HINYN (Chininum; a synonym of Quinine) — antimalarial means; the alkaloid which is contained in bark of different types of a cinchonic tree (Cin-choma). [6 '-Metoksikhinolil-(4')] - [5-vinilkhinuklidil-(2)] - carbinol; C20H24N2O2:
In medical practice quinine is used in the form of the following salts. Quinine hydrochloride (Chinini hydro-chloridum; synonym of Quinini hydrochlori-dum; GFH) — colourless brilliant silky sticks or inodorous white fine-crystalline powder, very bitter taste. Let's dissolve in water (1:30), it is easy — in boiling (1:1), in alcohol (1:3). Contains 82% of quinine (basis). Water solutions will sterilize at t ° 100e within 30 min.
Quinine dihydrochloride (Chininum dihydrochloricum; synonym of Quinini di-hydrochloridum; GFH) — colourless crystals or inodorous white crystal powder, very bitter taste. Let's very easily dissolve in water (1:0,7), it is alcohol-soluble (1:12). Contains 72,3% of quinine (basis). Water r-ry prepare aseptically.
Quinine sulfate (Chinini sulfas; synonym of Quinini sulfas; GFH) — colourless brilliant silky acicular crystals or inodorous white fine-crystalline powder, very bitter taste. We will dissolve in water (1:900) a little, we will dissolve in a boiling water (1:25), it is difficult alcohol-soluble (1:100). Contains 74% of quinine (basis).
Quinine belongs to antimalarial drugs of gematoshizotrop-ny action and development of sexless erythrocyte forms of activators of all types of malaria oppresses. Besides, possesses a row pharmakol. effects: oppresses functions of c. the N of page, has febrifugal effect, lowers excitability and contractility of a myocardium, has antiarrhythmic effect, stimulates smooth muscles of a uterus.
Quinine is well soaked up at different ways of introduction and easily gets through fabric barriers, including through a placenta. After intake absorption of quinine happens hl. obr. from upper parts of a small bowel and in this regard it significantly is not broken at ponosa. A considerable part of the entered quinine is metabolized. Release of quinine and its metabolites happens rather quickly, generally kidneys. An elimination half-life — apprx. the 10th hour. At prolonged use of cumulation it is not observed.
Apply quinine of hl. obr. for treatment of drug resistant forms of tropical malaria. For this purpose it is appointed in a daily dose 1 — 1,2 g (in 2 — 3 receptions) in a combination with streptocides (see. Sulfanamide drugs) and Chloridinum (see). Treatment is carried out for 5 — 7 days. To children till 1 year of quinine sulfate is appointed at the rate of 0,01 g to 1 month of life of the child, but by no more than 0,1 g a day, to children from 1 year to 10 years — in a daily dose at the rate of 0,1 g for a year of life, children are from 11 to 15 years old — 1 g a day, 15 years — in the same doses, as well as the adult are more senior.
At the complicated course of tropical malaria and at development of a coma enter 50% solution of quinine of dihydrochloride kapelno intravenously at the rate of 0,005 — 0,02 g/kg a day. Introduction is repeated in 8 — 12
hours 2 — 3 days in a row. As soon as possible pass to treatment with quinine sulfate within 3 — 7 days. In the absence of quinine of dihydrochloride it is possible to use instead of it quinine a hydrochloride.
Side effect of quinine is shown by a sonitus, dizziness, vomiting, tachycardia, a tremor, sleeplessness. In high doses quinine can cause decrease in hearing and sight, kollaptoidny reactions. At an idiosyncrasy to quinine even small doses of this drug can cause a small tortoiseshell, an erythema, exfoliative dermatitis, uterine bleedings, hemoglobinuric fever.
Quinine is contraindicated at hypersensitivity to it, and also to non-narcotic analgesics, streptocides, aromatic sulphones and Primachinum, at congenital anomaly of erythrocytes (deficit of enzyme of a glyukozo-6-phosphate-dehydrogenase), hemoglobinuric fever, diseases of an inner and middle ear. Relative contraindications are the decompensation of cordial activity and late durations of gestation. In earlier durations of gestation in order to avoid its premature interruption the daily dose of quinine shall be not higher than 1 g, and it is necessary to appoint it in
4 — 5 receptions.
Forms of release: powder; tab
letka of quinine of a hydrochloride and quinine of sulfate on 0,25 and 0,5 g; ampoules of quinine of dihydrochloride on 1 ml of 50% of solution. Storage: in well corked container protecting from effect of light.
See also Antimalarial means.
Bibliography: The medicines used at parasitic diseases under the editorship of A. I. Krotov, M., 1979; L about and K. M. N and E. S. Malyariya's Slider, M., 1983; The Guide to tropical diseases, under the editorship of. And * Ya. Lysenko, page 99, etc., M., 1983; Instructions on treatment and chemoprophylaxis of malaria, under the editorship of Sh. D. Moszkowski, M., 1972; Chemotherapy of malaria, ed. by L. J. Bruce-Chwatt, Geneva, 1981. S. A. Rabinovich.