Pharmacodynamics

For chloroquine, the relations of dose and effect are not well defined. For the prophylaxis of malaria, the plasma concentrations of chloroquine are regarded as effective if they are greater than 30nmol/l (>9.6 |g/l) (better 40-100nmol/l (12.8-32 |g/l). For the treatment of malaria, 300-600 nmol/l (96-192 |g/l) should be reached. To treat inflammatory rheumatic disorders, the recommended plasma concentration is 200 nmol/l (65|g/l). With respect to the therapeutic effect, no differences in the plasma concentrations between responders and nonresponders were found (Miller et al. 1987,Wollheim et al. 1978). The rate of side effects, however, could be related to the plasma concentrations (not the cumulative total dose). Concentrations greater than 600 nmol/l are associated with an increased incidence of side effects. Furthermore, the acute intoxication symptoms after an overdose can be related to the plasma concentrations. Consequently, chloroquine should not be given intravenously or intramuscularly to avoid cardiotoxic effects.

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