High body temperatures should be reduced by antipyretics or sponging. The patient must not be allowed to lie in a wet bed, and should be turned every couple of hours. The drugs currently appropriate for the treatment of malaria vary according to the type of malaria. The maintenance dose must be repeated every 8-12 hours until the patient can take oral therapy. In all cases, loading doses are not required if the patient has taken quinine or quinidine or mefloquine in the preceding 7 days.
Oral therapy depends on parasite sensitivity and drug availability.
All of the drugs mentioned above have certain problems associated with them. Quinine, the drug of choice for severe malaria, may cause serious hypoglycaemia, and quinine poisoning is treated with oral activated charcoal. Chloroquine, still the most widely prescribed antimalarial in the tropics, and, though providing symptomatic relief, does cause nausea, blurred vision, hypotension and, in chloroquine poisoning, coma and dysrhythmias. Mefloquine resembles quinine in structure and remains generally effective - it may, however, cause nausea and diarrhoea. Halofantrine is effective against resistant falciparum, but has poor bioavailability and may not be used in pregnant women.