Malaria with other antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance to any single drug component. These additional antimalarials include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine. Another recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Infection with "P. vivax", "P. ovale" or "P. malariae" usually do not require
Tonic (physiology) Tonic (physiology) Tonic in physiology refers to a physiological response which is slow and may be graded. This term is typically used in opposition to a fast response. For instance, tonic muscles are contrasted by the more typical and much faster twitch muscles, while tonic sensory nerve endings are contrasted to the much faster phasic sensory nerve endings. Tonic muscles are much slower than twitch fibers in terms of time from stimulus to full activation, time to full relaxation upon cessation of stimuli, and maximal shortening velocity. These muscles are rarely found in mammals (only in the muscles moving the