According to legend it was first brought to Europe by a Countess who had been treated with it in Peru in the 1600s. In 1820, two French chemists isolated quinine from the cinchona bark and quinine became a treatment of reference for intermittent fever throughout the world. Quinine remains an important and effective treatment for malaria today, despite sporadic observations of quinine resistance. Recommended eye tests for sjogrens plaquenil Plaquenil toxicity Abstract. Fifty patients with Plasmodium vivax infection were treated with the standard regimen of chloroquine phosphate 1500 mg over 3 d followed by primaquine 45 mg immediately and then weekly for 8 weeks; 43 patients had sensitive infections but recrudescences of parasitaemia occurred between days 3 and 14 with RI, RII and RIII patterns in one, 3 and 3 patients, respectively. Chloroquine is commonly used to study the role of endosomal acidification in cellular processes 2, 3, such as the signaling of intracellular TLRs. Moreover, Chloroquine inhibits autophagy as it raises the lysosomal pH, which leads to inhibition of both fusion of autophagosome with lysosome and lysosomal protein degradation. The malaria parasite's development of resistance to the drug chloroquine is a major threat to world health. A protein likely to be involved in chloroquine resistance has recently been identified; this discovery is important, but raises as many questions as it answers. These compounds belonged to a new class of antimalarials, the four-amino quinolines. Research by German scientists to discover a substitute for quinine led to the synthesis in 1934 of Resochin (chloroquine) and Sontochin (3-methyl-chloroquine). Chloroquine resistance development History of antimalarials Medicines for Malaria Venture, Chloroquine & Hydroxychloroquine supporting chemo. Plaquenil decrease immune system Chloroquine resistance Chloroquine is ineffective in almost all malaria endemic countries In India chloroquine resistance was first detected in 1973 in Assam. Severe in northeast and southeastern regions of India with high morbidity and mortality. DRUG RESISTANT MALARIA CURRENT STATUS. Malaria Dissecting chloroquine resistance - ScienceDirect. A broad analysis of resistance development in the malaria.. Both adults and children should take one dose of chloroquine per week starting at least 1 week before. traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving. The weekly dosage for adults is 300mg base 500mg salt. Optimization of chloroquine treatment is essential to attain therapeutic exposure and thus prevent resistance development to the drug. Inadequate drug exposure may lead to subtherapeutic concentrations of chloroquine and an increased risk of severe vivax malaria as well as the development of resistant strains of P. vivax. RESULTS Development of Chloroquine Resistance The prophylactic EDgo of the parent N strain for chloroquine is 2.45 0.2 mg/kg X 4 daily on Dl to D4 inclusive and the EDgo 3.9 0.3 mg/kg. Figure 1 shows the fairly smooth increase of the dosage tolerated by the parasites from Passage 7 onwards as they developed resist- ance to chloroquine.