Quinine is a medicine used for the treatment of a type of malaria that is resistant to treatment with another anti-malarial agent called chloroquine. Quinine operates in conjunction with other antibiotics by inhibiting the growth of Plasmodium falciparum, one of the parasites that cause malaria. Quinine is also used to treat babesiosis, a parasitic illness that usually infects non-human mammals. Although there are newer anti-malarial drugs available, quinine is sill the first-line drug therapy for treatment of severe malaria in developing countries, because of its widespread availability and low cost.
Side Effects
Common side effects of quinine administration include flushing and itching of the skin, and headache. It can cause problems with vision, such as blurring or night blindness. Quinine can decrease the production of blood cells, resulting in anemia, and thrombocytopenia, a condition in which platelets are significantly reduced, leading to easy bruising and spontaneous bleeding.
Considerations
Patients with a history of cardiac arrhythmias or QT prolongation are at risk of arrhythmias when taking quinine. Patients with myasthenia gravis, a disorder that causes muscle weakness, need to be aware that quinine can make them feel even more weak because it blocks the action of nerves on muscles.
Quinine Overdose
The constellation of side effects due to quinine overdose is called cinchonism. In large doses, a patient can exhibit ringing in the ears (a condition called tinnitus), decreased hearing, double vision, blindness, vertigo, confusion, nausea and headache. These symptoms result from quinine's direct effects on the central nervous system.
Treatment
Most side effects of quinine administration will correct themselves when the medicine is discontinued. The more serious side effects, like cardiac arrhythmias, need proper monitoring, and occasionally the patient will need hospitalization. Treatment of prolonged QT may include cardiac medicines and, if persistent, an implantable defibrillator.
Warning
Quinine can interact with other medications, producing other side effects. Antacids may decrease the amount of quinine absorbed by the body. Quinine can increase the effects of blood pressure medicines and anti-psychotic drugs.
Quinine is used for treatment of malaria only. It should not be used for prophylaxis against the disease.
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