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Quinidine
Information about Quinidine
Quinidine is a natural cinchona alkaloid which has potent antiarrhythmic activity and has been used for decades in the treatment of atrial and ventricular arrhythmias.
Liver safety of Quinidine
Quinidine has been associated with fever, mild jaundice and clinically apparent liver injury in up to 2% of treated patients.
Mechanism of action of Quinidine
Quinidine (kwin' i deen) and its stereoisomer quinine (kwye' nine) are natural cinchona alkaloids found in the powdered bark of the American cinchona tree. The bark powder was used for centuries in the prevention and therapy of malaria, but was also known to decrease heart palpitations. Quinidine was found to be the most potent of the antiarrhythmic substances extracted from the cinchona plant and was introduced into medical practice in the 1940s. Quinidine acts by depressing action potentials and is considered a myocardial depressant.
FDA approval information for Quinidine
It was formally approved for use in the United States in 1950 and was widely used to treat ventricular arrhythmias and to suppress the frequency of premature ventricular contractions. However, careful prospective studies demonstrated that suppression of ventricular arrhythmias can be associated with a decrease in survival and use of quinidine has fallen out of favor and now used largely for therapy of atrial flutter or fibrillation. Quinidine is also approved for intravenous use in treatment of life threatening Plasmodium falciparum malaria.
Dosage and administration for Quinidine
Quinidine is available in multiple generic forms in tablets of 200 and 300 mg as well as in sustained release formulations and as a solution for intravenous administration. A typical maintenance dose of standard formulations in adults is 200 to 400 mg three to four times daily.
Side effects of Quinidine
Common side effects include dizziness, headache, tinnitus, blurred vision, gastrointestinal upset, diarrhea, nausea and skin rash. List of antiarrhythmic agents:
- Amiodarone
- Disopyramide
- Dofetilide
- Dronedarone
- Flecainide
- Ivabradine
- Mexiletine
- Procainamide
- Propafenone
- Quinidine
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