Generic Name

Artesunate

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Classification

FDA Approved Indications

• Treatment of severe Plasmodium falciparum malaria

Mechanism of Action

Artesunate produces reactive oxygen species and free radicals, which damage the parasite's proteins and membranes, leading to parasite death.

Dosage and Administration

Adult: Administer IV injection as per severity, typically 2.4 mg/kg at 0, 12, and 24 hours, then daily for 7 days.

Pediatric: Same dosing based on weight; specific protocols vary by age and severity.

Geriatric: Adjust dosage based on renal and hepatic function, no specific change recommended without renal/hepatic impairment.

Renal Impairment: Adjust dosage if necessary; monitor renal function.

Hepatic Impairment: Use with caution; monitor liver function.

Pharmacokinetics

Absorption: Rapidly absorbed IV; oral bioavailability less relevant as IV is primary route.

Distribution: Widely distributed; crosses placenta, limited data on breast milk.

Metabolism: Metabolized in the liver, primarily via phase I oxidative reactions.

Excretion: Excreted through biliary/fecal pathways; minimal urinary excretion.

Half Life: Approximately 1 hour.

Contraindications

• Hypersensitivity to artesunate or artemisinin derivatives.

Precautions

• Use with caution in patients with G6PD deficiency, as hemolysis risk is increased.

Adverse Reactions - Common

• Nausea (Common)
• Headache (Common)
• Dizziness (Common)

Adverse Reactions - Serious

• Transient leukopenia (Rare)
• Hemolytic anemia (Rare)
• Anaphylaxis (Very rare)

Drug-Drug Interactions

• Potential CYP450 interactions; monitor when used with other hepatically metabolized drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report any signs of allergic reaction, hemolysis, or severe side effects.
• Complete the full course of therapy.
• Inform about possible side effects like headache, nausea.

Special Considerations

Black Box Warnings:

• Potential risk of hemolytic anemia in G6PD-deficient patients.

Genetic Factors: Screen for G6PD deficiency in high-risk populations.

Lab Test Interference: May alter some blood tests, such as hemoglobin levels.

Overdose Management

Signs/Symptoms: Nausea, dizziness, anemia, hemolysis.

Treatment: Supportive care; no specific antidote. Dialysis generally not effective.

Storage and Handling

Storage: Store at room temperature, protected from light.

Stability: Stable under recommended storage conditions for the duration specified by manufacturer.