Description of the medicine: Quinine (Chininum)
The alkaloid contained in the bark of various species of the quinine tree (Chinchona). The chemical structure is (6'-methoxyquinolyl-4 ') - (5-vinylquinuclidyl-2) -carbinol.
Quinine has a versatile effect on the human body. It inhibits thermoregulatory centers and reduces body temperature in case of febrile illnesses; lowers the excitability of the heart muscle, lengthens the refractory period and slightly reduces its contractility; excites the muscles of the uterus and enhances its contractions, reduces the spleen.
Quinine depresses the central nervous system; in large doses, causes a state of stunning, tinnitus, headache, dizziness; may cause visual impairment.
The main feature of quinine is its antimalarial effect. By the type of action, it is similar to hingamine (chloroquine), but inferior to it in activity. Quinine is rapidly excreted from the body. Currently, quinine is mainly used for the resistance of the malaria parasite to chingamine (and other antimalarial drugs), since in some cases, the malaria parasite remains sensitive to the action of quinine.
In medical practice, the following quinine salts are used.
Quinine hydrochloride (Chinini hydrochloridum; synonyms: Chininum hydrochloricum, Quinini hydrochloridum).
Colorless shiny needles or white crystalline powder, very bitter in taste. Soluble in water (easier in hot).
Quinine dihydrochloride (Chinini dihydrochloridum).
Colorless crystals or a white crystalline powder. It tastes very bitter. Very soluble in water.
Quinine sulfate (Chinini sulfas, synonyms: Chininum sulfuricum, Quinini sulfas).
Colorless shiny silky, needle-like crystals or white fine crystalline powder, bitter in taste. Slightly soluble in water.
Hydrochloride and quinine sulfate are prescribed in tablets, powders, capsules; dihydrochloride - in the form of injections.
With malaria, quinine sulfate or hydrochloride, adults take orally in a daily dose of 1, 0 - 1, 2 g (in 2 - 3 doses) for 5 to 7 days.
The daily dose for children under 1 year is 0.01 g per month of the child's life (but not more than 0.1 g), from 1 year to 10 years - 0.1 g per 1 year of life, from 11 to 15 years - 1 g, over 15 years old - adult dose. Quinine injections are not recommended for children due to the possibility of necrosis.
In severe cases, malaria is given orally to adults by 1, 5 g of quinine hydrochloride per day in 2 to 3 doses.
In malignant malaria, quinine dihydrochloride is injected deep into the subcutaneous fat (but not into the muscles) on the 1st day at a dose of 2 g (4 ml of 25% or 2 ml of a 50% solution of quinine dihydrochloride, twice with an interval between injections of 6 - 8 hours ) In extremely severe cases, make the first injection intravenously, introducing 0.5 g of quinine dihydrochloride, for which 1 ml of a 50% solution of the drug is diluted in 20 ml of a 40% glucose solution or 20 ml of an isotonic sodium chloride solution. Intravenously administered very slowly. The solution is preheated to + 35 C. Following the introduction into the vein, 0.5 g (1 ml of a 50% solution) of quinine dihydrochloride is injected into the subcutaneous fat.