. 2019 May 23;18(5):314–328. doi: 10.1093/bfgp/elz008

Table 1.

Commonly used antimalarials and their known genetic mediators of resistance in P. falciparum and P. vivax. SNVs known to be essential to resistance are highlighted with an asterisk

Antimalarial drug class	Mechanism of action	Specific drugs	Genetic mediator(s) of resistance
Antimalarial drug class	Mechanism of action	Specific drugs	*P. falciparum*	*P. vivax*
4-aminoquinolines	Interfere with heme detoxification	chloroquine (CQ)	SNVs in pfcrt (K76 T); SNVs in pfmdr1* (N86Y*)	Not well understood; pvcrt-o amplification
		amodiaquine(AQ)	SNVs in pfcrt (K76 T); SNVs in pfmdr1* (N86Y*)
		piperaquine (PPQ)	SNVs in pfcrt (C101F, H97Y, F145I, M343 L, G353 V); Plasmepsin 2 and 3 amplifications; pfmdr1 single copy
4-aminoquinolines	Unknown	Primaquine	Unknown	Unknown
4-aminoquinolines	Unknown	Tafenaquine	Unknown	Unknown
Antifolate drugs	Inhibition of folate synthesis	DHFR inhibitors (proguanil, pyrimethamine)	SNVs in pfdhfr (S108 N, N51I, C59R, I164L); amplification of gtp cyclohydrolase 1	SNVs in pvdhfr
Antifolate drugs	Inhibition of folate synthesis	Sulfa drugs (sulfamethoxazole, sulfadoxine)	SNVs in SNVs in pfdhps	Inherently resistant due to SNV in pvdhps (V585)
Aryl amino-alcohols	Unclear; thought to interfere with heme detoxification	lumefantrine (LMF)	Amplification of pfmdr1	Amplification of pvmdr1
		mefloquine (MFQ)	Amplification of pfmdr1	Amplification of pvmdr1
		Quinine	Not clear, involves mediators of LMF and MQ resistance; ms4760 microsatellites in pfnhe-1	Not reported
Antibiotics	Inhibition of protein synthesis	Doxycycline	Unknown	Not reported
Antibiotics	Inhibition of protein synthesis	Clindamycin	SNV in 23S rRNA (A1875C)	Not reported
Napthoquinones	Inhibits cytochrome bc₁ complex	Atovaquone	SNV in cyt-b (Y268S/C/N)	Not reported
Artemisinin compounds	Causes oxidative stress	Artemisinin, artemether, DHA	SNVs in kelch13 (C580Y)	Not reported