In complication of falciparum malaria, which drug is not given –
Correct Answer: Dexmethosone
Description: Cerebral malaria
Many adjuvant therapies have been suggested based on the prevailing pathophysiology and hypothesis of the time.
These include heparin, low molecular weight dextran, urea, high dose corticosteroid, aspirn, prostacycline, pentoxifflline, desferioxamine, anti TNF antibody, cyclosporin and hyperimmune serum.
Unfortunately, none have proved beneficial and several have proved harmful none of these adjuvants should be used, the cornerstone of management is good intensive care and correct antimalarial treatment.
Management of cerebral malaria
Antimalarial treatment
In cerebral malaria rapidly acting parenteral drugs should be given. Quinine is the drug of choice.
Fluid balance
Following admission patient should be rehydrated to a CVP of approximately 5 cm
Hypoglycemia
Slow intravenous injection of 50% dextrose water
Lactic acidosis
Hypovolemia should be corrected first
Acute renal failure
Fluid should be restricted to replace insensible losses only. Dialysis should be started early when there is evidence of multiple organ dysfunction.
Acute pulmonary edema
They should be nursed upright and given oxygen and the right-sided filling pressure should be reduced
Bleeding
Less than 5% of patients of cerebral malaria develop D.I.C. These patients should be given a fresh blood transfusion and vitamin K.
Bacterial superinfection / continued fever
Patient with secondary pneumonia should be given empirical treatment with a third-generation cephalosporin.
Category:
Medicine
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