Quinine

Other Names : Qualaquin, (R)-(6-Methoxyquinolin-4-yl)((2S,4S,8R)-8-vinylquinuclidin-2-yl)methanol
Quinine is a drug obtained from the cinchona bark that is used mainly in the treatment of malaria, an infection caused by the protozoan parasite Plasmodium, which is transmitted to humans by the bite of various species of mosquitoes. During the 300 years between its introduction into Western medicine and World War I, quinine was the only effective remedy for malaria. As a specific treatment for this disease, quinine has benefited more people than any other drug used thus far to fight infectious diseases. The treatment of malaria with quinine marked the first successful use of a chemical compound in combating an infectious disease. Quinine was first synthesized in a laboratory in 1944; however, synthesis of the drug on a commercial scale is not economically feasible.

Special Precautions of Quinine

• Potentially serious interactions with other drugs
• Abnormal heart rhythms (Cardiac Arrhythmias) : Quinine treatment has been known to cause cardiac arrhythmias. Cardiac arrhythmia is a disruption of the heart's normal beating pattern, causing it to beat too fast, too slow or in an irregular interval. Heart rhythm problems impair the heart's ability to properly pump blood to vital organs and potentially impair the ability to sustain life. Cardiac arrhythmias can be treated by a class of drugs known as anti-arrhythmics or even an artificial pacemaker if the condition is severe enough.
• Thrombocytopenia, a blood platelet disorder that can cause hemorrhage or clotting problems. This disorder is characterized by a decreased number of platelets in the blood. Platelets are the cells that give blood the ability to clot. Thrombocytopenia can lead to abnormal blood clotting or abnormal bleeding. There often are no symptoms associated with this condition. However, thrombocytopenia may lead to blood clot formation, which can cause headaches, dizziness or tingling in the extremities.
• Cinchonism (Mild) : Cinchonism, also known as quinism, is a medical condition in humans that occurs from an overdose of quinine. There are several medical symptoms associated with cinchonism. Individuals who acquire this condition may experience flushed or sweaty skin, ringing in the ears, confusion, blurred vision, abdominal pain and headache. These effects generally occur with a small overdose when a therapeutic dose of quinine is given, or with long-term use of products that contain quinine, such as tonic water. Large overdoses of quinine have effects that are far more severe.
• Cinchonism (Severe) : There is an extremely small margin for error when dealing with quinine doses and treatment. There is a very small difference between correct dose and overdose. Severe overdoses of quinine can have potentially fatal consequences. Major overdoses of quinine can cause cardiotoxic effects such as hypotension, cardiogenic shock and life-threatening cardiac arrhythmias. A major overdose of quinine may also have toxic effects to the central nervous system, causing loss of consciousness, seizures and coma. In addition, toxic levels of quinine may cause respiratory abnormalities such as pulmonary edema (lungs fill with fluid) and adult respiratory distress syndrome (severe lung disease which may lead to multiple organ failure and possibly death).
• Severe hypersensitivity reactions : Other quinine side effects may include nausea, stomach cramps, ringing in the ears, headache, anxiety, blurry or double vision, irregular heart rhythms, skin rash and fever.

Benefits and uses of Quinine are

Currently, treatment of malaria is the only approved use of quinine by the U.S. Food and Drug Administration (FDA). This medication was once believed to have value for the treatment of leg cramps. However, quinine treatments were linked to severe, even fatal medical effects, which prompted the FDA in 1995 to ban the substance for all uses other than treatment of malaria.

• Uncomplicated Malaria : According to Drugs.com, quinine is mainly used to treat uncomplicated malaria, a disease that is transmitted through the bites of mosquitoes. Malaria is a parasitic disease that is characterized by high fever, shaking chills, headache, fever, nausea, vomiting, muscle aches, anemia and jaundice. Malaria disease normally affects people living in warm climates such as South America, Africa and India. Malaria is not a common disease in the U.S., and the disease is mainly diagnosed in Americans who engage in international travel to countries where malaria is common. Quinine should not be used to prevent malaria, due to adverse side effects.
• Babesiosis : Drugs.com states that quinine may be used to treat babesiosis. Babesiosis is a life-threatening disease that is transmitted from animals to human beings by ticks. Signs and symptoms of babesiosis include fever, chills, sweating, weakness, muscle aches, loss of appetite, headache, joint pain and fatigue.
• Nighttime Leg Cramps : According to PubMed Health, the majority of quinine's use in the United States is for the treatment or prevention of nighttime leg cramps. Night leg cramps are sudden, painful, involuntary contractions of muscles in the legs. In most cases, night leg cramps involve the calf muscles, but muscles in the feet or thighs may cramp as well. Quinine may cause serious side effects and should only be used to treat nighttime leg cramps when alternative remedies have failed.