Transcript 03/03/2009 Joyce Thomas

[SportsFan68]

Much of the malarial world is now chloroquine resistent but some of the current alternative prophlaxis and treatment is still in the quinine family like mefloquine and primaquine.

There some bad news.

By the time I go to Costa Rica again, it will probably be chloroquine resistant also.

[earendel]

Wasn't there an episode of M*A*S*H in which primaquine was a plot point? IIRC Klinger and another orderly were given primaquine (along with the rest of the camp) because the chloroquine pills they had requisitioned didn't arrive (or were replaced by the primaquine). Potter said something about not administering them to the "Negro" members of the unit because they would have an adverse reaction. But Klinger and the other orderly came down with hemolytic anemia because they, too, had the adverse reaction. That's when it was found that people of Mediterranean descent also can't take primaquine.

[tanstaafl2]

Wasn't there an episode of M*A*S*H in which primaquine was a plot point? IIRC Klinger and another orderly were given primaquine (along with the rest of the camp) because the chloroquine pills they had requisitioned didn't arrive (or were replaced by the primaquine). Potter said something about not administering them to the "Negro" members of the unit because they would have an adverse reaction. But Klinger and the other orderly came down with hemolytic anemia because they, too, had the adverse reaction. That's when it was found that people of Mediterranean descent also can't take primaquine.

Yes, the big hook with Primaquine is G6PD or Glucose-6-phosphate dehydrogenase deficiency. Primaquine causes hemolytic anemia in people who have this. Rare in women because it is X-linked recessive but a fairly common genetic disorder found most typically in men of African, Middle Eastern and Asian ancestry.

I think Klinger was supposed to be Lebanese, as was Farr himself.

It doesn't affect everyone of a particular ancestry but now that there is a test for G6PD you should test first before giving it.

[tanstaafl2]

Wasn't there an episode of M*A*S*H in which primaquine was a plot point? IIRC Klinger and another orderly were given primaquine (along with the rest of the camp) because the chloroquine pills they had requisitioned didn't arrive (or were replaced by the primaquine). Potter said something about not administering them to the "Negro" members of the unit because they would have an adverse reaction. But Klinger and the other orderly came down with hemolytic anemia because they, too, had the adverse reaction. That's when it was found that people of Mediterranean descent also can't take primaquine.

Yes, the big hook with Primaquine is G6PD or Glucose-6-phosphate dehydrogenase deficiency. Primaquine causes hemolytic anemia in people who have this. Rare in women because it is X-linked recessive but a fairly common genetic disorder found most typically in men of African, Middle Eastern and Asian ancestry.

I think Klinger was supposed to be Lebanese, as was Farr himself.

It doesn't affect everyone of a particular ancestry but now that there is a test for G6PD you should test first before giving it.

And interestingly enough G6PD confers a degree of immunity against malaria which probably explains why it is so commonly found in people from the "malaria belt".

Survival of the fittest and all that jazz.

[Weyoun]

I can speak with a little authority on this, since my microbiology final is next week. There is no way you can get through a discussion of malaria without quinine and cousins being mentioned. Thankfully she is not an MD.