A patient is diagnosed with chloroquine resistant falciparum malaria. His treating physician advises nurse to administer quinine by IV infusion. The preferred IV fluid for quinine infusion is:
- The nurse will give quinine infusion through 5% dextrose. - Hypoglycaemia is the most impoant side effect which can be prevented by infusing quinine in 5% dextrose. Note: Adverse effects of quinine infusion: Hypoglycemia is also common, mostly in the treatment of severe malaria, and can be life threatening if not treated promptly with intravenous glucose. Hypotension is rarer but also serious and most often is associated with excessively rapid intravenous infusions of quinine or Quinidine. Quinine diluted preferably in 5% (w/v) glucose solution to counteract hypoglycemia. In the absence of glucose, physiological saline may be used. This method of administration minimizes the danger of severe hypotension and subsequent respiratory collapse. Don't give quinine as bolus. OTHER ADVERSE EFFECTS: 'Cinchonism' Syndrome Large single dose or higher therapeutic doses taken for a few days. Consists of ringing in ears, nausea, vomiting (due to both gastric irritation and CTZ stimulation), headache, mental confusion, veigo, difficulty in hearing. Visual defects (due to direct neurotoxicity as well as constriction of retinal and auditory vessels). Diarrhoea, flushing and marked perspiration. Completely STOPS once the drug is stopped. - Seldomly cause hemolyisis and idiosyncratic reactions.
Normal saline
5% dextrose
Ringer lactate
1/2 Normal saline
Anti-Malaria Drugs