84228 Quinine

Name of the Procedure:

Quinine Administration

Summary

Quinine is a medication used to treat malaria, a disease caused by parasites transmitted through mosquito bites. The drug is typically administered orally in tablet form but can also be given intravenously under certain conditions.

Purpose

Quinine is primarily used to treat malaria, specifically caused by Plasmodium falciparum, the most dangerous type of malaria parasite. The goal is to eliminate the parasite from the patient's bloodstream, alleviating symptoms and preventing further complications.

Indications

• Signs and symptoms of malaria such as fever, chills, sweating, headache, nausea, and vomiting.
• Confirmed diagnosis of Plasmodium falciparum infection based on blood tests.

Preparation

• No specific preparation is typically required for oral administration.
• For intravenous administration, a blood test to confirm malaria and kidney function tests may be required.
• Patients should inform their healthcare provider of any other medications they are taking to avoid potential interactions.

Procedure Description

Oral Administration:

1. Patient swallows the quinine tablet(s) with water.

2. Medication is taken with food to minimize gastrointestinal discomfort.

   Intravenous Administration:

3. An IV line is inserted into a vein.
4. Quinine solution is infused over a specified period, often several hours.
5. Monitoring for any adverse reactions during and after infusion.

Duration

• Oral administration: A course of treatment typically lasts 7 days.
• Intravenous administration: Each infusion can take several hours and may be done daily for several days based on severity.

Setting

• Oral administration: Can be done at home or in any comfortable setting.
• Intravenous administration: Performed in a hospital setting or outpatient clinic.

Personnel

• Oral: Prescribed by a physician, no other healthcare personnel are required for administration.
• Intravenous: Administered by a nurse or healthcare provider, with a physician overseeing the treatment plan.

Risks and Complications

Common risks:

• Nausea
• Headache
• Ringing in the ears (tinnitus)
• Dizziness

Rare but serious risks:

• Cardiac arrhythmias
• Severe allergic reactions
• Low blood sugar
• Hemolytic anemia

Benefits

• Effective clearance of the malaria parasite from the bloodstream.
• Symptom relief often begins within 1-2 days of starting treatment.
• Prevents complications from severe malaria, such as organ failure.

Recovery

• Patients should rest and stay hydrated.
• Follow-up blood tests may be required to ensure the infection is cleared.
• Mild side effects may persist during the course of the treatment but should resolve after completion.

Alternatives

• Artemisinin-based combination therapies (ACTs): Often used as first-line treatments.
• Chloroquine: For specific types of malaria.

• Mefloquine or Atovaquone-proguanil: Other antimalarial medications.

  Pros and cons:

• Some alternatives may have fewer side effects or different dosing schedules.
• Quinine is often used when other treatments are not suitable or available.

Patient Experience

• Oral administration is straightforward but may cause gastrointestinal or auditory side effects.
• Intravenous administration requires more time and monitoring, and patients may feel discomfort from the IV line.
• Pain management for side effects involves over-the-counter pain relievers as recommended by a healthcare provider.

Comfort measures:

• Staying hydrated and taking medications with food can help reduce side effects.
• Patients should report any severe or unusual symptoms to their healthcare provider immediately.