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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 56 - Chloroquine

False a. is contraindicated in pregnancy
True b. is schizonticidal for P.ovale
True c. is the treatment of choice for non-falciparum malaria

False d. causes cinchonism
True e. inhibits plasmodial haemin polymerase

Chloroquine can be used for chemoprophylaxis and for treatment. It can be safely taken by pregnant and lactating women. Chloroquine resistance has been reported in P.vivax in India and parts of South East Asia but it is not widespread and chloroquine remains the treatment of choice for non falciparum malaria. Chloroquine is a 4-aminoquinoline, not a cinchona alkaloid. (Quinine can cause cinchonism - tinnitus, deafness, dizziness, nausea, tremor.)
Haemin is a toxic metabolite of haemoglobin digestion by the parasite. It is detoxified by haemin polymerase to form malarial pigment.
Side effects of chloroquine include dizziness, diplopia and pruritus.

Copyright: Rob Skelly 2006