NAME OF THE DRUG Quinine

CLASSIFICATION anti-pyretic, antimalarial, analgesic, and antiinflammatory

DOSAGE AND ROUTE

MECHANISM OF ACTION Quinine depresses oxygen uptake and carbohydrate metabolism, elevates pH in intracellular organelles of parasites. It then produces parasitic death. Quinine also relaxes skeletal muscle by increasing the refractory period, decreasing excitability of motor end plates, and affecting the distribution of calcium with muscle fiber.

INDICATIONS Quinine is used to prevent and treat nocturnal recumbent leg cramps. Used alone, or with pyrimethamine and sulfonamide for the treatment of chloroquineresistant falciparum malaria.

CONTRAINDICATIONS Contraindicated to pregnant women,

ADVERSE EFFECTS Nausea Headache Tinnitus Slight visual disturbances Rashes Wheezing Dyspnea Angioedema Cardiac conduction disturbances Decreased hearing

NURSING CONSIDERATIONS

Question for possibility of pregnancy prior to initiating therapy. Question for hypersensitivity to quinine, quinidine. Evaluate initial ECG and CBC results. Check for hypersensitivity: flushing, rash/urticaria, itching, dyspnea, and wheezing. Assess level of hearing, visual acuity, presence of headache or tinnitus, and nausea. Report adverse effects promptly

Monitor CBC results for blood dyscrasias Be alert to infection, bleeding or bruising, and unusual tiredness or weakness. Assess pulse and ECG for arrhythmias. Check fasting blood sugar levels; watch out for hypoglycemia.