The reality of using primaquine.
The reality of using primaquine.
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DOI：
10.1186/1475-2875-9-376
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发表时间：
2010-12-27
期刊：
影响因子：
3
通讯作者：
Nosten F
中科院分区：
文献类型：
--
作者：
Burgoine KL;Bancone G;Nosten F
伯氨喹是目前唯一用于根治间日疟原虫感染的药物。不幸的是，它的使用并非没有风险。葡萄糖-6-磷酸脱氢酶(G6PD)缺乏的患者在服用伯氨喹时，溶血的易感性增加。如果患者在接受治疗之前对G6PD缺乏进行测试并充分了解情况，这种潜在的致命临床综合征是可以避免的。一位35岁男性患者在泰国-缅甸边境的诊所就诊，病史和临床检查与血管内溶血一致。四天前，这名患者因感染间日疟原虫而被开了伯喹和氯喹的处方。药物说明书没有用患者理解的语言给出，他也没有接受过G6PD缺乏症测试。患者不仅G6PD缺乏，而且误解了说明，并将他所有的伯喹药片一起服用。经过适当治疗，患者康复，一周后出院。虽然伯喹仍然是根除催眠虫和控制间日疟原虫传播的首选药物，但在部署期间必须将与使用它相关的风险降至最低。在间日疟原虫存在的地区，患者应在服用伯氨喹之前进行G6PD缺乏症检测并充分告知。
Primaquine is currently the only medication used for radical cure of Plasmodium vivax infection. Unfortunately, its use is not without risk. Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency have an increased susceptibility to haemolysis when given primaquine. This potentially fatal clinical syndrome can be avoided if patients are tested for G6PD deficiency and adequately informed before being treated. A 35-year old male presented to our clinic on the Thai-Burmese border with a history and clinical examination consistent with intravascular haemolysis. The patient had been prescribed primaquine and chloroquine four days earlier for a P. vivax infection. The medication instructions had not been given in a language understood by the patient and he had not been tested for G6PD deficiency. The patient was not only G6PD deficient but misunderstood the instructions and took all his primaquine tablets together. With appropriate treatment the patient recovered and was discharged home a week later. Whilst primaquine remains the drug of choice to eradicate hypnozoites and control P. vivax transmission, the risks associated with its use must be minimized during its deployment. In areas where P. vivax exists, patients should be tested for G6PD deficiency and adequately informed before administration of primaquine.
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