Quinidine
Sulfate (Quinadex Extentabs, Quinora) |
Category:
Description:
Indications:
-
PO:
PVC’s, ventricular tachycardia (when not associated with complete
heart block), junctional (nodal) dysrhythmias, AV junctional premature
complexes, paroxysmal junctional tachycardia, premature atrial
contractions, paroxysmal atrial tachycardia, atrial flutter, atrial
fibrillation (chronic and paroxysmal)
-
IM/IV:
when PO therapy not feasible or when rapid therapeutic effect is
required, life threatening Plasmodium
falciparum malaria
Contraindications:
-
Digitalis
intoxication manifested by AV conduction disorders, complete AV block
with an AV nodal or idioventricular pacemaker, left bundle branch
block, or other severe intraventicular condition defects with marked
QRS widening, ectopic impulses, and abnormal rhythms due to escape
mechanisms, history of drug-induced torsade de pointes, history of
long QT syndrome, myasthenia gravis
Precautions:
-
Pregnancy
category C; use during pregnancy considered safe for the fetus; high
doses can produce oxytocic properties and potential for abortion;
excreted in breast milk; compatible with breast feeding
-
Treatment
of atrial flutter without prior medication to control ventricular rate
-
Marginally
compensated cardiovascular disease, incomplete AV block
-
Digitalis
intoxication, hyperkalemia, renal, or hepatic insufficiency
Adverse
Reactions (Side Effects):
-
CNS:
apprehension, ataxia, confusion, delirium, dementia, depression,
dizziness, excitement, fever, headache, vertigo
-
CV:
angioedema, arterial embolism, bradycardia, complete AV block,
hypotension, prolonged QT interval, syncope, torsade de pointes,
ventricular extrasystoles, ventricular flutter, ventricular
tachycardia and fibrillation, widening of the QRS complex
-
EENT:
disturbed hearing, disturbed vision, optic neuritis, reduced visual
field
-
GI:
abdominal pain, diarrhea, esophagitis, hepatotoxicity, nausea,
vomiting
-
HEME:
acute hemolytic anemia, agranulocytosis, leukocytosis, neutropenia,
thrombocytopenic purpura
-
MS:
arthralgia, increase in serum skeletal muscle creatine phosphokinase,
myalgia
-
SKIN:
abnormalities of pigmentation, cutaneous flushing with intense
pruritus, eczema, exfoliative eruptions, photosensitivity, psoriasis,
purpura, rash, urticaria, vasculitis
-
MISC:
cinchonism, lupus nephritis, positive ANA, systemic lupus
erythematosus
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Dosage:
Administered
orally
-
Adult: Give 200mg test dose PO/IM (gluconate) several hours before
full dosage to determine possibility of idiosyncratic reaction: PO
10-600mg every 4-6 hours, initiate at 200 mg/dose and adjust dose to
maintain desired therapeutic effect, max 3-4g daily; SUS REL 300-600mg
every 8-12 hours;
-
Child: Give 2 mg/kg test dose PO/IM (gluconate) several hours before
full dosage to determine possibility of idiosyncratic reaction: PO
15-60 mg/kg/day divided into 4-5 doses or 6 mg/kg every 4-6 hours;
usual 30 mg/kg/day or 900mg per square meter daily given in 5 divided
doses
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The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
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