Quinidine gluconate

Identify the monitoring parameters for quinidine gluconate in severe malaria. 

Treatment of serious malarial infection requires admission to an acute care service, intravenous administration of quinidine gluconate, and symptomatic support. 

In an uncomplicated attack of malaria (for all plasmodia except chloroquine-resistant P. falciparum and P. vivax), the recommended regimen is chloroquine 600 mg (base) initially, followed by 300 mg (base) 6 hours later, and then 300 mg (base) daily for 2 days.3 In severe illness or falciparum malaria, patients should be admitted to an acute care unit and quinidine gluconate 10 mgsalt/kg... 

Quinidine gluconate - Life-threatening Plasmodium falciparum malaria. 

Test dose Administer a single 200 mg tablet of quinidine sulfate or 200 mg IM quinidine gluconate to determine whether the patient has an idiosyncratic reaction. Adjust the dosage to maintain plasma concentration between 2 to 6 mcg/mL. 

IM- n the treatment of acute tachycardia, the initial dose is 600 mg quinidine gluconate. Subsequently, 400 mg quinidine gluconate can be repeated as often as every 2 hours. 

V- In approximately 50% of patients who respond successfully to quinidine, the arrhythmia can be terminated by 330 mg quinidine gluconate or less (or its equivalent in other salts) as much as 500 to 750 mg may be required. Inject... 

QUINIDINE GLUCONATE - P. falciparum malaria The following 2 regimens are effective empirically. As soon as practical, institute standard oral antiplasmodial therapy. 

IV (quinidine gluconate) - 2 to 10 mg/kg/dose every 3 to 6 hours as needed however, this route is not recommended. 

Quinidine is rapidly absorbed from the Gl tract. Maximum effects of quinidine gluconate occur 30 to 90 minutes after IM administration onset is more rapid after IV administration. Activity persists for at least 6 to 8 hours. The average therapeutic serum levels are reported to be 2 to 7 mcg/mL. Toxic reactions may occur at levels from 5 to 8 mcg/mL or more. Quinidine is 80% to 90% bound to plasma proteins the unbound fraction may be significantly increased in patients with hepatic insufficiency. 

Class I, Type 1A Antiarrhythmics disopyramide disopyramide phosphate procainamide hydrochloride quinidine bisulfate quinidine gluconate quinidine sulfate... 

Cinchona alkaloids quinidine gluconate injection quinine sulfate... 

Oral sustained-release (Quinidex Extentabs) 300 mg tablets Quinidine gluconate [62% quinidine base] (generic)... 

The stability of procainamide in glucose infusions may be improved by the addition of sodium bicarbonate. Patients receiving sodium chloride infusions of procainamide are prone to the risk of heart failure due to sodium load.121122 Quinidine gluconate is incompatible with intravenous infusion sets made of PVC due to drug loss by adsorption.123... 

D. Darbar, et al., Loss of quinidine gluconate injection in a polyvinyl chloride infusion system. Am. J. Health Sys. Pharmacol. 53 655-658, 1996. 

Soluble 1 in 8 of water and 1 in 3 of ethanol practically insoluble in ether. Quinidine Gluconate... 

Quinidine Gluconate 582.6 Kanamycin Sulphate 707.8 Dihydroergocristine Mesylate... 

Quinidine Gluconate Pseudoephedrine Hydro- 189-192 Hydroxy amphetamine Hydro-... 

Glucono delta lactone 5.5-7.0 Quinidine Gluconate(Lilly)... 

A previously healthy 63-year-old man, who had taken quinidine gluconate 972 mg/day for 9 months, developed diffuse edematous erythema on the extensive surfaces of the hands, arms, and face, with marked accentuation over the joints. His nail-fold capillaries were dilated and the shoulder abductors were shghtly weak. His erythrocyte sedimentation rate was shghtly raised (29 mm/hour) and there was a positive ANA titer (1 640) with a speckled pattern. There were no antibodies to Sm, ribonucleoprotein, SSA or SSB antigens, or histones. There was no evidence of inflammatory myopathy on electromyography, and a skin biopsy showed a mild, superficial, perivascular, lymphocytic inflammation with positive direct immunofluorescence for IgG and IgM at the dermoepidermal junction. There was no evidence of malignancy. All these abnormalities resolved rapidly after quinidine withdrawal. 

Saraiya K, Bolton S. Use of Precirol to prepare sustained release tablets of theophylline and quinidine gluconate. Drug Dev Ind Pharm 1990 16(13) 1963-1969. 

Quinidine also inhibits a adrenoceptors, causing vasodilatation the subsequent reflex increase in sympathetic outflow (as a result of hypotension) results in this drug having proarrhythmic effects. Quinidine can be given either via nasogastric tube (quinidine sulfate) or intravenously (i.v. quinidine gluconate). 

Quinidine sulfate is indicated for the treatment of sustained AF while i.v. qumidine gluconate is indicated for treatment of ventricular tachycardia (Fig. 12.3, Table 12.3) and recent onset AF (<7 days duration. Table 12.3) (Gerber et al 1971, Muir et al 1990), although paroxysmal AF can convert spontaneously to sinus rhythm within 48h in the absence of treatment. The recommended regimen for use of quinidine gluconate is 1.1-2.2 mg/kg i.v. 

Quinidine gluconate Acute-onset atrial fibrillation ventricular tachycardia 2.2 mg/kg i.v. every 10 min 12 mg/kg total... 

Lidocaine is indicated for the treatment of ventricular tachycardias (Fig. 12.4). Electrolyte abnormalities should be investigated and corrected prior to lidocaine administration. Lidocaine is administered as i.v. bolus doses of 0.5 mg/kg every 5 min, up to a total dose of 4 mg/kg (Table 12.3) (Muir Mcguirk 1987). Although lidocaine is used frequently in anaesthetized horses, quinidine gluconate or procainamide are preferred in conscious horses because they do not produce CNS side effects. 

Quinidine gluconate 1.1-2.2mg/kg, every lOmin, total dose 8-12mg/kg 0.064% solution, 0.5-2.01/h i.v. 

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