DOI: 10.36347/sjmcr.2014.v02i01.012

Pages: 32-33

Quinine is the chief alkaloid of cinchona, the powdered bark of the South American cinchona tree.Resistance to quinine is uncommon but increasing. It acts primarily against asexual erythrocytic forms and associated with doserelated toxicitieslike cinchonism, hypoglycemia, and hypotension. Mild forms of cinchonism consisting of high-tone deafness, visual disturbances and headache occur very frequently.Disturbance of vision had reported that in 17% of patients with quinine overdose, 75% of these patients were completely blind.A 30 years old female, admitted in the female general medicine department with the complaints of vomitings along with fever, chills, rigors and treated with a loading dose of quinine IV in normal saline, along with intravenously pantoprazole and intravenously ondansetron. Within one hour after administration of quinine intravenously, the patient complained severe headache and visual disturbances. Naranjo ADR scale was used to assess the causality of reported ADR (Score-7 indicating a probable association).Upon confirmation of the causality, quinine was withdrawn from the patient.The patient was treated for malaria with artesunate, ceftriaxone and was discharged two days later after he was found to be stable.