QUINAQUIN 50MG/5ML SYRUP

Indications

• Food preservation
• Antioxidant applications
• Reduction of oxidative stress

Dosage

Children: Refer to specific guidelines or consult a healthcare professional for dosing recommendations, as doses can vary based on the indication.

Adults: Refer to specific guidelines or consult a healthcare professional for dosing recommendations, as doses can vary based on the indication.

Mechanism of action

Bisulphate acts as a reducing agent, donating electrons to other molecules, which can help in neutralizing free radicals and preventing oxidative stress. It interacts with sulfite oxidase in the body, facilitating the conversion of sulfite to sulfate, a less toxic form. This mechanism is particularly relevant in the context of sulfite metabolism and detoxification.

Pharmacodynamics

Bisulphate's pharmacodynamics are primarily related to its antioxidant properties. It helps to protect cells from oxidative damage by scavenging free radicals. The compound also plays a role in maintaining the acid-base balance in the body, as it can act as a buffer in certain physiological conditions.

Pharmacokinetics

Bisulphate is rapidly absorbed and metabolized in the body. It is primarily metabolized in the liver, where it is converted to sulfate. The elimination route is mainly through urine, where it is excreted as sulfate. The half-life of bisulphate is short, necessitating frequent dosing in certain applications.

Adverse effects

• Headache
• Nausea
• Diarrhea
• Skin rash
• Hypersensitivity reactions

Precautions

• Use with caution in patients with asthma or respiratory issues
• Monitor for allergic reactions in sensitive individuals

Pregnancy

The safety of bisulphate during pregnancy has not been established. Use only if clearly needed and after assessing risks versus benefits.

Breast-feeding

It is not known whether bisulphate is excreted in human milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Severe falciparum malaria
• Chloroquine-resistant malaria
• Malaria prophylaxis in high-risk areas

Dosage

Children: Child (body-weight 45 kg and above): Loading dose 20 mg

Adults: Loading dose: 20 mg/kg (max. 1.4 g) infused over 4 hours. Maintenance: 10 mg/kg every 8 hours (max. per dose 700 mg). For non-falciparum malaria, 600 mg every 8 hours for 5–7 days, in combination with doxycycline or clindamycin.

Mechanism of action

Quinine and related antimalarial drugs are theorized to be toxic to malaria parasites by interfering with their ability to digest hemoglobin. This leads to starvation of the parasite and accumulation of toxic levels of partially degraded hemoglobin. Quinine acts as a blood schizonticide and has been shown to inhibit heme polymerase, resulting in increased levels of cytotoxic heme within the parasite.

Pharmacodynamics

Quinine is particularly effective against chloroquine-resistant strains of Plasmodium falciparum. It acts as a blood schizonticide and possesses gametocytocidal activity against Plasmodium vivax and Plasmodium malariae. It is a weak base and becomes concentrated in the food vacuoles of the parasite, which enhances its antimalarial efficacy. Due to its side effects and toxicity, its use is generally reserved for severe cases of malaria.

Pharmacokinetics

Quinine is administered intravenously or orally, with a half-life that can vary based on the route of administration and the patient's renal function. Peak plasma concentrations are typically achieved within 1 to 3 hours of intravenous administration. It is metabolized in the liver and excreted primarily through urine. Dosing must be adjusted in cases of renal impairment to avoid toxicity.

Adverse effects

• alopecia
• angioedema
• bone marrow disorders
• choleostasis
• constipation
• diarrhoea
• fever
• gastric disorders
• megaloblastic anaemia
• oral disorders
• skin reactions
• vasculitis

Interactions

• quinine + digoxin: Moderate (increases concentration)
• hiv-protease inhibitors + quinine: Unknown (affects exposure)
• cimetidine + quinine: Unknown (increases exposure)
• rifampicin + quinine: Unknown (decreases exposure)

Precautions

• history of seizures-avoid large loading doses
• predisposition to folate deficiency

Pregnancy

Benefit of prophylaxis in malaria outweighs risk. Adequate folate supplements should be given to the mother.

Breast-feeding

Quinine is excreted in breast milk, caution is advised.

Storage

Store in a cool, dry place. Protect from light.

Formulations

• Quinine hydrochloride
• Quinine dihydrochloride
• Quinine sulfate

Mechanism of action

The theorized mechanism of action for quinine and related anti-malarial drugs is that these drugs are toxic to the malaria parasite. Specifically, the drugs interfere with the parasite's ability to break down and digest hemoglobin. Consequently, the parasite starves and/or builds up toxic levels of partially degraded hemoglobin in itself. Quinine has a local anesthetic action and analgesic, antipyretic, and oxytocic effects. Quinine also has cardiovascular effects similar to those of quinidine.

Pharmacodynamics

Quinine is used parenterally to treat life-threatening infections caused by chloroquine-resistant Plasmodium falciparum malaria. Quinine acts as a blood schizonticide although it also has gametocytocidal activity against P. vivax and P. malariae. Because it is a weak base, it is concentrated in the food vacuoles of P. falciparum. It is thought to act by inhibiting heme polymerase, thereby allowing accumulation of its cytotoxic substrate, heme. As a schizonticidal drug, it is less effective and more toxic than chloroquine. However, it has a special place in the management of severe falciparum malaria in areas with known resistance to chloroquine.