Quinine is the primary alkaloid of cinchona bark, which was used for centuries in the treatment of malaria. Quinine has been replaced to a large extent in modern therapy by the synthetic agents, but is still used for the relief of skeletal muscle cramps. It may also be found as an adulterant in heroin and is also present in small amounts in tonic water.
Adverse reactions to quinine include tinnitus, deafness, dizziness, visual difficulties and gastrointestinal disturbances; this spectrum of effects is known as cinchonism. Convulsions, cyanosis, hypotension, cardiac arrhythmias, coma, blindness and renal damage have been noted in cases of acute poisoning; haemodialysis or peritoneal dialysis was usually effective in attenuating the intoxication.
For TDM, sample should be taken prior to dose. If toxicity is suspected, take sample at earliest opportunity
Quinine measured by HPLC-DAD.
Therapeutic range: 1.0 - 7.0 mg/L. Toxic: >10 mg/L. (Schulz et al. Critical Care 2012, 16:R136).
Copyright heftpathology 2013, 2014, 2015, 2016, 2017, 2018
HTA licence number is 12366
Protection of Personal Information – Laboratory Medicine comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.
The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database https://heftpathology.site/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235
