Artemisinin and its derivatives are widely used throughout the world. The mechanism of action of these compounds appears to involve the heme-mediated decomposition of the endoperoxide bridge to produce carbon-centred free radicals. The involvement of heme explains why the drugs are selectively toxic to malaria parasites. The resulting carbon-centred free radicals are alkylate heme and proteins, one of which is the translationally controlled tumour protein. Clinically relevant artemisinin resistance has not been demonstrated, but it is likely to occur since artemisinin resistance has been obtained in laboratory models. At high doses, artemisinin can be neurotoxic but toxicity has not been found in clinical studies. The mechanism of neurotoxicity may be similar to the mechanism of action.

中文翻译：

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青蒿素：作用机制、耐药性和毒性。

青蒿素及其衍生物在世界范围内广泛使用。这些化合物的作用机制似乎涉及血红素介导的内过氧化物桥分解以产生以碳为中心的自由基。血红素的参与解释了为什么这些药物对疟疾寄生虫具有选择性毒性。由此产生的以碳为中心的自由基是烷基化血红素和蛋白质，其中之一是翻译控制的肿瘤蛋白质。临床相关的青蒿素耐药性尚未得到证实，但由于在实验室模型中获得了青蒿素耐药性，因此可能会发生。高剂量的青蒿素可能具有神经毒性，但在临床研究中尚未发现毒性。神经毒性的机制可能与作用机制相似。