A 19-year-old tribal woman from Chhattisgarh is brought comatose with a peripheral smear showing Plasmodium falciparum rings. She cannot take oral medication. Which is the drug of choice for immediate management?

• A Oral artemether-lumefantrine
• B Intravenous quinine infusion
• C Chloroquine intramuscular injection
• D Parenteral artesunate ✓

Explanation

Parenteral artesunate is the recommended first-line treatment for severe malaria including cerebral malaria in both adults and children, given intravenously followed by a complete course of an oral ACT once the patient can swallow. Intravenous quinine was the older standard but is slower acting, more toxic with hypoglycaemia and arrhythmias, and inferior in mortality trials. Chloroquine is obsolete due to widespread falciparum resistance in India.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.