PHARMACOKINETICS AND CLINICAL TOXICITY OF QUININE OVERDOSAGE - LACK OF EFFICACY OF TECHNIQUES INTENDED TO ENHANCE ELIMINATION

  • 1 January 1985
    • journal article
    • research article
    • Vol. 54  (214) , 125-131
Abstract
Clinical details in 16 cases of quinine poisoning were reported. [Quinine is used to treat myotonia, nocturnal cramps and as an illicit abortifacient.] Plasma quinine concentrations > 15 mg/l were associated with increased risks of permanent visual damage and of cardiac arrhythmias from which 1 patient died. The rate of quinine elimination was not significantly altered by forced acid diuresis in 5 patients. (t1/2 25.1 .+-. SEM [standard error of the mean] 4.6 h) as compared to 8 patients treated conservatively (t1/2 26.5 .+-. SEM 5.78 h). Neither urinary pH or flow rate correlated consistently with urinary quinine clearance. In 3 other patients charcoal column hemoperfusion, hemodialysis and exchange transfusion were performed. These were also ineffective in increasing quinine elimination. Techniques advocated to increase quinine elimination are ineffective in the management of quinine poisoning.