PHARMACOKINETICS AND PHARMACODYNAMICS OF PRIMAQUINE TO PATIENTS WITH UNCOMPLICATED FALCIPARUM MALARIA IN HALMAHERA INDONESIA

Malaria remains one of deadly diseases in Indonesia which mainly occurred in Tobelo, North Halmahera. Genetic factor is one of significant factors where the gene acting in protein and enzyme coding influences the drug pharmacokinetics. However, no studies have been carried out on the pharmacokinetics of anti-malaria of primaquine in Indonesia. The purpose of this research is to know the kinetic profile of primaquine combination in the uncomplicated falciparum malaria, the relation of drug content and parasite clearance, and its pharmacological effects. Random clinical tests were conducted with experimental method to 12 patients RSUD Tobelo, North Halmahera from September to December, 2014. Blood samples were taken sequentially starting from day 0 to day 28, and then thick blood drop, liver function, kidney function, leucocyte, erythrocyte and hemoglobin were tested, The samples were then tested to measure the kinetic concentration of by using LCMS as well as analyzing the parameters of its pharmacokinetics. The results showed that the kinetic the primaquine kinetics synergized well and it was mutually complementing where the patients were cured without any side effects. The kinetic The primaquine kinetics included Ka = 2.63 hours, C_max = 3,1672 ng/ml, T_max = 1.08 ug/ml, t1/2 = 6.22 hours, AUC = 1,237.24 ng/hour/ml, VD = 67.99 liters, Cl = 20.78 liters/hour. Primaquine was able to clean the parasite and showed that there was a relation (P=0.041 < 0.05) between the drug content and significant parasite clearance. The pharmacological effect was APCR, with 100% of treatment. The malaria treatment as conducted in Papua still success.