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ARTESUNATE: Artemisinin derivative are the potent and rapidly acting blood schizonticides. These are concentrated in parasities erythrocytes. Artesunates acts rapidly, stopping parasite development and preventing subsquent cytoadherence and rosettig.

Artesunate is well distributed and achievies high concentration in the intestines, liver and kidneys. Only a small amount of artesunate is excreted in the urine and in the stools.

Indications: Severe malaria including cerebral malaria and as a second line treatment in chloroquineresistant flciparum malaria.

Dosage: Adults: Parenteral : 120mg on the first day followed by 60mg daily for the next four days. In severe cases: Extra dose of 60mg can be given on the first day itself 6 hours after the first dose. Oral: 100mg twice a day on the first day followed by50mg twice daily for the next four days.
Children: 1.2mg/kg X5 days (Maximum 60 gm)

Contra Indications: Not know.

Special Precaution: Avoid in pregnant women especially in the first trimester.
Pediatrics: May be used if choroquinie resistant.
Pregnancy: Contraindicated in 1st trimester
Lactation: Safety not established.

Side -effects: Transient and reversible reticulocytopenia, drug, fever, drug rash, bradycardia transient first degree heart block and transient & reversible elevation of serum transaminases.

Drug Interactions: Antimalarial acton potentiated by oxidant drug. Additive effect seen with chloroquine. Antagonistic aeffect seen with pyrimethamine and sulfonamides.

Other: Meflquine, primaquinie, tetracycline.