The pharmacokinetic properties of intramuscular quinine in Gambian children with severe falciparum malaria.
Plasma quinine concentrations were measured in 21 Gambian children with severe falciparum malaria after intramuscular administration of a 20 mg (salt) per kg loading dose of quinine dihydrochloride followed by 10 mg/kg at 12 h intervals. Quinine was well absorbed reaching mean peak concentrations of 15.6 (standard deviation [SD] 4.5) mg/litre in a median time of 3 h (range 1-6 h). A one compartment model was fitted to the plasma concentration-time profile. The mean estimated systemic clearance (Cl/F) was 0.89 (SD 0.81) ml/kg/min and the mean elimination half life was 18.8 (SD 8.0) h. Two patients, one of whom died, had low plasma quinine levels which remained below 10 mg/litre. Mean peak and trough plasma concentrations after subsequent intramuscular doses ranged between 11.1 and 15.1 mg/litre. In most cases this dose regimen provided a satisfactory profile of blood concentrations for the treatment of severe malaria in children.
Waller
D
D
Nuffield Department of Clinical Medicine, University of Oxford, UK.
Krishna
S
S
Craddock
C
C
Brewster
D
D
Jammeh
A
A
Kwiatkowski
D
D
Karbwang
J
J
Molunto
P
P
White
N J
NJ
D000818:Animals; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008288:Malaria / Q000097:blood / Q000188:drug therapy*; D010963:Plasmodium falciparum; D011803:Quinine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use
D011803:Quinine