HININ (Chininum).

     Alkaloid contained in the crust different tree bark (Chinchona). According to the chemical structure of a (6'- metoksihinolil-4 ') - (5-vinilhinuklidil-2) - karbinolom.

     Quinine has diverse effects on the human organism. It oppresses thermostatic centers and reduce body temperature with febrile illnesses; Anxiety lowers heart muscle, lengthens Refractory period and slightly reduces its ability Oxytocics; Institute uterine musculature and makes its reductions reduces spleen.

     Quinine TSNS oppresses; In high doses cause of bleeding, ringing in the ears, headache, dizziness; Can cause of view.

     The main feature is its antimalarial quinine effect. By type of action, it is similar to hingaminom (chloroquine), but it gives way to activity. Quinine quickly withdrawn from the body. Currently quinine mainly used in the malaria parasite resistance to hingaminu (and other antimalarial drugs), because in some cases, malaria parasite remain sensitive to the quinine.

     In medical practice, apply the following salt quinine.

     Quinine hydrochloride (Chinini hydrochloridum; Synonyms: Chininum hydrochloricum, Quinini hydrochloridum).

     Newly dyed bright or white powder melkokristallichesky, very bitter taste. Soluble in water (easier in the hot).

     Quinine digidrohlorid (Chinini dihydrochloridum).

     Colourless crystals or a white crystalline powder. It is a bitter taste. Very easily soluble in water.

     Quinine sulfate (Chinini sulfas, synonyms: Chininum sulfuricum, Quinini sulfas).

     Yield bright silky, M melkokristallichesky crystals or a white powder, bitter taste. Few soluble in water.

     Hydrochloride and quinine sulfate tablets designate, powders, capsules; Digidrohlorid, in the form of injections.

     With malaria, quinine sulphate or hydrochloride adults taken inside in a daily dose 1 0-1, 2 g (2 - 3 admission) for 5 to 7 days.

     Daily dose for children under 1 year, 0.01 grams per month of the child's life (not more than 0.1 grams), from 1 year to 10 years - to 0.1 g for 1 year life of 11 to 15 years - 1 g, age 15-adult dose. Children quinine injections are not recommended because of the power of education aims.

     In severe cases of malaria are inside adults and 1, 5 g quinine hydrochloride per day in 2 - 3 admission.

     In malignant malaria during quinine digidrohlorid enter deeply into the subcutaneous fat skin (but not in the muscle) in one-day dose of 2 g (4 mL of 25% or 2% 50 ml solution quinine dihydrochloride, with a minimum interval between injections 6 to 8 h. ). In an extremely difficult course make the first injection intravenously, giving 0.5 g quinine dihydrochloride, which 1 ml 50% solution drug razvodyat in 20 ml of 40% glucose solution, or 20 ml isotonic sodium chloride solution. Intravenous impose very slowly. Solution tentatively fuel to + 35 C. Following the introduction of veins, impose 0.5 g (1 ml 50% solution) dihydrochloride quinine in subcutaneous fat skin. The rest of quinine (1 g) subcutaneously imposed after 6 to 8 h.

     Before intravenous must ensure that the patient is well past endured quinine. With the realms of intravenous quinine can cause sudden death.

     In vascular events weakness (low frequency pulse, crush vein), a type of skin isotonic sodium chloride solution and stimulating sensation means: camphors, caffeine, ephedrine, Norepinephrine, korazol and others.

     In the days following the treatment cycle to quinine injections in dose 2 grams per day. Upon his return in the absence of consciousness and diarrhoea quinine appointed interior.

     Quinine often causes side effects: noise in the ears, dizziness, nausea, heart, shaking hands, insomnia. In realms of quinine already small dose can cause erythema, hives, increased body temperature, uterine bleeding, gemoglobinuriynuyu fever.

     Contraindications: increased sensitivity to the drug, indicating a deficit enzyme glyukoza-6- fosfatdegidrogenazy, gemoglobinuriynaya fever, diseases of middle and inner ear. The relative contraindications: cardiac decompensation and later months of pregnancy. In appointing quinine pregnant to avoid abortion, daily intake should not exceed 1 g, and this dose should be divided into 4 - 5 receptions.

     To initiate and strengthen tribal activities, quinine salt (more hydrochloride) previously designated usually in combination with other means rodostimuliruyuschimi (estrogens, oxytocin, calcium chloride, etc.). Is inside of 0.1 - 0.15 g 4 to 6 times a day (in 15 - 30 minutes after taking other drugs). If hypotension uterus in the early postpartum period, sometimes introducing intravenous 1 - 3 ml of 50% solution quinine dihydrochloride in 20 ml of 5% glucose solution and isotonic sodium chloride solution.

     Currently, the new effective (see Tools, enabling the uterine musculature), quinine in obstetric practices do not apply.

     With regard to the ability of lower anxiety and cardiac muscles lengthened Refractory period quinine previously used for the treatment and prevention ekstrasistoly, usually in combination with medication digitalis. To prevent attacks paroxysmal tachycardia, appoint a long-term (7 to 10 days a month) to 0.1 g quinine hydrochloride into 2 to 3 times a day. In paroxysmal tachycardia attacks sometimes resorted to a solution intravenous quinine dihydrochloride: slowly entered 1 - 2 mL of 50% or 2 to 4 mL of 25% solution.

     Currently on the widely used as a means antiaritmicheskogo isomer quinine quinidine sulfate (see).

     Method of issuance: powder; Quinine hydrochloride tablets and quinine sulfate for 0.25 and 0.5 g; 50% solution quinine dihydrochloride in 1 ml ampoule.

     Storage: a well ukuporennoy packaging keeps from the world.

Materials allowed to copy only with the active hyperlink to the handbook of medicines