The curative of primaquine

 

I watched a old episode of MASH and this drug was being used by the Military, some of the MASH episodes are based on actual events in units of the medical service of the military.

Malaria Prevention

Hans D. Nothdurft, Kevin C. Kain, in The Travel and Tropical Medicine Manual (Fifth Edition), 2017

Primaquine

Primaquine is an 8-aminoquinoline that has antimalarial activity against both blood and tissue stages and can be used as a chemoprophylactic agent as well as for “terminal” prophylaxis. Recent randomized controlled field trials have convincingly demonstrated the prophylactic potential of primaquine, showing a protective efficacy of 85-95% against both P. falciparum and P. vivax infections.

Primaquine has been shown to be tolerated as well as or better than other standard regimens but may cause nausea and abdominal pain that can be decreased by taking the drug with food. Of importance, primaquine may cause oxidant-induced hemolytic anemia with methemoglobinemia, particularly in individuals with a deficiency of G6PD. It is contraindicated in patients with G6PD deficiency and also during pregnancy. If not already documented, a traveler's G6PD status should be determined with a G6PD blood test before primaquine is prescribed. The use of primaquine as a malaria chemoprophylaxis regimen during travel is off-label (FDA, April, 2015). However, in the absence of contraindications, primaquine may be a useful alternative prophylactic agent to consider for selected travelers, and because of its causal acitvity may be discontinued 1 week after leaving an endemic area.

If the risk of P. vivax infection is thought to be particularly high (e.g., in long-term expatriates and soldiers) a 14-day course of primaquine phosphate (“radical” or “terminal” prophylaxis, also called presumptive antirelapse therapy) may be given at the conclusion of the standard post-travel chemoprophylaxis regimen to eliminate latent hepatic parasites (as indicated by the FDA label). See section below, Primaquine for Relapse Prevention.