Aghahowa S E, Obianwu H O, Isah A O, Arhewoh I M
Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Benin, Benin City, Nigeria.
Indian J Pharm Sci. 2010 May;72(3):283-9. doi: 10.4103/0250-474X.70471.
Chloroquine-induced pruritus remains one of the most common side-effects in the use of chloroquine in the prophylaxis and treatment of uncomplicated malaria before the advent of artemisinin-based combination therapies. It has been reported to vary from a tolerable to intolerable intensity among susceptible individuals resulting in disruption of treatment and development of resistance to the drug thus leading to therapeutic failures as reported. This scourge is quite challenging due to the complex physiologic mechanism that has not been fully elucidated. Factors observed to be responsible in the induction of pruritus such as age, race, heredity, density of parasitaemia; impurities in formulations, plasmodial specie, dosage form and metabolites have been discussed in this review. Efforts to ameliorate this burden have necessitated the use of drugs of diverse pharmacological classes such as antihistamines, corticosteroids and multivitamins either alone or as a combination. This review is to look into the use of chloroquine retrospectively, and consider its re-introduction due to its safety. Efficacy can be attained if the pruritic effect is resolved.
在基于青蒿素的联合疗法出现之前,氯喹诱发的瘙痒症仍然是使用氯喹预防和治疗非复杂性疟疾时最常见的副作用之一。据报道,在易感个体中,其强度从可耐受到无法耐受不等,导致治疗中断以及对该药物产生耐药性,从而如报道的那样导致治疗失败。由于尚未完全阐明的复杂生理机制,这种祸害极具挑战性。本综述讨论了观察到的与瘙痒症诱发相关的因素,如年龄、种族、遗传、寄生虫血症密度、制剂中的杂质、疟原虫种类、剂型和代谢产物。为减轻这一负担所做的努力使得人们单独或联合使用了多种药理类别的药物,如抗组胺药、皮质类固醇和多种维生素。本综述旨在回顾氯喹的使用情况,并鉴于其安全性考虑重新引入该药物。如果能解决瘙痒效应,就可以实现疗效。