Volume 4, Number 1—March 1998
Synopsis
Proteases of Malaria Parasites: New Targets for Chemotherapy
Philip J. Rosenthal
Table 1
Established antimalarial drugsa
| Drug | Role | Best Feature(s) | Limitations |
|---|---|---|---|
| Chloroquine | TX of and CP against non- Pf and sensitive Pf parasites | Very safe; low cost; long half-life | Widespread R |
| Quinine/quinidine | Best TX for Pf malaria; low cost | Limited R; rapidly acting | Fairly toxic (cinchonism, cardiac) |
| Amodiaquineb | TX of R Pf malaria | Low cost | Toxicity (bone marrow, liver); R common |
| Mefloquine | CP against R Pf malaria; not approved for TX in United States | Relatively little R, though increasing; long half-life | Moderately toxic (mostly CNS); high cost; R in SE Asia |
| Fansidar | TX of Pf malaria; no longer recommended for CP | Relatively low cost; long half-life | Skin toxicity (can be fatal); increasing R |
| Primaquine | Eradication of chronic liver stage Pv, Po malaria | Only drug for this indication | Hemolysis with G6PD deficiency; increasing R |
| Proguanilb | CP only (often with chloroquine) | Low cost; nontoxic | R common |
| Maloprimb | CP only (often with chloroquine) | Low cost | R common; skin rashes |
| Tetracyclines | CP; TX of Pf malaria in combination with quinine | Low cost | Skin and gastrointestinal toxicity |
aTX, therapy; CP, chemoprophylaxis; R, resistance/resistant; Pf, Plasmodium falciparum; Pv, P. vivax; Po, P. ovale; CNS, central nervous system; G6PD, glucose 6-phosphate dehydrogenase.
bNot available in the United States.
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