Abstract
Quinine poisoning is rare but serious. Attempts at treatment by active removal have proved unsuccessful because of its high degree of protein binding. We describe two cases of non-accidental overdose of quinine (19.5 g and 15 g) with potentially fatal serum quinine levels. Both patients were treated by 2 periods of charcoal haemoperfusion during which quinine clearances of up to 125 ml/min were obtained. Both patients recovered, though one had some residual visual disturbance. We suggest that in cases of quinine poisoning, charcoal haemoperfusion may be a safe and effective method of drug removal, to be used with stellate ganglion block.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Burrows A. W., Hambleton G., Hardman M. J., Wilson B. D. Quinine intoxication in a child treated by exchange transfusion. Arch Dis Child. 1972 Apr;47(252):304–305. doi: 10.1136/adc.47.252.304. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coutselinis A., Boukis D. Quinine concentrations in blood and viscera in a case of acute fatal intoxication. Clin Chem. 1977 May;23(5):914–914. [PubMed] [Google Scholar]
- Donadio J. V., Jr, Whelton A., Kazyak L. Quinine therapy and peritoneal dialysis in acute renal failure complicating malarial haemoglobinuria. Lancet. 1968 Feb 24;1(7539):375–379. doi: 10.1016/s0140-6736(68)91351-2. [DOI] [PubMed] [Google Scholar]
- Floyd M., Hill A. V., Ormston B. J., Menzies R., Porter R. Quinine amblyopia treated by hemodialysis. Clin Nephrol. 1974 Jan-Feb;2(1):44–46. [PubMed] [Google Scholar]
- GLICK L., MUMFORD J. Quinine amblyopia; treatment by stellate ganglion block. Br Med J. 1955 Jul 9;2(4931):94–96. doi: 10.1136/bmj.2.4931.94. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kolthammer J. The in vitro adsorption of drugs from horse serum onto carbon coated with an acrylic hydrogel. J Pharm Pharmacol. 1975 Nov;27(11):801–805. doi: 10.1111/j.2042-7158.1975.tb10220.x. [DOI] [PubMed] [Google Scholar]
- Markham T. N., Dodson V. N., Eckberg D. L. Peritoneal dialysis in quinine sulfate intoxication. JAMA. 1967 Dec 18;202(12):1102–1103. [PubMed] [Google Scholar]
- Taggart J. V., Earle D. P., Berliner R. W., Zubrod C. G., Welch W. J., Wise N. B., Schroeder E. F., London I. M., Shannon J. A. STUDIES ON THE CHEMOTHERAPY OF THE HUMAN MALARIAS. III. THE PHYSIOLOGICAL DISPOSITION AND ANTIMALARIAL ACTIVITY OF THE CINCHONA ALKALOIDS. J Clin Invest. 1948 May;27(3 Pt 2):80–86. doi: 10.1172/JCI101977. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vale J. A., Rees A. J., Widdop B., Goulding R. Use of charcoal haemoperfusion in the management of severely poisoned patients. Br Med J. 1975 Jan 4;1(5948):5–9. doi: 10.1136/bmj.1.5948.5. [DOI] [PMC free article] [PubMed] [Google Scholar]