Quinine: Difference between revisions
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==General== | ==General== | ||
*Type: Antimalarial | *Type: [[Antimalarial]] | ||
*Dosage Forms: PO 324 (IM and IV formulations available outside US) | *Dosage Forms: PO 324 (IM and IV formulations available outside US) | ||
*Common Trade Names: Qualaquin | *Common Trade Names: Qualaquin | ||
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==Adult Dosing== | ==Adult Dosing== | ||
===[[Malaria]]=== | ===[[Malaria]]=== | ||
* | *648mg PO Q8h x 7 days | ||
*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations | *See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations | ||
===[[Babesiosis]]=== | ===[[Babesiosis]]=== | ||
* | *648mg PO q6-8h x7-10 days | ||
*Use with [[Clindamycin]] | *Use with [[Clindamycin]] | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===[[Malaria]]=== | ===[[Malaria]]=== | ||
* | *30mg/kg/day PO q8h x 3-7 days | ||
*Max: | *Max: 648mg/dose | ||
*See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations | *See [http://www.cdc.gov/malaria/resources/pdf/treatmenttable.pdf CDC Recommendations] for full treatment recommendations | ||
===[[Babesiosis]]=== | ===[[Babesiosis]]=== | ||
* | *8mg/kg PO q8h x 7-10 days | ||
*Max: | *Max: 648mg/dose | ||
*Use with [[Clindamycin]] | *Use with [[Clindamycin]] | ||
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*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
***Severe chronic renal failure: | ***Severe chronic renal failure: 648mg PO x 1 then 324mg PO q12h | ||
***If on HD give after dialysis | ***If on HD give after dialysis | ||
**Pediatric | **Pediatric | ||
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==Contraindications== | ==Contraindications== | ||
===Black Box Warnings=== | ===Black Box Warnings=== | ||
*Hematologic Toxicity | *Hematologic Toxicity with use for nocturnal leg cramps | ||
**Thrombocytopenia | **Thrombocytopenia | ||
**[[HUS]]/[[TTP]] | **[[HUS]]/[[TTP]] | ||
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*Recent MI | *Recent MI | ||
===Caution=== | ===Caution=== | ||
*Torsades | *[[Torsades de pointes]] | ||
*Atrial fibrillation/Atrial flutter | *[[Atrial fibrillation]]/[[Atrial flutter]] | ||
*Pregnancy | *Pregnancy | ||
*Hepatic impairment | *Hepatic impairment | ||
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===Serious=== | ===Serious=== | ||
*Cinchonism | *Cinchonism | ||
*QT prolongation | *[[QT prolongation]] | ||
*Torsades de pointes | *[[Torsades de pointes]] | ||
*Anaphylaxis | *[[Anaphylaxis]] | ||
*Angioedema | *[[Angioedema]] | ||
*Bronchospasm | *Bronchospasm | ||
*Thrombocytopenia | *[[Thrombocytopenia]] | ||
*TTP/HUS | *[[TTP]]/[[HUS]] | ||
*Hemolytic anemia | *Hemolytic anemia | ||
*Black water fever | *Black water fever | ||
*Stevens-Johnson syndrome | *[[Stevens-Johnson syndrome and toxic epidermal necrolysis]] | ||
*Intestinal nephritis | *Intestinal nephritis | ||
*Renal impairment | *Renal impairment | ||
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*Leukopenia | *Leukopenia | ||
*Neutropenia | *Neutropenia | ||
*DIC | *[[DIC]] | ||
*Hypoglycemia | *[[Hypoglycemia]] | ||
* | *[[Myasthenia gravis]] exacerbation | ||
*Lupus | *[[Lupus]] | ||
*Optic neuritis | *[[Optic neuritis]] | ||
*Blindness | *Blindness | ||
*Deafness | *Deafness | ||
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*Pruritus | *Pruritus | ||
*Urticaria | *Urticaria | ||
*Diarrhea | *[[Diarrhea]] | ||
*Abdominal pain | *Abdominal pain | ||
*Photosensitivity | *Photosensitivity | ||
==Pharmacology== | ==Pharmacology== | ||
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*Excretion: Urine | *Excretion: Urine | ||
*Mechanism of Action: Unknown | *Mechanism of Action: Unknown | ||
==Administration== | |||
*Give with food | |||
==Toxicity== | |||
*Mild | |||
**Nausea | |||
**Vomiting | |||
**Tinnitus | |||
**Vertigo | |||
**Deafness | |||
*Severe | |||
**Ataxia | |||
**Convulsions | |||
**Coma | |||
**QRS/QT prolongation | |||
**Arrhythmia | |||
*Retinal Toxicity | |||
**Blurry vision | |||
**Impaired visual fields | |||
**Blindness | |||
==See Also== | ==See Also== | ||
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*[[Babesiosis]] | *[[Babesiosis]] | ||
== | ==References== | ||
*Epocrates | *Epocrates | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 22:12, 23 September 2019
General
- Type: Antimalarial
- Dosage Forms: PO 324 (IM and IV formulations available outside US)
- Common Trade Names: Qualaquin
Adult Dosing
Malaria
- 648mg PO Q8h x 7 days
- See CDC Recommendations for full treatment recommendations
Babesiosis
- 648mg PO q6-8h x7-10 days
- Use with Clindamycin
Pediatric Dosing
Malaria
- 30mg/kg/day PO q8h x 3-7 days
- Max: 648mg/dose
- See CDC Recommendations for full treatment recommendations
Babesiosis
- 8mg/kg PO q8h x 7-10 days
- Max: 648mg/dose
- Use with Clindamycin
Special Populations
- Pregnancy Rating: C
- Lactation: Probably safe
- Renal Dosing
- Adult
- Severe chronic renal failure: 648mg PO x 1 then 324mg PO q12h
- If on HD give after dialysis
- Pediatric
- Not defined
- Adult
- Hepatic Dosing
- Adult and Pediatric
- No adjustment for Child-Pugh Class A or B
- Avoid in Child-Pugh Class C
- Adult and Pediatric
Contraindications
Black Box Warnings
General
- Allergy to class/drug
- Allergy to mefloquine or quinidine
- Black water fever
- ITP/TTP/HUS
- Thrombocytopenia
- Glucose-6-Phosphate Deficiency (G6PD)
- Myasthenia gravis
- Optic neuritis
- QT prolongation/Congenital long QT syndrome
- Electrolyte abnormalities
- Bradycardia
- Ventricular arrhythmias
- CHF
- Recent MI
Caution
- Torsades de pointes
- Atrial fibrillation/Atrial flutter
- Pregnancy
- Hepatic impairment
Adverse Reactions
Serious
- Cinchonism
- QT prolongation
- Torsades de pointes
- Anaphylaxis
- Angioedema
- Bronchospasm
- Thrombocytopenia
- TTP/HUS
- Hemolytic anemia
- Black water fever
- Stevens-Johnson syndrome and toxic epidermal necrolysis
- Intestinal nephritis
- Renal impairment
- Hepatitis
- Leukopenia
- Neutropenia
- DIC
- Hypoglycemia
- Myasthenia gravis exacerbation
- Lupus
- Optic neuritis
- Blindness
- Deafness
Common
- Cinchonism
- Headache
- Vasodilation
- Diaphoresis
- Nausea/Vomiting
- Tinnitus
- Impaired hearing
- Vertigo
- Visual impairment
- Fever
- Flushing
- asthenia
- Rash
- Pruritus
- Urticaria
- Diarrhea
- Abdominal pain
- Photosensitivity
Pharmacology
- Half-life: 9-12 hours
- Metabolism: Liver 80%, CYP450
- Excretion: Urine
- Mechanism of Action: Unknown
Administration
- Give with food
Toxicity
- Mild
- Nausea
- Vomiting
- Tinnitus
- Vertigo
- Deafness
- Severe
- Ataxia
- Convulsions
- Coma
- QRS/QT prolongation
- Arrhythmia
- Retinal Toxicity
- Blurry vision
- Impaired visual fields
- Blindness
See Also
References
- Epocrates