title: Evaluation of pharmacokinetics of single-dose chloroquine in malnourished children with malaria- a comparative study with normally nourished children.
abstract: OBJECTIVE
  Studies on antimalarial kinetics in children or adults who are undernourished or malnourished are both limited and have yielded conflicting results. The present study was carried out with the objectives of evaluating the pharmacokinetics of single dose chloroquine and its metabolite desethylchloroquine in children who were undernourished and compare them with children who were normally nourished.
  
  
  METHODS
  Children of either gender between the ages of 5 and 12 years, smear positive forP. vivaxmalaria and classified either as well nourished or undernourished were included. Undernourishment was adjudged based on the Indian Academy of Pediatrics (IAP) classification of protein energy malnutrition [PEM] which in turn was based on Khadilkar's growth charts. All participants received 10 mg/kg on the first day followed by 10 mg/kg on Day 2 and 5 mg/kg on Day 3 along with supportive treatment. Blood samples for the levels of chloroquine [CQ] and desethylchloroquine [DECQ] were collected at 0, 0.5, 1, 2 4, 8, 12, 24, 48, 72 hours and 14 days after the first dose and levels assessed by High Performance Liquid Chromatography.
  
  
  RESULTS
  A total of 12 children who were normally nourished and 13 who were undernourished were studied. Wide inter-individual variability was seen in the levels of both drug and metabolite in both groups of patients. However, the differences in Cmax, AUC 0-inf, Clearance, half life and Vd between the two groups were not significantly different.
  
  
  CONCLUSIONS
  Our results indicate that dosage requirement is unlikely to be needed for chloroquine in undernourished children with uncomplicatedP. vivaxmalaria.
authors.affiliation: Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Prashant P
authors.initials: PP
authors.lastname: Kadam
authors.affiliation: Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Nithya Jaideep
authors.initials: NJ
authors.lastname: Gogtay
authors.affiliation: Department of Pediatrics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Karande
authors.affiliation: Department of Pediatrics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: V
authors.initials: V
authors.lastname: Shah
authors.affiliation: Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
authors.forename: Urmila M
authors.initials: UM
authors.lastname: Thatte
mesh_terms: D000962:Antimalarials / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002648:Child; D015362:Child Nutrition Disorders / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*; D002675:Child, Preschool; D002738:Chloroquine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*; D008297:Male
chemical_list: D000962:Antimalarials; D002738:Chloroquine; C007278:desethylchloroquine
keywords: Children; chloroquine; nourishment status; pharmacokinetics