Pharmacokinetics of quinine and 3-hydroxyquinine in severe falciparum malaria with acute renal failure

✍ Scribed by Paul Newton; Duangsuda Keeratithakul; Paktiya Teja-Isavadharm; Sasithon Pukrittayakamee; Dennis Kyle; Nicholas White

• Publisher: Elsevier Science
• Year: 1999
• Tongue: English
• Weight: 468 KB
• Volume: 93
• Category: Article
• ISSN: 0035-9203
• DOI: 10.1016/s0035-9203(99)90184-0

✦ Synopsis

The plasma concentrations of quinine and its main metabolite, 3-hydroxyquinine (30HQn), were measured in 5 adult Thai patients with severe Plasmodium falciparum malaria and acute renal failure. Two patients required peritoneal dialysis but all survived. During acute renal failure plasma concentrations of 30HQn rose to reach up to 45% of the levels of the parent compound. The estimated median (range) quinine clearance was 0.83 mL/kg/ min (0.58-l-16), and 30HQn clearance/fraction of quinine converted was 3.40 ml/kg/mm (2.58-4.47). The estimated 30HQn terminal elimination half-life was 2 1 h (16.5-32.5). These data suggest that 30HQn contributes about 12% of the antimalarial activity of the parent compound in patients with falciparum malaria and acute renal failure. It is also likely that 30HQn contributes to adverse effects, although this metabolite is not quantitated routinely by current highperformance liquid chromatography quinine assays.