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    Quinine is an alkaloid that is rapidly absorbed and widely distributed throughout the body. It undergoes extensive hepatic biotransformation and 20% is excreted by the kidneys. Quinine is used to treat uncomplicated malaria and complete treatment following parenteral therapy for severe falciparum malaria. Common side effects include cinchonism such as tinnitus, nausea, and dizziness. It can also cause hyperinsulinemic hypoglycemia and prolong the QTc interval.

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    Quinine summary

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    Quinine is an alkaloid that is rapidly absorbed and widely distributed throughout the body. It undergoes extensive hepatic biotransformation and 20% is excreted by the kidneys. Quinine is used to treat uncomplicated malaria and complete treatment following parenteral therapy for severe falciparum malaria. Common side effects include cinchonism such as tinnitus, nausea, and dizziness. It can also cause hyperinsulinemic hypoglycemia and prolong the QTc interval.

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    8 views3 pages

    Quinine Summary

    Uploaded by

    Alice
    Quinine is an alkaloid that is rapidly absorbed and widely distributed throughout the body. It undergoes extensive hepatic biotransformation and 20% is excreted by the kidneys. Quinine is used to treat uncomplicated malaria and complete treatment following parenteral therapy for severe falciparum malaria. Common side effects include cinchonism such as tinnitus, nausea, and dizziness. It can also cause hyperinsulinemic hypoglycemia and prolong the QTc interval.

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    QUININE

    ORAL FORM
    Pharmacokinetics
    QUININE

    ● Rapidly absorbed
    ● Widely distribute throughout the
    body
    Alkaloid - Detected in CSF, breast
    milk and placenta
    Aryl amino alcohol group
    ● Extensive hepatic
    Unclear mechanism of action
    biotransformation
    - inhibition of parasite heme - CYP3A4, CYP2C9,
    detoxification inside the food vacuole
    CYP1A2, CYP2D6
    ● 20% of administered drug is
    excreted by kidneys
    ● Vd and systemic clearance are
    reduced in severe malaria
    Kills ● Pregnant women have rapid
    Large ring and elimination
    trophozoite asexual parasites ● Total clearance normalized to ideal
    Gametocidal Against body weight
    P. vivax, P. ovale and P. malariae
    BUT not P. falciparum malaria
    Guideline for the treatment of malaria 3rd edition, WHO
    01 02
    DOSE STRENGTHS
    10mg salt/kg BW q 8 hr 300mg quinine sulfate tablet
    QUININE

    - Adult ≥ 50 kg: 600 mg (10mg quinine sulfate = 8 mg quinine base)


    - Child and adult < 50 kg: 10 mg/kg
    3 times daily at 8-hour intervals for 7 days

    03 04
    INDICATIONS CONTRAINDICATION
    ● Treatment of uncomplicated malaria Known hypersensitivity to quinine or any of
    ● Completion treatment following parenteral therapy with the cinchona alkaloids
    quinine for severe falciparum malaria
    • 1st trimester of pregnancy
    • Alternative treatment when effective an ACT is
    not promptly available

    05
    ADVERSE EFFECTS
    • CINCHONISM
    Mild – tinnitus, impair of hearing, N/V, dizziness, visual disturbance, impaired of high tone hearing
    Severe – vertigo, abdominal pain, diarrhea, marked auditory loss and visual symptoms
    • Hyperinsulinemic hypoglycemia
    • Prolong QTc interval
    Guideline for the treatment of malaria 3rd edition, WHO

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