II. Pathophysiology
- Artesunate is a semisynthetic derivative of Artemisinin, which in turn is isolated from the plant Artemisia annua
III. Indications: Severe Malaria (Intravenous Artesunate)
- Malaria confirmation by microscopy (may be waived in some cases by CDC clinician) AND
- One of the following criteria (or inability to take oral medications despite Antiemetics)
- High Parasite density (>5%)
- Altered Level of Consciousness
- Seizures
- Hemodynamic instability or shock
- Acute Respiratory Distress Syndrome (ARDS)
- Pulmonary Edema
- Acidosis
- Acute Kidney Injury
- Disseminated Intravascular Coagulation (ARDS) or other Abnormal Bleeding
- Jaundice AND one other of the criteria
- Severe Anemia (Hemoglobin <7 g/dl)
IV. Efficacy: Severe Malaria
- Artesunate (and other Artemisinin derivatives) are preferred for severe Malaria with reduced morbidity and mortality
V. Adverse Effects: In Malaria Patients
- Acute Renal Failure requiringf Dialysis
- Hemoglobinuria
- Anemia
- Jaundice
VI. Preparations: Intravenous Artesunate
- Available from CDC (if not commercially available)
- Contact CDC Malaria Hotline
VII. References
- Lovecchio (2021) Crit Dec Emerg Med 35(11): 26