science

Piperaquine

Piperaquine is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Piperaquine rather than just read about it. In short: Piperaquine is an antiparasitic drug used in combination with dihydroartemisinin to treat malaria. Piperaquine was developed under the Chinese National Malaria Elimination Programme in the 1960s and was adopted throughout China as a replacement for the structurally similar antimalarial drug chloroquine.

Key takeaways

Piperaquine belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Piperaquine to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Piperaquine from memory before moving on to harder problems.

Reference excerpt

Piperaquine is an antiparasitic drug used in combination with dihydroartemisinin to treat malaria. Piperaquine was developed under the Chinese National Malaria Elimination Programme in the 1960s and was adopted throughout China as a replacement for the structurally similar antimalarial drug chloroquine. Due to widespread parasite resistance to piperaquine, the drug fell out of use as a monotherapy, and is instead used as a partner drug for artemisinin combination therapy. Piperaquine kills parasites by disrupting the detoxification of host heme.

Medical uses Piperaquine is used in combination with dihydroartemisinin for the treatment of malaria. This combination is one of several artemisinin combination therapies recommended by the World Health Organization for treatment of uncomplicated malaria. This combination is also recommended by the World Health Organization for treatment of severe malaria after administration of artesunate. Piperaquine is also registered for use in some countries in combination with arterolane. However, this combination is not recommended by the World Health Organization due to insufficient data.

Contraindications Like chloroquine, piperaquine can prolong the QT interval. Although large randomized clinical trials have not revealed evidence of cardiotoxicity, the World Health Organization recommends not using piperaquine in patients with congenital QT prolongation or who are on other drugs that prolong the QT interval.

Pharmacology

Mechanism of action Like chloroquine, piperaquine is thought to function by accumulating in the parasite digestive vacuole and interfering with the detoxification of heme into hemozoin.

Resistance Parasites that survive piperaquine treatment have been increasingly reported since 2010, particularly in Southeast Asia. The epicenter of piperaquine resistance appears to be western Cambodia where in 2014 over 40% of dihydroartemisinin-piperaquine treatments failed to eliminate parasites from the patient's blood. Characterizing piperaquine-resistant parasites has been technically challenging, as parasites that survive piperaquine treatment in patients appear to remain sensitive to piperaquine in vitro; i.e. piperaquine appears to have the same IC50 in sensitive parasites and resistant parasites. The mechanism by which parasites become resistant to piperaquine remains unclear. Amplification of the parasite proteases plasmepsin 2 and plasmepsin 3, both involved in degrading host hemoglobin, is associated with resistance to piperaquine. Similarly, mutations in a gene related to chloroquine resistance, PfCRT, have been associated with piperaquine resistance; however, parasites that are resistant to chloroquine remain sensitive to piperaquine. In contrast, amplification of the gene for the parasite transporter PfMDR1, a mechanism of parasite resistance to mefloquine, is inversely correlated with piperaquine resistance.

Pharmacokinetics Piperaquine is a lipophilic drug and therefore is rapidly absorbed and distributed across much of the body. The drug reaches its maximal concentrations approximately 2 hours after administration.

Chemistry Piperaquine is available as a base, and as a water-soluble tetraphosphate salt.

History Piperaquine was discovered in the 1960s by two separate groups working independently of one another: the Shanghai Pharmaceutical Industry Research Institute in China and the Rhone Poulenc in France. In the 1970s and 1980s piperaquine became the primary antimalarial drug of the Chinese National Malaria Control Programme due to increased parasite resistance to chloroquine. By the late 1980s, the use of piperaquine as an antimalarial monotherapy diminished as increasing parasite resistance to piperaquine was observed. Beginning in the 1990s, piperaquine was tested and adopted as a partner drug for artemisinin combination therapy.

References

Illustrations

Worked examples

Example 1 — a first encounter with Piperaquine

Start with the simplest possible case. Write down what Piperaquine claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Piperaquine before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Piperaquine ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Piperaquine

In research: Piperaquine appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Piperaquine in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Piperaquine is common in secondary-school and first-year university syllabi. It links to neighbouring topics Anti-infective agent stubs, Antimalarial agents, Chinese discoveries, so understanding it makes those chapters shorter.
In everyday life: Look for Piperaquine outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Piperaquine in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Piperaquine means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Piperaquine out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Piperaquine in simple terms?

Why does Piperaquine matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Piperaquine?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Piperaquine.