Quinine Injection is a sterile solution used primarily for the treatment of severe malaria. It contains quinine dihydrochloride as the active ingredient and is available in 2 ml ampoules, typically at a concentration of 300 mg/ml.
Key Features
- Active Ingredient: Each 2 ml ampoule contains 600 mg of quinine dihydrochloride.
- Forms and Strengths: The injection is provided in a concentrated form that requires dilution before administration.
- Pack Size: Commonly available in packs of 10 ampoules.
Indications
Quinine Injection is indicated for:
- Severe Malaria: Used as an alternative to injectable artesunate when the latter is not available. It is effective against Plasmodium falciparum, the most dangerous malaria parasite.
Dosage Instructions
- Loading Dose: Administer 20 mg/kg of body weight over a period of 4 hours.
- Maintenance Dose: After 8 hours, administer 10 mg/kg every 8 hours. If treatment exceeds 48 hours, the maintenance dose may be reduced to 5-7 mg/kg.
- For children under 20 kg, doses should be calculated based on weight, typically given in a volume of 10 ml/kg.
Administration
- Route of Administration: Quinine should be administered via slow intravenous infusion or intramuscular injection. It should never be given as an intravenous bolus due to the risk of severe hypotension.
- For intravenous administration, dilute the quinine in a suitable volume (e.g., 250 ml of 5% glucose solution) for slow infusion.
Side Effects
Common side effects may include:
- Nausea and vomiting
- Tinnitus (ringing in the ears)
- Headache and dizziness
- Visual disturbances
Serious side effects can include:
- Severe allergic reactions (e.g., rash, difficulty breathing)
- Cardiac arrhythmias and hypotension if administered improperly
- Hypoglycemia (low blood sugar)
- Hemolytic anemia or thrombocytopenia (low platelet count)
Precautions
- Contraindications: Not suitable for individuals with known hypersensitivity to quinine or those with certain conditions such as myasthenia gravis or optic neuritis.
- Monitor blood glucose levels, especially in pregnant women, as quinine can stimulate insulin release.
- Use caution in patients with renal impairment; dosage adjustments may be necessary.
