CLASS: GENERIC NAME: TRADE NAMES:
• Therapeutic: Chloroquine Aralen
antimalarials
antirheumatics
(DMARDs)
MOA:
• Inhibits protein synthesis in susceptible organisms by inhibiting DNA and RNA polymerase.
INDICATIONS:
• Prophylaxis and treatment of acute attacks of malaria.
• Treatment of extraintestinal amebiasis.
Unlabeled Use(s):
• Treatment of severe rheumatoid arthritis.
• Treatment of systemic lupus erythematosus.
CONTRAINDICATIONS/PRECAUTIONS:
Contraindicated in:
• Hypersensitivity;
• Hypersensitivity to other 4-aminoquinolones (hydroxychloroquine);
• Visual damage caused by chloroquine or other 4-aminoquinolones;
• Lactation: Lactation.
Precautions:
• Liver disease;
• Alcoholism;
• Patients receiving hepatotoxic drugs;
• Porphyria (may exacerbate condition);
• Psoriasis;
• G6PD deficiency (increased risk of severe hemolysis);
• Bone marrow depression;
• Hearing impairment;
• Epilepsy;
• OB: Use only if potential maternal benefit justifies potential fetal risk;
• Pedi: Extremely sensitive to chloroquine effects;
• Geri: May be predisposed to adverse effects.
INTERACTIONS with other Drugs/Substances:
• Antacids may increase absorption (separate administration of these agents by at least 4 hr).
• Blood levels may be increased by cimetidine, fluconazole, ketoconazole, clarithromycin, erythromycin, fluoxetine, nefazodone, paroxetine, protease
inhibitors, quinidine, ritonavir, and verapamil (concurrent use with cimetidine, should be avoided).
• May increase absorption of ampicillin (separate administration of these agents by at least 2 hr).
• May increase levels of cyclosporine, fluoxetine, lidocaine, mirtazapine, nefazodone, paroxetine, risperidone, ritonavir, thioridazine, tricyclic
antidepressants, and venlafaxine.
, • Carbamazepine, nevirapine, phenobarbital, phenytoin, and rifampin may decrease levels and efficacy.
• May increase the risk of hepatotoxicity when administered with other hepatotoxic agents.
• Urinary acidifiers may increase renal excretion and decrease effectiveness.
• Concurrent use with mefloquine may increase risk of seizures.
Drug-Food:
• Foods that acidify urine may increase excretion and decrease effectiveness.
PATIENT RESPONSE / COMMON SIDE EFFECTS: ADVERSE REACTIONS: S/S TOXICITY: TOXICITY/OVERDOSE
REACTIONS: • Cardiomyopathy • Stevens-Johnson • n/a TX:
DESIRED OUTCOME: • Alopecia syndrome • Wide QRS
• Prevention of or • Photosensitivity • Toxic Epidermal complexes
improvement in • Pigmentary changes Necrolysis • Ventricular
signs and • Skin eruptions • Agranulo cytosis fibrillation
symptoms of • Hearing impairment • Aplastic anemia • Hypokalemia
malaria. • Tinnitus • Leukopenia
• Regression of • Abdominal cramps • Seizures
extraintestinal • Anorexia
amebic disease.
• Diarrhea
• Decrease in the
• Hepatitis
symptoms and
• Nausea
progression of
rheumatoid • Vomiting.
arthritis and • Agitation,
systemic lupus • Anxiety,
erythematosus. • Confusion
• Depression
• Hallucinations,
• Headache,
• Insomnia,
• Personality changes
NURSING ACTIONS: ASSESS: CARE/IMPLEMENT: TEACH: EVALUATE:
• Proper • Determine baseline that • For malaria • Advise patient to notify • Prevention of or
monitoring includes current symptoms suppression/prophylaxis, health care professional improvement in
changes in of disease, for future chloroquine therapy promptly if sore throat,
• Therapeutic: Chloroquine Aralen
antimalarials
antirheumatics
(DMARDs)
MOA:
• Inhibits protein synthesis in susceptible organisms by inhibiting DNA and RNA polymerase.
INDICATIONS:
• Prophylaxis and treatment of acute attacks of malaria.
• Treatment of extraintestinal amebiasis.
Unlabeled Use(s):
• Treatment of severe rheumatoid arthritis.
• Treatment of systemic lupus erythematosus.
CONTRAINDICATIONS/PRECAUTIONS:
Contraindicated in:
• Hypersensitivity;
• Hypersensitivity to other 4-aminoquinolones (hydroxychloroquine);
• Visual damage caused by chloroquine or other 4-aminoquinolones;
• Lactation: Lactation.
Precautions:
• Liver disease;
• Alcoholism;
• Patients receiving hepatotoxic drugs;
• Porphyria (may exacerbate condition);
• Psoriasis;
• G6PD deficiency (increased risk of severe hemolysis);
• Bone marrow depression;
• Hearing impairment;
• Epilepsy;
• OB: Use only if potential maternal benefit justifies potential fetal risk;
• Pedi: Extremely sensitive to chloroquine effects;
• Geri: May be predisposed to adverse effects.
INTERACTIONS with other Drugs/Substances:
• Antacids may increase absorption (separate administration of these agents by at least 4 hr).
• Blood levels may be increased by cimetidine, fluconazole, ketoconazole, clarithromycin, erythromycin, fluoxetine, nefazodone, paroxetine, protease
inhibitors, quinidine, ritonavir, and verapamil (concurrent use with cimetidine, should be avoided).
• May increase absorption of ampicillin (separate administration of these agents by at least 2 hr).
• May increase levels of cyclosporine, fluoxetine, lidocaine, mirtazapine, nefazodone, paroxetine, risperidone, ritonavir, thioridazine, tricyclic
antidepressants, and venlafaxine.
, • Carbamazepine, nevirapine, phenobarbital, phenytoin, and rifampin may decrease levels and efficacy.
• May increase the risk of hepatotoxicity when administered with other hepatotoxic agents.
• Urinary acidifiers may increase renal excretion and decrease effectiveness.
• Concurrent use with mefloquine may increase risk of seizures.
Drug-Food:
• Foods that acidify urine may increase excretion and decrease effectiveness.
PATIENT RESPONSE / COMMON SIDE EFFECTS: ADVERSE REACTIONS: S/S TOXICITY: TOXICITY/OVERDOSE
REACTIONS: • Cardiomyopathy • Stevens-Johnson • n/a TX:
DESIRED OUTCOME: • Alopecia syndrome • Wide QRS
• Prevention of or • Photosensitivity • Toxic Epidermal complexes
improvement in • Pigmentary changes Necrolysis • Ventricular
signs and • Skin eruptions • Agranulo cytosis fibrillation
symptoms of • Hearing impairment • Aplastic anemia • Hypokalemia
malaria. • Tinnitus • Leukopenia
• Regression of • Abdominal cramps • Seizures
extraintestinal • Anorexia
amebic disease.
• Diarrhea
• Decrease in the
• Hepatitis
symptoms and
• Nausea
progression of
rheumatoid • Vomiting.
arthritis and • Agitation,
systemic lupus • Anxiety,
erythematosus. • Confusion
• Depression
• Hallucinations,
• Headache,
• Insomnia,
• Personality changes
NURSING ACTIONS: ASSESS: CARE/IMPLEMENT: TEACH: EVALUATE:
• Proper • Determine baseline that • For malaria • Advise patient to notify • Prevention of or
monitoring includes current symptoms suppression/prophylaxis, health care professional improvement in
changes in of disease, for future chloroquine therapy promptly if sore throat,
