Product information:
| Product name |
Quinine Sulfate Tablets |
| Specifications |
300mg |
| Package |
10*10/Box |
| Storage |
Cool & Dry Place |
| Shelf Life |
2 Years |
| Usage |
Antimalarial |
Indication:
It is used to treat falciparum malaria caused by chloroquine resistant and multi drug resistant strains. It can also be used to treat vivax malaria.
Adverse reactions:
1. Quinine more than 1G per day or used for a long time often causes cinchona reaction, which is similar to salicylic acid reaction. It has tinnitus, headache, nausea, vomiting, vision, hearing loss and other symptoms. In severe cases, it has temporary deafness, which can be recovered after withdrawal.
2. When the dose is more than 4G within 24 hours, it can directly damage the nerve tissue and constrict the retinal blood vessels, resulting in reduced visual field, diplopia and amblyopia.
3. In addition to the aggravation of the above reactions, large dose poisoning can also inhibit the myocardium, prolong the refractory period, slow down the conduction, weaken the contractile force of myocardium, expand peripheral blood vessels, sometimes cause sudden drop of blood pressure, slow and shallow breathing, fever, irritability, delirium, etc., and most of them die of respiratory paralysis.
4. The lethal dose of quinine is about 8g.
5. A few patients are highly sensitive to quinine, and a small amount of quinine can cause serious cinchona reaction.
6. A small number of falciparum malaria patients using small amount of quinine can cause acute hemolysis (black urine fever) death.
7. Quinine can also cause skin rash, pruritus, asthma, etc.
Matters needing attention:
1. Patients with asthma, atrial fibrillation and other serious heart diseases, glucose-6-phosphate dehydrogenase deficiency and women in menstrual period should be cautious.
2. Interference in diagnosis: quinine can interfere with the determination of 17 hydroxysteroid.
Medicine interactions:
1. The absorption of quinine can be delayed or reduced by acid making drugs and aluminum containing preparations.
2. The anticoagulant effect can be enhanced when combined with quinine.
3. Muscle relaxants such as succinylcholine and tubulinine may cause respiratory depression when they contract with quinine.
4. When quinidine is combined with quinine, cinchona reaction can be increased.
5. Urine alkalizers such as sodium bicarbonate can increase the reabsorption of quinine in renal tubules, resulting in the increase of quinine concentration and toxicity in blood.
6. Combined with vitamin K can increase the absorption of quinine.
7. It can cause tinnitus and vertigo when combined with buklizine, seclizine, meclizine, phenothiazines, thiazoles, trimethylbenzamide and aminoglycosides.
8. When combined with nifedipine, the concentration of free quinine increased.
Pharmacology and Toxicology:
Quinine is a kind of quinoline derivative, which can combine with DNA of Plasmodium to form a complex, inhibit DNA replication and RNA transcription, thus inhibit protein synthesis of Plasmodium. In addition, quinine can reduce the oxygen consumption of Plasmodium, resist the phosphorylase in Plasmodium and interfere with its glucose metabolism.
Quinine also causes malarial pigment aggregation, but it develops slowly, rarely forms large lumps, and is often accompanied by cell death. Electron microscope observation showed that the nucleus and outer membrane of protozoa were swollen, and there were small vacuoles. The aggregation of blood cell particles in the small vacuoles was different from the pigment agglutination of chloroquine. In the blood, a certain concentration of quinine can cause premature rupture of the parasitized red blood cells, thus preventing the schizont from maturing.
The long course of treatment can cure falciparum malaria, but it has no direct effect on Gametophyte of falciparum malaria, so it can't stop transmission.
Pharmacokinetics:
The absorption is rapid and complete after oral administration. The protein binding rate was about 70%. The highest concentration was found in liver, followed by lung, kidney and spleen, and the lowest in skeletal muscle and nerve tissue. The blood concentration reached the peak 1-3 hours after the first administration, and the T1 / 2 was 8.5 hours. Quinine is oxidated and decomposed in the liver, and fails rapidly. Its metabolites and a small amount of protodrug (about 10%) are excreted through the kidney. It appears in the urine 15 minutes after taking the drug, and almost all of them are excreted 24 hours later. Therefore, quinine has no accumulation.
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