DOXYCYCLINE

MEFLOQUINE

Trade name : vibramycin ,vibra- tabs

doryx

Trade name : lariam ,mephaquin

Packaging

Packaging

: 100 mg

: 250 mg base (salt in US

Adult dose : 100 mg once daily

Adult dose : 250 mg base once weekly

Pediatric dose : 1.5 mg/kg once daily

(max 100 mg daily )
<25 kg or if <8 years
:contraindicated
25-35 kg ; 50mg
36-50 kg ; 75 mg
>50 kg or if > 14 years :100
mg
Adverse effects : GI upset,vaginal candidiasis ,
photosensitivity allergic reactions , blood
dyscrasiasis ,azotemiain renal desease
hepatitis

Pediatric dose : <5 kg : no data

5-15 kg ;5 mg/kg on
weekly
15-19 kg; tablet
20-30 kg; tablet
31-45 kg ; table
>45 kg ;itablet onc
weekly
Adverse effect : dizziness
,diarrhea,nausea,vivid dreams,
nightmares,irritability,mood alteratio
,headache,insomnia,anxiety,seizures
is

Description ,pharmacology and

mode of action

Description ,pharmacology an
mode of action

The tetracyclines form a class of broad

spectrum antimicrobial agents with activity
against Gram-positive and Gram-negative
aerobic and anaerobic bacteria
,mycoplasma ,rickettsia chlamydiae and
protozoa ,including those that cause malaria
Doxycyline and minocycline were derived semi
synthetically in 1967 and 1972 respectively
Tetracyclines including doxycycline are
relatively slow acting schizonticidal agents
and are therefore not used alone treatment
The efficacy of doxycycline as a solo
chemopropphylactic agents against P.vivax
and P.falciparum malaria
Doxycyline is thought to possess some preerythrocytic (causal )activity
Doxycyline needs to be taken as a
chemosuppresive for 4 weeks after leaving a
malaria endemic area ,to be optimally
effective
Doxycyline has several advantages over first

Was selected in the 196os by the

reed army institute of research f
nearly 300 quinoline methanol
compound for futher investigatio
because of its high anti malarial
Mefloquine is used clinically as a
recemic mixture of the erythro is
and all clinical studies with the d
have used this mixture
Mefloquine is potent ,long acting
schizontocide and is effective a
malaria special including P. Falc
resistant to chloroquine and
pyrimethamine sulfonamide
combination
Mefloquine is thought to compet
the complexing protein for heme
and the resulting drug-heme com
tosix to the parasite

generation tetracyclines ,including improved

absorption ,a broader spectrum ,a longer halflife and an improved safety profile

Efficacy and drug resistance

Doxycyline has been shown to be equivalent
to mefloquine and atovaquone proguanil and
superior to azithromycin and chlorequine
/proguanil

Contraindications,precautio
ns,and drug interactions
Doxycyline administration is not
recommended in the following
situations ,pregnancy ,breast-feeding
,infants and childrenunder 8 years of
age,allergy or hypersensitivity

Doxycyline is partially metabolized by the

liver in individuals with significant hepatic
dysfunction there may be a prolonged
half-life and a dose adjustment may be
required

Efficacy and drug resistan

Mefloquine is recognized as a hig

effective malaria chemoprophyla

non-immune traveler to high ris
areas

Contraindications,prec
ns,and drug interaction

Mefloquine is contraindicated in pe
a history of hypersensitivity to mefl
realted substances such as quinine
with a history of epilepsy or psychia
disorders including active depressi
not use the drug
Most authorities now allow the use
mefloquine in the first trimester if t
expected benefit outweighs the risk
It has been suggested by some aut
that pregnancy should be avoided f
month after completing prophylaxis
mefloquine`s long half-life although
inadvertent pregnancy while using
mefloquine is not considered groun
pregnancy termination
Mefloquine is secreted into breast m
small quantities

Indication and
administration
Doxycyline is currently indicated as an

Indication and
administration
Mefloquine is effective in the pre

agent of choice for prevention of

mefloquine resistan P. falciparum malaria

Doxycyline has a long half-life that permits

once-daily dosing

of CRPF malaria ,except in clear

defined Thai border regions of m
resistence

Mefloquine and its metabolite ar

appreciably removed by hemodi

No special dosage adjustment ar

indicated for dialysis patients to

concentration in plasma similar
in healthy volunteers

SOAL-SOAL UJIAN OLEH

DR.BUDI AGUNG
(MATERI TRAVEL HEALTH

AND MEDICAL KIT,CRIME AVOIDANCE AND PERSONAL

SECURITY,KLINIK&AMBULANSI ,
MOBILISASI &EVAKUASI )

1. Seorang pelancong wanita berumur 65 tahun dengan gangguan sendi lutut akan berangkat
ke Cina untuk berlibur selama 10 hari ,selama ini sudah mendapatkan obat
immunosupresan ,anda sebagai seorang dokter di klinik Medicine diminta bantuan untuk
mempersiapkan obat-obatan sebelum berangkat obat-obatan tersebut sebagai berikut
1. Obat
Minum berapa kali .