Antimalarials

A 28-year-old man from rural Jharkhand presents with fever, rigors, and jaundice on day 7 of illness. Blood smear shows P. falciparum with 8% parasitaemia. He is conscious, has a respiratory rate of 32/min, and blood glucose is 35 mg/dL. Which is the most appropriate immediate next step?

A 32-year-old woman from rural Odisha presents with fever, chills, and headache for 3 days. Blood smear microscopy confirms Plasmodium vivax malaria. She is started on chloroquine for the acute attack. Which is the most common adverse effect encountered during chloroquine therapy for malaria?

A 32-year-old woman from Odisha presents with fever, chills, and sweating for 3 days. Blood smear shows P. vivax trophozoites. She is started on chloroquine 600 mg base stat, followed by 300 mg at 6, 24, and 48 hours. On day 5 of treatment, fever recurs with similar parasitaemia. What is the most appropriate next step in management?

Which of the following antimalarials is contraindicated in patients with a history of psychiatric disorders due to risk of neuropsychiatric adverse effects?

A 32-year-old woman from rural Odisha presents with fever, chills, and sweating for 3 days. She reports a 2-week history of travel to a malaria-endemic zone. Physical examination reveals hepatosplenomegaly and mild jaundice. Blood smear shows ring forms and multiple ring forms within a single RBC. She is started on chloroquine 600 mg base stat, followed by 300 mg at 6 hours, then 300 mg daily for 2 days. On day 3 of therapy, she develops severe pruritus, urticaria, and angioedema. What is the most appropriate management at this point?