to Plasmodium has revealed a profound effect of innate immune control of parasitemia. Control of parasitemia is important for timely development of the GC response, a response critical for both the efficient generation of high-affinity antibodies and durable immune memory (59-62). Furthermore, our ability to track parasitemia throughout the course of infection combined with the potential to rapidly clear blood-stage infection with atovaquone provided us with an elegant system in which the effects of innate control of parasite burden could be disentangled from the effects of early innate signals on the adaptive immune response. Specifically, the collapse of the GC response in cGAS-/- mice as parasitemia persisted could be abolished with ...
Various analytical methods for formulations, raw materials, APIs and intermediates have been developed at SDPARC. Instrumental methods developed include, Proguanil Hydrochloride, Forskolin, Guggulsterone, Many dissolutions methods have been developed and validated at the centre. Methods for estimating residual solvents and organic volatile impurities are also developed and validated at the centre.. ...
The most common side effects of proguanil (Malarone) are vomiting, headache, diarrhea, loss of appetite, nausea, and mouth sores. Some people temporar
Medications that can be used for the treatment of malaria in pregnancy include chloroquine, quinine, atovaquone-proguanil, clindamycin, mefloquine (avoid in first trimester), sulfadoxine-pyrimethamine... more
It works by killing the parasites in the blood and also in the liver. It is effective against strains of falciparum malaria which may be resistant to other antimalarials and so is especially useful for those travelling to places where there is a high risk of encountering malaria which is resistant to other drugs. It would be particularly useful for those individuals who cannot tolerate, or who are unable to take mefloquine ...
Proguanil is used to prevent malaria. It is usually used in combination with another antimalarial medicine to increase its effectiveness.
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Malaria Medication? - Medications & Other Treatments - Hallucinogen Persisting Perception Disorder (HPPD) Support Forum
Has anyone had any issues with malaria medications like atovaquone-proguanil? Im going to Thailand, Vietnam, and Cambodia this month and am very worried ab...
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Research: Malaria chemoprophylaxis: cross-sectional study of use among air travellers departing from Accra, Ghana | MalariaWorld
This study investigated the use of chemoprophylaxis for malaria prevention in air travellers departing from Kotoka International Airport (KIA) in Accra, Ghana. A cross-sectional study was conducted in the departure lounge of the KIA between February and May 2012. A total of 424 respondents voluntarily completed a semi-structured questionnaire, which included socio- demographic characteristics, duration of stay, nationality, country of permanent residence, chemoprophylaxis used, number of doses missed, cost and side effects experienced, and cost of treatment. The mean age of respondents was 37 ± 0.84 years with a male:female ratio of 1.2:1.The mean duration of stay in Ghana was 47.9 days [SD 56.8] and 73.5% had made one trip to the country in the preceding year. Of the respondents, 50.7% were from Europe, 24.1% from North America and 17.5% from Africa. The most popular malaria prevention method used was prophylactics (37%) with atovaquone/proguanil used most frequently (34.9%), followed by ...
Environmental, Health and Safety News: Babesiosis is an emerging tickborne life-threatening, disease endemic to the...
Babesiosis is an emerging zoonotic disease caused primarily by Babesia microti, an intraerythocytic protozoan. Babesia microti, like the causal agents for Lyme disease and anaplasmosis, is endemic to the northeastern and upper midwestern United States where it is usually transmitted by the blacklegged tick, Ixodes scapularis. Although babesiosis is usually a mild to moderate illness, older or immunocompromised persons can develop a serious malaria-like illness that can be fatal without prompt treatment. The most common initial clinical signs and symptoms of babesiosis (fever, fatigue, chills, and diaphoresis) are nonspecific and present diagnostic challenges that can contribute to delays in diagnosis and effective treatment with atovaquone and azithromycin (1). Results of one study revealed a mean delay of 12-14 days from symptom onset to treatment (2). Knowledge of the incidence and geographic distribution of babesiosis can raise the index of clinical suspicion and facilitate more prompt ...
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Question: Hello, Im wondering if I should be worried about whether my malaria will come back or not. I came down with Falciparum in the US and was treated with malarone pills (four pills a day for three days); was ill enough to be hospitalized, but did not have severe malaria. About a week and a half after finishing the treatment (and two days after returning to a malaria-endemic country) I … [Read more...] ...
Latest advice on Malaria prophylaxis (oral medication) is routinely provided.It is always advisable to speak to Dr Edmonds before coming for vaccinations as some vaccines have to be ordered specially in advance and may not be in stock ...
Genetic Confirmation of Atovaquone-Proguanil-Resistant Plasmodium falciparum Malaria Acquired by a Nonimmune Traveler to East...
We report a case of atovaquone-proguanil-resistant Plasmodium falciparum malaria acquired by a nonimmune traveler to Kenya. Recurrent parasitemia occurred 30 days after directly observed therapy with a combination of atovaquone and proguanil. Treatment failure was confirmed by genetic fingerprinting and sequencing. The primary isolate had wild-type sequence of cytochrome b; however, the recrudescent isolate had a single mutation at position 268 (Tyr268Ser).. ...
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PubMed journal article [Therapeutic alternatives for cases of cerebral toxoplasmosis in patients with AIDS: clarithromycin and atovaquone were found in PRIME PubMed. Download Prime PubMed App to iPhone or iPad.
Malarone: highly effective, well-tolerated, and with an extremely low rate of side-effects, but more expensive and currently only available on an unlicensed basis from specialist centres. Chloroquine and Paludrine have little risk of side effects and were previously widely used, but are now only about 50-60 per cent effective in many parts of East, West, and Central Africa, and must be used with caution, if at all. Commercial import to Tanzania has even been stopped.. Whatever your choice, you must take an anti malarial drug if you are visiting a malarial region, and you must continue taking the drug for the necessary period after your return; you must also take precautions to reduce the number of insect bites (see below).. Visitors to malarial areas are at much greater risk than local people and long term expatriates - from malaria as from several other diseases: do not change or discontinue your malaria medication other than on skilled professional advice. Travellers to very remote places ...
Chloroquine was the most widely used anti-malarial, until recently when parasitic strains became drug-resistant. It is also the least expensive, best tested and safest of all the drugs. It can be used in conjunction with Proguanil in areas of drug resistance. But Mefloquine, Doxycycline and Malarone are recommended if visiting an area known for drug resistance.. All of these drugs can give you higher sensitivity to the sun, nausea, diarrhea, or a dull headache. Nausea especially, can occur when you dont take the malaria tablet with or after food.. Slight hair loss and mouth ulcers have been occasionally reported with the use of Proguanil. Mefloquine has been found to cause vivid dreams and nightmares among some users. Doxycycline can cause abnormal tooth enamel, depression of bone growth and photosensitivity, so its not recommended for young children or pregnant women.. If youre not used to taking medication or vitamins daily, then sticking to a new regimen might be hard. The drugs are not ...
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The American Journal of Tropical Medicine and Hygiene | A Classification of Measures of Malaria Prophylaxis and Mosquito Control
Science, in one of its meanings, is co-ordinated and systematized knowledge. Co-ordination and system imply classification, and it is useful occasionally to spend a little time in preparing or testing systematic groupings of the various phases of a given specialty. Exhaustive and organized lists of this sort may lead to clearer understanding of both extent and limitations of a subject, orienting one's thinking and perhaps suggesting lines of experimentation. Classifications of measures of malaria prophylaxis and mosquito control have been few and not very satisfactory. The material for this paper has been developed over a period of years and is based partly on studies published by Russell (1934), by Russell and Hackett (1938), and by Hackett et al. (1938). It is an attempt to prepare a systematic list in which every recently suggested measure is included in its logical place.
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There is a £10 charge for duplicate certification or exemption certificates.. Malaria Tablets:. Paludrine & Chloroquine & now Malarone are available without a private prescription from most Pharmacys over the counter. The nurse or Pharmacist will advise you at your what type of anti-malarial medication is required for your particular destination.. All other malaria tablets are available on a private prescription for which there is an £15 charge. You can then shop around for the best price for the actual tablets as the costs do differ.. At our surgery we use the on line professional Travax system which is up dated daily. You can access its sister site for advice and information from home www.fitfortravel.scot.nhs.uk ...
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A 26 y/o medical student who took primaquine for malaria prophylaxis for a mission trip to Nigeria presents with malaise, fatigue and weakness. A peripheral
Cannot be used in areas with chloroquine or mefloquine resistance; May exacerbate psoriasis; Some people would rather not take a weekly medication; For trips of short duration, some people would rather not take medication for 4 weeks after travel; Not a good choice for last-minute travelers because drug. Four medications are commonly used in the USA to prevent malaria while traveling: Atovone/proguanil (Malarone), mefloqine (Lariam), chloroquine (Aralen), and doxycycline. But which medication should you take to prevent malaria when traveling? Here is a simple way to choose between the medications.. Lariam (mefloquine) chloroquine lariam used for the treatment of mild to urgent acute malaria caused by mefloquine-susceptible instances of P. chloroquine lariam falciparum (both chloroquine-susceptible and shaky strains) or by Giving chloroquine lariam. There are unique clinical data to document the medication of mefloquine in malaria caused by P. ovale or. Hand Approach: The effects of quinine, ...
National News: Docs debate benefits of malaria drugs (12/26/02) | Southeast Missourian newspaper, Cape Girardeau, MO
Dont expect a simple answer.. Different risks. The malaria parasite has developed resistance to that old standby drug, chloroquine, in most of the world, rendering it largely useless. That leaves most travelers three options: Lariam, a newer and possibly safer drug called Malarone, and the antibiotic doxycycline.. Each has pros and cons that make declaring a No. 1 choice for everybody all but impossible, cautions Dr. Bradley Connor, a New York travel-medicine specialist.. "Your one-week business traveler vs. your teenage backpacker across Africa have very different risks," agreed Dr. Kevin Kain, director of the University of Torontos Center for Travel and Tropical Medicine.. All three drugs "work well if you take them," Kain said. Customizing the prescription to each patients health and destination can limit side effects, ensuring travelers dont abandon their pills.. The advantages and disadvantages are the reason the Centers for Disease Control and Prevention wants to debate the matter at ...
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Here is a an interesting travel medicine post regarding vaccinations taken by a US scientist traveling to Tanzania. Many Indians appear skeptical about the need for these vaccinations, but most Westerners take it quite seriously. I always urge all travelers coming to me to not only complete the recommended vaccinations, but consider taking Malaria prophylaxis, […]. ...
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- The combination of atovaquone and proguanil to treat malaria was patented by Glaxo Wellcome in 1999, and its patent protection expired in 2013. (wikipedia.org)
- The combination of atovaquone and proguanil is used to treat a certain kind of malaria infection (a serious infection that is spread by mosquitoes in certain parts of the world and can cause death) and to prevent a certain kind of malaria infection in travelers who visit areas where malaria is common. (medlineplus.gov)
- The combination of atovaquone and proguanil comes as a tablet to take by mouth. (medlineplus.gov)
- The combination of atovaquone and proguanil is used to treat or prevent malaria. (rexhealth.com)
- The combination of atovaquone and proguanil hydrochloride may not be effective for treatment of recrudescent malaria that develops after prior therapy with the combination. (bioportfolio.com)
- If you are taking atovaquone and proguanil to prevent malaria, you will probably start taking it once daily 1 or 2 days before you travel to an area where malaria is common, and then continue during your time in the area and for 7 days after you return. (medlineplus.gov)
- If you are taking atovaquone and proguanil to treat malaria, you will probably take it once daily for 3 days in a row. (medlineplus.gov)
- If you become pregnant while taking atovaquone and proguanil, call your doctor. (medlineplus.gov)
- If you are taking atovaquone and proguanil to prevent malaria, call your doctor immediately if you develop any of these symptoms. (medlineplus.gov)
- In addition to taking atovaquone and proguanil, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could cause malaria. (rexhealth.com)
- What should I discuss with my healthcare provider before taking atovaquone and proguanil? (rexhealth.com)
- Always take atovaquone and proguanil with food or a milky drink. (medlineplus.gov)
- Take atovaquone and proguanil at around the same time every day. (medlineplus.gov)
- Take atovaquone and proguanil exactly as directed. (medlineplus.gov)
- If you vomit within 60 minutes after you take atovaquone and proguanil, take another full dose. (medlineplus.gov)
- Your doctor may tell you not to take atovaquone and proguanil. (medlineplus.gov)
- Take atovaquone and proguanil at the same time each day with food or a milky drink. (rexhealth.com)
- How should I take atovaquone and proguanil? (healthbanks.com)
- Finally, in patients with acute myelogenous leukemia treated with hematopoietic stem cell transplantation, extended use of atovaquone for Pneumocystis prophylaxis was associated with improved relapse-free survival. (bloodjournal.org)
- Malarone® (atovaquone/proguanil) is frequently used in malaria prophylaxis. (clinicaltrials.gov)
- The available data on the efficacy of atovaquone prophylaxis in Toxoplasma sero-positive stem cell transplant recipients remain limited, and other strategies, such as preemptive strategy using toxoplasma PCR or TMP-SMX desensitization should be considered in this setting. (ovid.com)
- Atovaquone and proguanil tablets are available in two combination strengths: 250/100 mg (adults) and 62.5/25 mg (pediatric). (medicinenet.com)
- Store Atovaquone and proguanil tablets should be stored between 15 C to 30 C (59 F to 86 F). (medicinenet.com)
- Pediatric Tablets are a fixed-dose combination of the antimalarial agents atovaquone and proguanil hydrochloride. (bioportfolio.com)
- Atovaquone and Proguanil Hydrochloride Pediatric Tablets are for oral administration. (bioportfolio.com)
- Atovaquone and proguanil hydrochloride tablets should be taken with food or a milky drink. (bioportfolio.com)
- MALARONE (atovaquone and proguanil hydrochloride) Tablets (adult strength) and MALARONE (atovaquone and proguanil hydrochloride) Pediatric Tablets, for oral administration, contain a fixed-dose combination of the antimalarial agents atovaquone and proguanil hydrochloride. (rxlist.com)
- Generic Malarone (atovaquone 250mg) (proguanil 100mg) tablets are brought to you by our Online Doctor Service to help prevent the risk of being infected with malaria. (chemistdirect.co.uk)
- Please note, like all medicine, Generic Malarone (atovaquone 250mg) (proguanil 100mg) tablets can cause side effects - although this does not apply to everyone who has taken them. (chemistdirect.co.uk)
- Please read all packaging before taking Generic Malarone (atovaquone 250mg) (proguanil 100mg) tablets. (chemistdirect.co.uk)
- Atovaquone Proguanil 250mg/100mg (Generic - Malarone Tablets): Always take Malarone exactly as your doctor has told you. (chemistdirect.co.uk)
- These highlights do not include all the information needed to use atovaquone and proguanil hydrochloride tablets safely and effectively. (nih.gov)
- See full prescribing information for atovaquone and proguanil hydrochloride tablets. (nih.gov)
- Tablets (adult strength): 250 mg atovaquone and 100 mg proguanil hydrochloride. (nih.gov)
- Pediatric Tablets: 62.5 mg atovaquone and 25 mg proguanil hydrochloride. (nih.gov)
- Enhanced efficacy of the combination compared to either atovaquone or proguanil hydrochloride alone was demonstrated in clinical studies in both immune and non-immune patients (see CLINICAL STUDIES). (bioportfolio.com)
- Atovaquone shows anticancer efficacy in vitro, in vivo, and in a retrospective study of AML patient outcomes after atovaquone treatment. (bloodjournal.org)
- These findings establish atovaquone as a novel, clinically accessible STAT3 inhibitor with evidence of anticancer efficacy in both animal models and humans. (bloodjournal.org)
- Combining atovaquone/proguanil with tetracycline can lower atovaquone levels in the body, leading to lack of effectiveness of the antimalarial medication. (medicinenet.com)
- Concomitant use of atovaquone/proguanil and rifampin or rifabutin can lower atovaquone levels approximately 50% and 34%, reducing effectiveness of malarial medication. (medicinenet.com)
- The purpose of this study is to find out if HIV patients using HAART regimes with either lopinavir/ritonavir, atazanavir/ritonavir or efavirenz have lower atovaquone plasma levels than healthy volunteers after a single dose of atovaquone/proguanil. (clinicaltrials.gov)
- MEPRON (atovaquone) is a quinone antimicrobial drug for oral administration. (rxlist.com)
- MEPRON suspension is a formulation of micro- fine particles of atovaquone. (rxlist.com)
- Each 5 mL of MEPRON suspension contains 750 mg of atovaquone and the inactive ingredients benzyl alcohol , flavor, poloxamer 188, purified water, saccharin sodium, and xanthan gum. (rxlist.com)
- MEPRON is a bright yellow, citrus-flavored, oral suspension containing 750 mg of atovaquone in 5 mL. (rxlist.com)
- MEPRON suspension (bright yellow, citrus-flavored) containing 750 mg atovaquone in 5 mL. (rxlist.com)
- Using a computational strategy to identify compounds opposing the gene expression signature of STAT3, we discovered atovaquone (Mepron), an antimicrobial approved by the US Food and Drug Administration, to be a potent STAT3 inhibitor. (bloodjournal.org)
- This is potentially due to the high lipophilicity and slow uptake of atovaquone, which results in a relatively prolonged period of parasite exposure at ineffective concentrations. (wikipedia.org)
- Through the use of this technology, the trans-Atlantic research team developed an LAI version of a daily anti-malarial tablet (atovaquone) which provided prophylactic blood concentrations in mice for a period of 28 days. (medindia.net)
- The FDA-approved drug atovaquone is a novel, clinically available inhibitor of STAT3 at standard human plasma concentrations. (bloodjournal.org)
- We show that, at drug concentrations routinely achieved clinically in human plasma, atovaquone inhibits STAT3 phosphorylation, the expression of STAT3 target genes, and the viability of STAT3-dependent hematological cancer cells. (bloodjournal.org)
- The extent of plasma protein binding of atovaquone in human plasma is not affected by the presence of therapeutic concentrations of phenytoin, nor is the binding of this drug affected by the presence of atovaquone. (pediatriconcall.com)
- Atovaquone and proguanil is an anti-malarial medication. (medicinenet.com)
- Long-acting injectable version of a daily anti-malarial tablet (atovaquone) has now been developed. (medindia.net)
- A long-acting injectable version of atovaquone aims to utilize nanotechnology to improve the delivery of an existing anti-malarial drug. (medindia.net)
- Atovaquone and proguanil (Malarone) oral is a medication prescribed to treat and prevent malaria. (medicinenet.com)
- Atovaquone and proguanil should not be used to treat malaria in a child who weighs less than 11 pounds, and should not be used to prevent malaria in a child who weighs less than 24 pounds. (healthbanks.com)
- Use atovaquone and proguanil regularly to best prevent malaria. (healthbanks.com)
- If you stop taking atovaquone too soon or skip doses, your infection may not be completely treated or you may not be protected from future infections. (medlineplus.gov)
- Atovaquone will not treat these infections. (medlineplus.gov)
- Atovaquone, a new 'long-acting' injectable medicine can provide longer protection against malarial plasmodium infections, finds a new study. (medindia.net)
- Which drugs or supplements interact with atovaquone-proguanil-oral? (medicinenet.com)
- This list is not complete and other drugs may interact with atovaquone and proguanil. (everydayhealth.com)
- Therefore, caution should be used when administering atovaquone concurrently with other highly plasma protein bound drugs with narrow therapeutic indices, as competition for binding sites may occur. (pediatriconcall.com)
- Atovaquone is not a kinase inhibitor but instead rapidly and specifically downregulates cell-surface expression of glycoprotein 130, which is required for STAT3 activation in multiple contexts. (bloodjournal.org)
- When atovaquone is used to treat pneumonia, it is usually taken with meals twice a day for 21 days. (medlineplus.gov)
- When atovaquone is used to prevent pneumonia, it is usually taken with a meal once a day. (medlineplus.gov)
- The clinical experience of human immunodeficiency virus (HIV) + patients treated with oral atovaquone for acute Pneumocytstis carinii pneumonia (PCP) under a Treatment Investigational New Drug (IND) protocol (mild or moderate PCP) and an Open-Label Study protocol (severe PCP) was evaluated. (rti.org)
- Atovaquone has shown prophylactic potential in adults in the treatment of PCP but is poorly absorbed in tablet form. (clinicaltrials.gov)
- These effects were also observed with atovaquone treatment of primary blasts isolated from patients with acute myelogenous leukemia or acute lymphocytic leukemia. (bloodjournal.org)
- Atovaquone selectively inhibits the malarial cytochrome bc1 complex in the parasitic electron transport chain, collapsing the mitochondrial membrane potential. (wikipedia.org)
- Atovaquone may cause side effects. (medlineplus.gov)
- you should plan what to do in case you experience serious side effects from atovaquone and proguanil and have to stop taking the medication, especially if you are not near a doctor or pharmacy. (medlineplus.gov)
- What are the side effects of atovaquone-proguanil-oral? (medicinenet.com)
- Read user comments about the side effects, benefits, and effectiveness of atovaquone oral. (webmd.com)
- In mixed P. falciparum and Plasmodium vivax infection, P. vivax relapse occurred commonly when patients were treated with atovaquone and proguanil hydrochloridealone. (nih.gov)
- We became involved in the treatment of several cases of babesiosis in which atovaquone was used to treat this infection. (ajtmh.org)
- Atovaquone is also sometimes used along with other medications to treat babesiosis (an infectious disease carried by ticks). (medlineplus.gov)
- Atovaquone (100 mg/kg/day) and atovaquone (100 mg/kg/day) with azithromycin (150 mg/kg/day) were effective agents for the treatment of experimental babesiosis in hamsters. (ajtmh.org)
- Atovaquone should be considered in the therapeutic regimen of patients with babesiosis who have either failed standard therapy or have become intolerant to such therapy. (ajtmh.org)
- A population pharmacokinetic analysis demonstrated that the apparent volume of distribution of atovaquone (V/F) in adult and pediatric patients after oral administration is approximately 8.8 L/kg. (bioportfolio.com)