title: Effects of Plasmodium falciparum infection on the pharmacokinetics of quinine and its metabolites in pregnant and non-pregnant Sudanese women.
abstract: OBJECTIVE
  The study aimed to investigate the effects of Plasmodium falciparum infection on the pharmacokinetics of quinine and its metabolites in pregnant and non-pregnant Sudanese women.
  
  
  METHODS
  In a case-control study, nine pregnant and eight non-pregnant Sudanese women infected with P. falciparum were treated with intramuscular artemether. Before being given artemether, they received a single dose of quinine hydrochloride as intravenous infusion. Blood samples were collected frequently and analysed for quinine and its metabolites (phase I). One week later (after clearance of parasitaemia) the quinine part of the protocol was repeated (phase II).
  
  
  RESULTS
  During phase I, the AUCs (mean ± SD) of quinine and its major metaboplite, 3-hydroxyquinine, in pregnant women were 428.2 ± 132.4 and 27.8 ± 14.1 μmol l(-1) h(-1) respectively. In non-pregnant women the AUCs of quinine and 3-hydroxyquinine were 517.8 ± 100.0 and 32.3 ± 15.3 μmol l(-1) h(-1). In pregnant women the mean (90% confidence interval) AUC ratios of phase I to phase II of quinine and 3-hydroxyquinine were 1.6 (0.61, 4.22) and 1.01 (0.18, 5.60). In non-pregnant women, the AUC ratios of phase I to phase II of quinine and 3-hydroxyquinine were 1.93 (1.74, 2.15) and 1.19 (0.95, 1.47).
  
  
  CONCLUSIONS
  Plasmodium falciparum infection significantly increased plasma concentration of quinine in non-pregnant women and showed the same trend in pregnant women.
authors: Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. rmirghani@kfmc.med.sa
authors: Rajaa A
authors: RA
authors: Mirghani
authors: Ishraga
authors: I
authors: Elagib
authors: Gehad
authors: G
authors: Elghazali
authors: Urban
authors: U
authors: Hellgren
authors: Lars L
authors: LL
authors: Gustafsson
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019540:Area Under Curve; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy / Q000378:metabolism*; D011803:Quinine / Q000493:pharmacokinetics* / Q000627:therapeutic use; D013397:Sudan
chemical_list: D000962:Antimalarials; D011803:Quinine