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  Quinine

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems General (Systemic)
Category Antimalarial


Pharmacokinetics

Quinine is completely absorbed from the GIT, and reaches an effective plasma level in 1-3 hrs time. It can cross the placental barrier. It gets metabolised in the Liver by hepatic enzymes and is excreted in the urine within 24 hrs.



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Indications

Quinine belongs to cinchona alkaloids. It is schizonticidal in action. It is not effective against other forms of Plasmodia.



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Routes of Administration and Dosage

Quinine is the drug of choice for cerebral malaria. 600 mg of quinine dihydrochloride is diluted in 500 ml of 5% glucose solution over 2hours.For treatment of resistant malaria in Adults : Oral: 600 to 650 mg every eight hours for 7 days. Children: 10 mg/kg/ 8hourly. IV dose: For resistant Falciparum malaria: 20 mg/kg IV infusion over 4 hours repeated 8 hrly. Maintenance: 10 mg/kg infused over 4 hours every 8 hours. This drug may be taken in combination with other drugs to treat malaria.Other uses; A single tablet of quinine at bed time affords bennefit in some cases of nocturnal muscle cramps.



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Contra Indications

Quinine is contraindicated in hypersensitivity, mefloquine therapy, myasthenia gravis, hemolytic anemia, quinine resistant falciparum infection, digitalis therapy, in pregnancy and in patients with optic neuritis.



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Precautions

Patients with a history of blackwater fever, G6PD deficiency, or purpura may have an increased risk of hemolysis. Quinine depresses the heart and can cause hypotension. Quinine may cause hypoglycemia. Quinine may increase muscle weakness in patients with myasthenia gravis. CINCHONISM; large single dose or higher doses taken for few days produce a syndrome called cinchonism.It consists of ringing in ears,nausea,vommiting,headache,mental confusion,vertigo,difficulty in hearing and visual diffects.



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Interactions

Use of mefloquine with quinine may increase the chance of adverse effects. Quinine can interfere with the measurement of urinary alkaloids and Corticosteroids.Quinine increases the digitalis toxicity.Rifampicin increases the quinine clearance.Quinine may enchance the hypoglycaemic effect of oral antidiabetics.



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Brand Names

Falciquin(Brown & Burk), Kunen(Merind), P-Falci(Samir Remedies), Pbquin (P & B Labs), Quinarsol-300( Cipla), Quin-S (Bengal Immunity), Quininga(Inga), Quinsul(Bombay Tablets), Rez-Q (Plethico), Rubiquin(PCI), Uniquin-EC(Unicure).



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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