The Drug Quinine

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I was recently sick and diagnosed of malaria and typhoid, firstly a pharmacist prescribed medication for me (I know you will be wondering why I let a pharmacist prescribe medication for me without seeing a doctor. Oh! Yes, I always feel like I know what is right for me, because I was a health student and one of the course we had to study in school was Pharmacology. So I sometimes feel like not going to the hospital, when the illness isn’t serious but trust me please don’t try this, kindly see a doctor first. Well, after taking the doses of the said medication prescribed by the pharmacist, I wasn’t feeling any better “you then see why prescriptions. He prescribed his own medication for me. Among the drugs He prescribed for me was “Quinine” this particular medicine or should I say generally all medications with the word “quin” people react to them a lot, I for one do react to them a lot but with medications like “Piriton” and “Loratadine” which helps to minimize if not stop their side effect, these said drugs are safe to take and are very effective.

Cinchona calisaya

The quinine drug is always said to be the last option of medication for the treatment of malaria if other medication fails to do the work properly. Here is a short write up about the drug “Quinine” and also I will be giving you a tip of what worked for me, of course this was also prescribed by my doctor.
Quinine is a drug obtained from “cinchona” bark used chiefly to treat malaria and babesiosis. This include malaria due to plasmodium falciparum that is resistant to chloroquine when artesunate is not available. The bark extracts have been used to treat malaria since at least 1632. It is on the World Health Organization’s List Essential Medicines, the most effective and safe medicines needed in a health system.

BEFORE TAKING THIS MEDICINE.
If you have an allergy to quinine or any other part of quinine.
If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash hives, itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
If you have any of these health problems: Glucose-6-phosphate dehydrogenase (G6PD) deficiency, swelling of a nerve in the eye, heart problems like long QT on ECG or other abnormal heartbeat, or myasthenia gravis.
If you have any of these health problems: Liver problems, low magnesium levels, low potassium levels, or slow heartbeat.
If you are taking rifampin.
If you are taking ritonavir.
If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
This is not a list of all drugs or health problems that interact with quinine.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take quinine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
POSSIBLE SIDE EFFECTS OF QUININE.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using quinine and call your doctor at once if you have any of these serious side effects:
• fever, chills, confusion, weakness, sweating;
• severe vomiting, stomach pain, diarrhea;
• problems with vision or hearing;
• chest pain, trouble breathing, severe dizziness, fainting, fast or pounding heartbeats;
• severe flushing (warmth, redness, or tingly feeling);
• urinating less than usual or not at all;
• weak or shallow breathing, feeling like you might pass out;
• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
• blood in your urine or stools;
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
• loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
• headache, blurred vision, changes in color vision;
• mild dizziness, spinning sensation, ringing in your ears;
• upset stomach; or
• muscle weakness.

Quinine tablet

HOW TO TAKE QUININE.
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking quinine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth, with food to decrease upset stomach, exactly as prescribed by your doctor. This medication is usually taken every 8 hours for 3 to 7 days or as directed by your doctor.
Take this medication 2 to 3 hours before or after taking antacids containing aluminum or magnesium. These products bind with quinine, preventing your body from fully absorbing the drug.
Dosage and length of treatment are based on your medical condition, country where you were infected, other medications you may be taking for malaria, and your response to treatment.
The dosage in children is also based on weight.
It is very important to continue taking this medication (and other malaria medications) exactly as prescribed by your doctor. Do not take more or less of this drug than prescribed. Do not skip any doses. Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Skipping doses or stopping the medication too early may make the infection more difficult to treat and result in a return of the infection.
This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.
Tell your doctor if you do not start feeling better after 1-2 days of starting this medication. If your fever returns after completing this prescription, contact your doctor so that he/she can determine whether the malaria has returned.

DRUG INTERACTION.
Drug interactions may change how your medications work or increase your risk for serious side effects. This write up does not contain all possible drug interactions. Make sure to keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: “blood thinners” (such as warfarin), penicillamine.

QUININE OVERDOSE.
Symptoms of overdose may include:
 Blurriness or changes in color vision
 Symptoms of low blood sugar
 Changes in heartbeat
 Headache
 Nausea
 Vomiting
 Stomach pain
 Diarrhea
 Ringing in the ears or difficulty hearing
 Seizures
 Slow or difficult breathing


MISSED DOSE OF QUININE.
Take the missed dose as soon as you remember it.
However, if it has been more than four hours since the time you should have taken the dose, skip the missed dose and continue your regular dosing schedule.
Do not double up to make up for a missed one.
Lastly my secret tip for this particular medication and how it can be taken, is taking it with “Clindamycin” and this I will elaborate more on my next post.

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