Quinidine: Difference between revisions
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==Background==
==Administration==
*Inexpensive with restricted indications, causing it to be inaccessible in many areas globally
*Type:
*Main manufacturer halted production in 2010<ref>Olsson  G.; To the editor—Market withdrawal of quinidine bisulfate (Kinidin Durules) in 2006. Heart Rhythm. 2010;7:864</ref>
*Dosage Forms:
*Historically both supraventricular tachydysrhytmia, ventricular dysrhythmia, malaria treatment, many other first-line therapies have replaced its use
*Routes of Administration:
*Common Trade Names:
 
==Adult Dosing==
===Ventricular dysrhythmias<ref>Athena Health. Epocrates. Quinidine Gluconate Monograph. https://online.epocrates.com/u/10a72/quinidine+gluconate.</ref>===
*Quinidine gluconate IV 0.25 mg/kg/min over 20-40 min, max 10 mg/kg per conversion attempt
*PO alternative: 648 mg PO q8 x3-4 doses
 
===Severe [[malaria]]===
*Load 10 mg/kg IV over 2hrs, then 0.02 mg/kg/min IV/PO x3 days, in conjunction with [[doxycycline]]
 
==Pediatric Dosing==
 
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Lactation risk categories|Lactation risk]]:
===Renal Dosing===
*Adult:
*Pediatric:
===Hepatic Dosing===
*Adult:
*Pediatric:
 
==Indications==
*An effective treatment and prevention strategy for<ref>Viskin S et al. Quinidine, A Life-Saving Medication for Brugada Syndrome, Is Inaccessible in Many Countries. J Am Coll Cardiol. 2013;61(23):2383-2387.</ref>:
*An effective treatment and prevention strategy for<ref>Viskin S et al. Quinidine, A Life-Saving Medication for Brugada Syndrome, Is Inaccessible in Many Countries. J Am Coll Cardiol. 2013;61(23):2383-2387.</ref>:
**[[Brugada syndrome]] arrhythmic [[electrical storm]]
**[[Brugada syndrome]] arrhythmic [[electrical storm]]
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**Early repolarization syndrome (though NOT benign, see [[benign early repolarization]])
**Early repolarization syndrome (though NOT benign, see [[benign early repolarization]])
**Congenital [[short QT syndrome]]
**Congenital [[short QT syndrome]]
==Administration<ref>Athena Health. Epocrates. Quinidine Gluconate Monograph. https://online.epocrates.com/u/10a72/quinidine+gluconate.</ref>==
 
*For ventricular dysrhythmias:
==Contraindications==
**Quinidine gluconate IV 0.25 mg/kg/min over 20-40 min, max 10 mg/kg per conversion attempt
*Allergy to class/drug
**PO alternative: 648 mg PO q8 x3-4 doses
 
*For severe [[malaria]]: load 10 mg/kg IV over 2hrs, then 0.02 mg/kg/min IV/PO x3 days, in conjunction with [[doxycycline]]
==Adverse Reactions==
==Monitoring==
===Serious===
 
===Common===
 
==Pharmacology==
*Half-life:
*Metabolism:  
*Excretion:  
 
==Mechanism of Action==
 
==Comments==
*Inexpensive with restricted indications, causing it to be inaccessible in many areas globally
*Main manufacturer halted production in 2010<ref>Olsson  G.; To the editor—Market withdrawal of quinidine bisulfate (Kinidin Durules) in 2006. Heart Rhythm. 2010;7:864</ref>
*Discontinue quinidine infusion if<ref>Quinidine gluconate dilution. GlobalRPH. http://www.globalrph.com/quinidine_gluconate_dilution.htm</ref>:
*Discontinue quinidine infusion if<ref>Quinidine gluconate dilution. GlobalRPH. http://www.globalrph.com/quinidine_gluconate_dilution.htm</ref>:
**Sinus rhythym restored
**Sinus rhythym restored
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**Development of significant tachycardia, symptomatic bradycardia, hypotension
**Development of significant tachycardia, symptomatic bradycardia, hypotension


==Sources==
==See Also==
 
==References==
<references/>
<references/>
 
[[Category:Pharmacology]]
[[Category:Cardiology]]
[[Category:Cardiology]]

Revision as of 14:47, 2 October 2016

Administration

  • Type:
  • Dosage Forms:
  • Routes of Administration:
  • Common Trade Names:

Adult Dosing

Ventricular dysrhythmias[1]

  • Quinidine gluconate IV 0.25 mg/kg/min over 20-40 min, max 10 mg/kg per conversion attempt
  • PO alternative: 648 mg PO q8 x3-4 doses

Severe malaria

  • Load 10 mg/kg IV over 2hrs, then 0.02 mg/kg/min IV/PO x3 days, in conjunction with doxycycline

Pediatric Dosing

Special Populations

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult:
  • Pediatric:

Indications

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:

Mechanism of Action

Comments

  • Inexpensive with restricted indications, causing it to be inaccessible in many areas globally
  • Main manufacturer halted production in 2010[3]
  • Discontinue quinidine infusion if[4]:
    • Sinus rhythym restored
    • QRS complex widens > 130% of pre-treatment QRS duration
    • QTc widens > 130% of pre-treatment duration OR > 500 ms
    • Disappearance of T-waves
    • Development of significant tachycardia, symptomatic bradycardia, hypotension

See Also

References

  1. ↑ Athena Health. Epocrates. Quinidine Gluconate Monograph. https://online.epocrates.com/u/10a72/quinidine+gluconate.
  2. ↑ Viskin S et al. Quinidine, A Life-Saving Medication for Brugada Syndrome, Is Inaccessible in Many Countries. J Am Coll Cardiol. 2013;61(23):2383-2387.
  3. ↑ Olsson G.; To the editor—Market withdrawal of quinidine bisulfate (Kinidin Durules) in 2006. Heart Rhythm. 2010;7:864
  4. ↑ Quinidine gluconate dilution. GlobalRPH. http://www.globalrph.com/quinidine_gluconate_dilution.htm
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