QUINIDINE GLUCONATE

Other

Brand names: Quinidine Gluconate

Pregnancy: Category COral

Mechanism of Action

Mechanisms of action In patients with malaria, quinidine acts primarily as an intra-erythrocytic schizonticide, with little effect upon sporozites or upon pre-erythrocytic parasites. Quinidine is gametocidal to Plasmodium vivax and P. malariae , but not to P. falciparum . In cardiac muscle and in Purkinje fibers, quinidine depresses the rapid inward depolarizing sodium current, thereby slowing phase-0 depolarization and reducing the amplitude of the action potential without affecting the resting potential. In normal Purkinje fibers, it reduces the slope of phase-4 depolarization, shifting the threshold voltage upward toward zero. The result is slowed conduction and reduced automaticity in all parts of the heart, with increase of the effective refractory period relative to the duration of the action potential in the atria, ventricles, and Purkinje tissues. Quinidine also raises the fibrillation thresholds of the atria and ventricles, and it raises the ventricular de fibrillation thresho

Indications

generally patients who have had previous episodes of atrial fibrillation/flutter that were so frequent and poorly tolerated as to outweigh

in the judgment of the physician and the patient

the risks of prophylactic therapy with quinidine gluconate. The increased risk of death should specifically be considered. Quinidine gluconate should be used only after alternative measures (e.g.

use of other drugs to control the ventricular rate) have been found to be inadequate. In patients with histories of frequent symptomatic episodes of atrial fibrillation/flutter

the goal of therapy should be an increase in the average time between episodes. In most patients

the tachyarrhythmia will recur during therapy

Contraindications

• CONTRAINDICATIONS Quinidine is contraindicated in patients who are known to be allergic to it
• quinidine is also contraindicated in any patient whose cardiac rhythm is dependent upon a junctional or idioventricular pacemaker
• including patients in complete atrioventricular block. Quinidine is also contraindicated in patients who
• like those with myasthenia gravis
• might be adversely affected by an anticholinergic agent.

FDA Warnings

In many trials of antiarrhythmic therapy for non-life-threatening arrhythmias, active antiarrhythmic therapy has resulted in increased mortality; the risk of active therapy is probably greatest in patients with structural heart disease

Known Side Effects

8 documented side effects by frequency

Falls

1-10%

Drug Not Working

1-10%

Dizziness

1-10%

Fatigue

1-10%

Diarrhea

1-10%

Nausea

1-10%

Drowsiness

0.1-1%

Depression

0.1-1%

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Formulations

Dosage Forms

Tablet

Route

Oral