Pharm

Artesunate

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Artesunate

  • Pathophysiology
  1. Artesunate is a semisynthetic derivative of Artemisinin, which in turn is isolated from the plant Artemisia annua
  • Indications
  • Severe Malaria (Intravenous Artesunate)
  1. Malaria confirmation by microscopy (may be waived in some cases by CDC clinician) AND
  2. One of the following criteria (or inability to take oral medications despite Antiemetics)
    1. High Parasite density (>5%)
    2. Altered Level of Consciousness
    3. Seizures
    4. Hemodynamic instability or shock
    5. Acute Respiratory Distress Syndrome (ARDS)
    6. Pulmonary Edema
    7. Acidosis
    8. Acute Kidney Injury
    9. Disseminated Intravascular Coagulation (ARDS) or other Abnormal Bleeding
    10. Jaundice AND one other of the criteria
    11. Severe Anemia (Hemoglobin <7 g/dl)
  1. Artesunate (and other Artemisinin derivatives) are preferred for severe Malaria with reduced morbidity and mortality
  • Adverse Effects
  • In Malaria Patients
  1. Acute Renal Failure requiringf Dialysis
  2. Hemoglobinuria
  3. Anemia
  4. Jaundice
  • Preparations
  • Intravenous Artesunate
  1. Available from CDC (if not commercially available)
  2. Contact CDC Malaria Hotline
    1. https://www.cdc.gov/media/releases/2019/s0328-artesunate-first-line-treatment.html
  • References
  1. Lovecchio (2021) Crit Dec Emerg Med 35(11): 26