Description of the medicine: Quinine (Chininum)

HININ (Chininum).

The alkaloid contained in the bark of various species of cinchona (Chinchona). The chemical structure is (6'-methoxyquinolyl-4 ') - (5-vinylquinuclidyl-2) -carbinol.

Quinine has a multifaceted effect on the human body. It inhibits thermoregulatory centers and reduces body temperature in febrile illnesses; Reduces the excitability of the heart muscle, lengthens the refractory period and somewhat reduces its contractility; Excites the muscles of the uterus and strengthens its contractions, reduces the spleen.

Quinine depresses the central nervous system; In large doses causes a state of stunning, ringing in the ears, headache, dizziness; Can cause visual impairment.

The main feature of quinine is its antimalarial effect. According to the type of action, it is similar to hingamine (chloroquine), but inferior to it by activity. Quinine is rapidly excreted from the body. At present, quinine is mainly used for the resistance of the malarial parasite to hingamine (and to other antimalarial drugs), since in some cases, the malarial 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 fine crystalline powder, very bitter in taste. Soluble in water (lighter in hot water).

Quinine dihydrochloride (Chinini dihydrochloridum).

Colorless crystals or white crystalline powder. Very bitter to the taste. Very easily soluble in water.

Quinine sulfate (Chinini sulfas, synonyms: Chininum sulfuricum, Quinini sulfas).

Colorless shiny silky, needle-like crystals or white fine crystalline powder, bitter to the taste. Slightly soluble in water.

Hydrochloride and quinine sulfate are prescribed in tablets, powders, capsules; Dihydrochloride - in the form of injections.

When malaria, quinine sulfate or hydrochloride, adults take inside at 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 for the life of the child (but not more than 0.1 g), from 1 year to 10 years - 0.1 g for 1 year of life, 11 to 15 years - 1 G, over 15 years - the dose of an adult. Injections of quinine to children are not recommended in view of the possibility of the formation of necrosis.

In severe cases, malaria is given to adults by 1, 5 g quinine hydrochloride per day in 2 to 3 doses.

In the malignant course of malaria, quinine dihydrochloride is injected deep into the subcutaneous adipose tissue (but not into the muscles) on the 1st day at a dose of 2 g (4 ml 25% or 2 ml 50% quinine dihydrochloride solution, twice with an interval between injections of 6-8 h ). In extremely severe course, the first injection is done intravenously, injecting 0.5 g quinine dihydrochloride, for which 1 ml of a 50% solution of the drug is diluted in 20 ml of 40% glucose solution or 20 ml isotonic sodium chloride solution. Intravenously injected very slowly. The solution is preheated to +35 C. After introduction into the vein, 0.5 g (1 ml of a 50% solution) of quinine dihydrochloride is injected into the subcutaneous fatty tissue.