Quinine and chloroquine
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- 作者：Ruben Thanacoody
- 关键词：Alkalinization ; chloroquine ; cinchonism ; poisoning ; quinine ; torsade de pointes
- 刊名：Medicine
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：44
- 期：3
- 页码：197-198
- 全文大小：71 K
文摘
Quinine and chloroquine poisoning are characterized by severe cardiovascular toxicity resulting from sodium and potassium channel blockade, leading to hypotension, shock, arrhythmias and cardiac arrest. Quinine poisoning can cause irreversible visual loss. Severity of symptoms is closely related to the ingested dose and plasma concentration. Single-dose activated charcoal can be given within 1 hour of ingestion to reduce absorption. Multiple-dose activated charcoal enhances quinine elimination. Extracorporeal elimination techniques are ineffective. Arrhythmias are best treated by correction of hypoxia and electrolyte disturbances, and sodium bicarbonate to correct metabolic acidosis. Hypokalaemia resulting from intracellular potassium transfer is closely related to severity of chloroquine poisoning and should be corrected cautiously. Epinephrine is the vasopressor of choice in chloroquine poisoning. There is no proven effective treatment for established visual loss following quinine poisoning.