Quinidine

Details About Generic Salt ::  Quinidine 

Main Medicine Class:: Cardiovascular System   Sub Medicine Class ::  Anti Arrhythmics

4B. ANTI-ARRHYTHMICS in 4. CARDIOVASCULAR SYSTEM
QUINIDINE
CINCHONA ALKALOID | ANTI-ARRHYTHMIC (CLASS IA), ANTI-MALARIAL
also comes under 13J. Anti-Malarials in 13. Anti-Infectives
PK: D: 2-3 L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: CARDIAC ARRHYTHMIAS PO Adult 200-400mg 3-4 times/day as sulfate dehydrate (initial test dose of 200mg is recommended), adjust dose to response | IV Adult 5mg/kg given at rate of no faster than 250µg/kg/min gluconate max 10mg/kg; monitor ECG & BP throughout the infusion | PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA PO Adult 400–600mg (as sulfate) q2-3h | PLASMODIUM FALCIPARUM MALARIA Severe IV Adult Infusion: Loading dose 10mg/kg over 1-2h, continuous maintenance infusion of 0.02mg/kg/min for 72h or until parasitemia drops to <1% or shift oral therapy | PREMATURE ATRIAL CONTRACTIONS PO Adult Initially 200–400mg (as sulfate) q2–4h Child Initially 30mg/kg/day or 900 mg/m2/day 5 divided doses (as sulfate) | IV Adult 800mg (16mg/min as gluconate) | IM Adult 600mg (as gluconate) then 400mg q2h as needed | TO CONVERT ATRIAL FIBRILLATION TO SINUS RHYTHM PO Adult 200mg q2 or 3h for 5-8 doses (as sulfate), increase daily until sinus rhythm returns/toxic effects occur max 4g or 300mg q8-12h (as sulphate ER) or 324-660mg q8-12h (as gluconate ER) | IV Adult 800mg (as gluconate) in diluted solution infused no faster than 0.25mg/kg/min

Precautions: Arrhythmias

ADR: Serious: blood dyscrasias, anaphylaxis, granulomatous hepatitis, lupus-like syndrome, cinchonism, hypotension, prolongs QT interval, precipitate ventricular arrhythmia, dyspnea, angina, Others: GI irritation, urticaria, pruritus, rashes, light headedness

DDI: Serious Neuromuscular blockers activity potentiated, Verapamil/Diltiazem causes hypotension, bradycardia, ventricular tachycardia, AV block, pulmonary edema, Aspirin causes petechiae & GI bleeding, Magnesium Hydroxide/Aluminum Hydroxide Gel increases drug level, Amiodarone increases drug level leads to fatal arrhythmias, β-blockers increases plasma levels, Anticoagulants increases risk of bleeding, Itraconazole leads to QT prolongation, Disopyramide level is increased, Procainamide prolongs QT interval, Sucralfate/Rifampicin reduces drug effect, Phenytoin/Phenobarbital/Primidone reduces drug levels, Digoxin risk of toxicity increases

Diet: With food

Monitor: ECG, CBC, LFTs, renal function tests

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