Nurses Compass
Drug Guide
Amodiaquine Hydrochloride
Classification
Therapeutic: Antimalarial agent
Pharmacological: Aminoquinoline
FDA Approved Indications
- Prophylaxis and treatment of malaria caused by Plasmodium falciparum and Plasmodium vivax
Mechanism of Action
Amodiaquine interferes with the parasite's DNA and mitochondrial function, inhibiting the parasite's ability to replicate and survive within red blood cells.
Dosage and Administration
Adult: Typically 25 mg base once daily for prophylaxis; treatment doses vary based on severity and species of malaria.
Pediatric: Dosing based on weight; consult specific guidelines.
Geriatric: Use with caution; adjust dose based on renal and hepatic function.
Renal Impairment: Adjust dose carefully; monitor closely.
Hepatic Impairment: Use with caution; hepatic function should be monitored.
Pharmacokinetics
Absorption: Well absorbed oral administration.
Distribution: Wide distribution, including into tissues and liver.
Metabolism: Metabolized in the liver via CYP enzymes.
Excretion: Excreted mainly in bile and feces.
Half Life: Approximately 4-5 days, allowing once-weekly dosing for prophylaxis.
Contraindications
- Known hypersensitivity to amodiaquine or related compounds.
- History of adverse reactions to quinoline antimalarials.
Precautions
- Monitor for hematological reactions, especially with prolonged use.
- Use cautiously in patients with hepatic impairment or G6PD deficiency.
- Pregnancy category C; use only if clearly needed.
Adverse Reactions - Common
- Gastrointestinal discomfort (Uncommon)
- Headache (Uncommon)
- Dizziness (Uncommon)
Adverse Reactions - Serious
- Hematological reactions (agranulocytosis, neutropenia, aplastic anemia) (Rare)
- Hepatotoxicity (Rare)
- Severe skin reactions including Stevens-Johnson syndrome (Rare)
Drug-Drug Interactions
- Mefloquine (may increase risk of neuropsychiatric adverse effects)
Drug-Food Interactions
- None well-documented
Drug-Herb Interactions
- Use caution with herbal products that affect liver enzymes.
Nursing Implications
Assessment: Monitor for allergic reactions, hematologic parameters, hepatic function.
Diagnoses:
- Risk for anemia or hematologic disturbances.
- Risk for hepatic injury.
Implementation: Administer with food to reduce gastrointestinal upset. Monitor blood counts and liver function during treatment.
Evaluation: Assess for effectiveness in malaria symptoms; monitor for adverse reactions.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report any signs of allergic reactions, unusual bleeding, or jaundice.
- Avoid alcohol and hepatotoxic drugs.
- Attend scheduled blood tests for monitoring.
Special Considerations
Black Box Warnings:
- Potential for agranulocytosis and hepatotoxicity with long-term use.
Genetic Factors: G6PD deficiency may predispose to hemolytic anemia.
Lab Test Interference: May cause false-positive results for certain assays.
Overdose Management
Signs/Symptoms: Nausea, vomiting, dizziness, seizures, hematological abnormalities.
Treatment: Supportive care; no specific antidote. Hematologic and hepatic function should be monitored. Activated charcoal may be considered if ingestion was recent.
Storage and Handling
Storage: Store in a tight, light-resistant container at room temperature.
Stability: Stable under normal conditions for shelf life as per manufacturer.