Artemether

Quinine also played a significant role in the colonization of Africa by Europeans. As the dawn of modern pharmacology, Quinine was the prime reason why Africa ceased to be known as the white man's grave. According to socialist historian Clifford D. Conner in "A People's History of Science", "It was quinine's efficacy that gave colonist fresh opportunities to swarm into the Gold Coast, Nigeria and other parts of west Africa.

Large scale use of quinine as a prophylaxis started around 1850, although it had been used in un-extracted form by Europeans since at least the early 1600s. Quinine was first used to treat malaria in Rome in 1631. During the 1600s, malaria was endemic to the swamps and marshes surrounding the city of Rome. Over time, malaria was responsible for the death of several Popes, many Cardinals and countless common citizens of Rome. Most of the priests trained in Rome had seen malaria victims and were familiar with the shivering brought on by the cold phase of the disease.

In addition to its anti-malarial properties, quinine is an effective muscle relaxant, long used by the quechua indians of peru to halt shivering brought on by cold temperatures. The jesuit brother agostino salumbrino (1561-1642), an apothecary by training and who lived in lima, observed the quechua using the quinine-containing bark of the cinchona tree for that purpose. While its effect in treating malaria (and hence malaria-induced shivering) was entirely unrelated to its effect in controlling shivering from cold, it was still the correct medicine for malaria. At the first opportunity, he sent a small quantity to rome to test in treating malaria. In the years that followed, cinchona bark became one of the most valuable commodities shipped from peru to europe.

In addition to its anti-malarial properties, quinine is an effective muscle relaxant, long used by the Quechua Indians of Peru to halt shivering brought on by cold temperatures. The Jesuit Brother Agostino Salumbrino (1561-1642), an apothecary by training and who lived in Lima, observed the Quechua using the quinine-containing bark of the cinchona tree for that purpose. While its effect in treating malaria (and hence malaria-induced shivering) was entirely unrelated to its effect in controlling shivering from cold, it was still the correct medicine for malaria. At the first opportunity, he sent a small quantity to Rome to test in treating malaria. In the years that followed, cinchona bark became one of the most valuable commodities shipped from Peru to Europe.

Quinine was the first effective treatment for malaria caused by P. falciparum, appearing in therapeutics in the 17th century. It remained the antimalarial drug of choice until the 1940s, when other drugs took over. Since then, many effective antimalarials have been introduced, although quinine is still used to treat the disease in certain critical situations. Quinine is available with a prescription in the United States. Quinine is also used to treat nocturnal leg cramps and arthritis, and there have been attempts (with limited success) to treat prion diseases. It was once a popular heroin adulterant.

Dihydroartemisinin is available as a fixed drug combination with piperaquine (each tablet contains 40 mg of dihydroartemisinin and 320 mg of piperaquine; trade name Artekin, manufactured by Holleykin Pharmaceuticals). The adult dose is 1.6/12.8 mg/kg per dose (rounded up or down to the nearest half tablet) given at 0 h, 8 h, 24 h, and 48 h. Alternatively, the same total dose may be given once daily for three days.

Primaquine (or primaquine phosphate) is a medication used in the treatment of malaria and pneumocystis pneumonia. It is a member of the 8-aminoquinoline group of drugs that includes pamaquine.

Primaquine is mainly used to treat the P. vivax or P. ovale malaria. Once the parasite has been eliminated from the bloodstream, the remaining hypnozoites must be removed from the liver and this is done by administering a 14 day course of primaquine (called radical cure).