Quinine: Difference between revisions

(Remove disease-specific entries now covered by AntibioticDose (8 sections))
(Fix corrupted content: restore correct Quinine (antimalarial) content, was incorrectly showing Risperidone)
 
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==Administration==
==General==
*Type: Atypical [[antipsychotic]]
*Type: [[Antimalarial]]
*Dosage Forms: 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg; 1mg/mL
*Dosage Forms: PO 324 (IM and IV formulations available outside US)
*Routes of Administration: Oral, IM
*Common Trade Names: Qualaquin
*Common Trade Names: Risperdal


==Adult Dosing==
==Adult Dosing==
===Indications by Disease===
===Indications by Disease===
{{#ask: [[Has DrugName::Quinine]] [[Has Population::Adult]]
{{#ask: [[Has DrugName::Quinine]] [[Has Population::Adult]]
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==Pediatric Dosing==
==Pediatric Dosing==
===Indications by Disease===
===Indications by Disease===
{{#ask: [[Has DrugName::Quinine]] [[Has Population::Pediatric]]
{{#ask: [[Has DrugName::Quinine]] [[Has Population::Pediatric]]
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==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out
*Lactation: Probably safe
*Renal:
*Renal Dosing
**Adult:
**Adult
***CrCl <30: Start 0.5 mg BID then increase by 0.5mg BID weekly
***Severe chronic renal failure: 648mg PO x 1 then 324mg PO q12h
***HD: Not defined
***If on HD give after dialysis
**Pediatric:
**Pediatric
***Not defined, see adult dosing.
***Not defined
*Hepatic:
*Hepatic Dosing
**Adult:
**Adult and Pediatric
***Child-Pugh Class C: Start 0.5 mg BID and increase by 0.5mg BID weekly
***No adjustment for Child-Pugh Class A or B
**Pediatric:
***Avoid in Child-Pugh Class C
***Not defined, see adult dosing.


==Contraindications==
==Contraindications==
===Black Box Warnings===
*Hematologic Toxicity with use for nocturnal leg cramps
**Thrombocytopenia
**[[HUS]]/[[TTP]]
===General===
*Allergy to class/drug
*Allergy to class/drug
*Caution:
*Allergy to mefloquine or quinidine
**Pediatric/adolescent pts
*Black water fever
**Pregnancy 3rd trimester
*ITP/[[TTP]]/[[HUS]]
**Elderly pts
*Thrombocytopenia
**Dementia-related psychosis
*[[Glucose-6-Phosphate Deficiency (G6PD)]]
**Renal impairment
*[[Myasthenia gravis]]
**Hepatic impairment
*[[Optic neuritis]]
**Parkinson's Disease
*QT prolongation/Congenital long QT syndrome
**[[Neuroleptic malignant syndrome]] history
*Electrolyte abnormalities
**Seizure history
*Bradycardia
**Cardiovascular disease
*Ventricular arrhythmias
**[[Diabetes mellitus]]
*[[CHF]]
**Suicide risk
*Recent MI
===Caution===
*[[Torsades de pointes]]
*[[Atrial fibrillation]]/[[Atrial flutter]]
*Pregnancy
*Hepatic impairment


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*[[Hypotension]], [[syncope]]
*Cinchonism
*Extrapyramidal symptoms: [[tardive dyskinesia]]
*[[QT prolongation]]
*[[Neuroleptic malignant syndrome]], [[hyperthermia]]
*[[Torsades de pointes]]
*[[Hyperglycemia]], [[diabetes mellitus]], [[DKA]]
*[[Anaphylaxis]]
*[[Seizure]], [[Priapism]], [[Stroke]], [[TIA]]
*[[Angioedema]]
*Dysphagia
*Bronchospasm
*[[Leukopenia]], [[Neutropenia]], [[Agranulocytosis]]
*[[Thrombocytopenia]]
*Suicidality
*[[TTP]]/[[HUS]]
*[[Pancreatitis]]
*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===
===Common===
*Akathisia, dystonia, parkinsonism, tremor
*Cinchonism
*Sedation/[[fatigue]], [[dizziness]], blurred vision, [[anxiety]], confusion
*Headache
*[[Rash]]
*Vasodilation
*Hyperprolactinemia, weight gain, increased appetite
*Diaphoresis
*[[Constipation]], [[diarrhea]], [[nausea]]/[[vomiting]]
*Nausea/Vomiting
*Urinary incontinence
*Tinnitus
*[[Cough]], URI
*Impaired hearing
*[[Photosensitivity]], visual disturbance
*Vertigo
*Visual impairment
*Fever
*Flushing
*asthenia
*Rash
*Pruritus
*Urticaria
*[[Diarrhea]]
*Abdominal pain
*Photosensitivity


==Pharmacology==
==Pharmacology==
*Half-life: 20h (PO); 3-6 day (IM)
*Half-life: 9-12 hours
*Metabolism: Hepatic, CYP2D6
*Metabolism: Liver 80%, CYP450
*Excretion: Urine 70%, Feces 14%
*Excretion: Urine
*Mechanism of Action: Unknown


==Mechanism of Action==
==Administration==
*Unknown
*Give with food
*5HT-2 inhibitor, weaker D2 inhibitor
 
==Comments==
==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==
[[Antipsychotics]]
*[[Malaria]]
*[[Babesiosis]]
 
==References==
==References==
*Epocrates
<references/>
<references/>
[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:Psychiatry]]
[[Category:ID]]

Latest revision as of 12:10, 20 March 2026

General

  • Type: Antimalarial
  • Dosage Forms: PO 324 (IM and IV formulations available outside US)
  • Common Trade Names: Qualaquin

Adult Dosing

Indications by Disease

DiseaseDoseContext
Babesiosis650mg TIDSevere parasitemia with Clindamycin use IV for severe
Malaria648mg PO q8h x 7 daysUncomplicated malaria, use with doxycycline or clindamycin

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Babesiosis8mg/kg PO q8h x 7-10 days (Max: 648mg/dose)Severe parasitemia with Clindamycin
Malaria30mg/kg/day PO q8h x 3-7 days (Max: 648mg/dose)Uncomplicated malaria, 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
  • Hepatic Dosing
    • Adult and Pediatric
      • No adjustment for Child-Pugh Class A or B
      • Avoid in Child-Pugh Class C

Contraindications

Black Box Warnings

  • Hematologic Toxicity with use for nocturnal leg cramps

General

Caution

Adverse Reactions

Serious

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
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