Quinine liquid extract

Quinine liquid extract DEFAULT

Quinine

Not to be confused with quinidine, quinone, quinoline, chloroquine, or Quinine (album).

medication used to treat malaria and babesiosis

Quinine structure.svg
Quinine-3D-balls.png
Pronunciation, or KWIN-een
Trade namesQualaquin, Quinbisul, others[1]
AHFS/Drugs.comMonograph
MedlinePlusa682322
License data
Pregnancy
category
Routes of
administration
By mouth, intramuscular, intravenous, rectal
ATC code
Legal status
  • AU: S4 (Prescription only)
  • CA: ℞-only
  • UK: POM (Prescription only)
  • US: ℞-only
Protein binding70–95%[3]
MetabolismLiver (mostly CYP3A4 and CYP2C19-mediated)
Elimination half-life8–14 hours (adults), 6–12 hours (children)[3]
ExcretionKidney (20%)

IUPAC name

  • (R)-(6-Methoxyquinolin-4-yl)[(1S,2S,4S,5R)-5-vinylquinuclidin-2-yl]methanol

CAS Number
PubChemCID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard(EPA)
ECHA InfoCard100.004.550Edit this at Wikidata
FormulaC20H24N2O2
Molar mass324.424 g·mol−1
3D model (JSmol)
Melting point177 °C (351 °F)

SMILES

InChI

  • InChI=1S/C20H24N2O2/c1-3-13-12-22-9-7-14(13)10-19(22)20(23)16-6-8-21-18-5-4-15(24-2)11-17(16)18/h3-6,8,11,13-14,19-20,23H,1,7,9-10,12H2,2H3/t13-,14-,19-,20+/m0/s1 checkY
  • Key:LOUPRKONTZGTKE-WZBLMQSHSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Quinine is a medication used to treat malaria and babesiosis.[4] This includes the treatment of malaria due to Plasmodium falciparum that is resistant to chloroquine when artesunate is not available.[4][5] While sometimes used for nocturnal leg cramps, quinine is not recommended for this purpose due to the risk of serious side effects.[4] It can be taken by mouth or intravenously.[4] Malaria resistance to quinine occurs in certain areas of the world.[4] Quinine is also the ingredient in tonic water that gives it its bitter taste.[6]

Common side effects include headache, ringing in the ears, trouble seeing, and sweating.[4] More severe side effects include deafness, low blood platelets, and an irregular heartbeat.[4] Use can make one more prone to sunburn.[4] While it is unclear if use during pregnancy causes harm to the baby, treating malaria during pregnancy with quinine when appropriate is still recommended.[4] Quinine is an alkaloid, a naturally occurring chemical compound.[4] How it works as a medicine is not entirely clear.[4]

Quinine was first isolated in 1820 from the bark of a cinchona tree, which is native to Peru.[4][7][8] Bark extracts had been used to treat malaria since at least 1632 and it was introduced to Spain as early as 1636 by Jesuit missionaries returning from the New World.[9] It is on the World Health Organization's List of Essential Medicines.[10]

Uses[edit]

Medical[edit]

As of 2006, quinine is no longer recommended by the World Health Organization (WHO) as a first-line treatment for malaria, because there are other substances that are equally effective with fewer side effects. They recommend that it be used only when artemisinins are not available.[11][12][13][14] Quinine is also used to treat lupus and arthritis.

Quinine was frequently prescribed as an off-label treatment for leg cramps at night, but this has become less common due to a warning from the US Food and Drug Administration (FDA) that such practice is associated with life-threatening side effects.[15][16][17]

Available forms[edit]

Quinine is a basic amine and is usually provided as a salt. Various existing preparations include the hydrochloride, dihydrochloride, sulfate, bisulfate and gluconate. In the United States, quinine sulfate is commercially available in 324-mg tablets under the brand name Qualaquin.

All quinine salts may be given orally or intravenously (IV); quinine gluconate may also be given intramuscularly (IM) or rectally (PR).[18][19] The main problem with the rectal route is that the dose can be expelled before it is completely absorbed; in practice, this is corrected by giving a further half dose. No injectable preparation of quinine is licensed in the US; quinidine is used instead.[20][21]

Name Quinine base equivalence
Quinine base 100 mg
Quinine bisulfate 169 mg
Quinine dihydrochloride 122 mg
Quinine gluconate 160 mg
Quinine hydrochloride 111 mg
Quinine sulfate dihydrate [(quinine)2H2SO4∙2H2O] 121 mg

Beverages[edit]

Quinine is a flavor component of tonic water and bitter lemondrink mixers. On the soda gun behind many bars, tonic water is designated by the letter "Q" representing quinine.[22]

According to tradition, because of the bitter taste of anti-malarial quinine tonic, British colonials in India mixed it with gin to make it more palatable, thus creating the gin and tonic cocktail, which is still popular today.[23]

In France, quinine is an ingredient of an apéritif known as quinquina, or "Cap Corse," and the wine-based apéritifDubonnet. In Spain, quinine (also known as "Peruvian bark" for its origin from the native cinchona tree) is sometimes blended into sweet Malaga wine, which is then called "Malaga Quina". In Italy, the traditional flavoured wine Barolo Chinato is infused with quinine and local herbs, and is served as a digestif. In Scotland, the company A.G. Barr uses quinine as an ingredient in the carbonated and caffeinated beverageIrn-Bru. In Uruguay and Argentina, quinine is an ingredient of a PepsiCo tonic water named Paso de los Toros. In Denmark, it is used as an ingredient in the carbonated sports drink Faxe Kondi made by Royal Unibrew.

As a flavouring agent in drinks, quinine is limited to less than 83 parts per million in the United States, and 100 mg⁄l in the European Union.[24][25][26]

Scientific[edit]

Quinine (and quinidine) are used as the chiral moiety for the ligands used in Sharpless asymmetric dihydroxylation as well as for numerous other chiral catalyst backbones. Because of its relatively constant and well-known fluorescencequantum yield, quinine is used in photochemistry as a common fluorescence standard.[27][28]

Contraindications[edit]

Because of the narrow difference between its therapeutic and toxic effects, quinine is a common cause of drug-induced disorders, including thrombocytopenia and thrombotic microangiopathy.[29] Even from minor levels occurring in common beverages, quinine can have severe adverse effects involving multiple organ systems, among which are immune system effects and fever, hypotension, hemolytic anemia, acute kidney injury, liver toxicity, and blindness.[29] In people with atrial fibrillation, conduction defects, or heart block, quinine can cause heart arrhythmias, and should be avoided.[30]

Quinine can cause hemolysis in G6PD deficiency (an inherited deficiency), but this risk is small and the physician should not hesitate to use quinine in people with G6PD deficiency when there is no alternative.[31]

Adverse effects[edit]

Quinine can cause unpredictable serious and life-threatening blood and cardiovascular reactions including low platelet count and hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP), long QT syndrome and other serious cardiac arrhythmias including torsades de pointes, blackwater fever, disseminated intravascular coagulation, leukopenia, and neutropenia.[4] Some people who have developed TTP due to quinine have gone on to develop kidney failure.[4][31] It can also cause serious hypersensitivity reactions including anaphylactic shock, urticaria, serious skin rashes, including Stevens–Johnson syndrome and toxic epidermal necrolysis, angioedema, facial edema, bronchospasm, granulomatous hepatitis, and itchiness.[4][31]

The most common adverse effects involve a group of symptoms called cinchonism, which can include headache, vasodilation and sweating, nausea, tinnitus, hearing impairment, vertigo or dizziness, blurred vision, and disturbance in color perception.[4][29][31] More severe cinchonism includes vomiting, diarrhea, abdominal pain, deafness, blindness, and disturbances in heart rhythms.[31] Cinchonism is much less common when quinine is given by mouth, but oral quinine is not well tolerated (quinine is exceedingly bitter and many people will vomit after ingesting quinine tablets).[4] Other drugs, such as Fansidar (sulfadoxine with pyrimethamine) or Malarone (proguanil with atovaquone), are often used when oral therapy is required. Quinine ethyl carbonate is tasteless and odourless,[32] but is available commercially only in Japan. Blood glucose, electrolyte and cardiac monitoring are not necessary when quinine is given by mouth.

Quinine has diverse unwanted interactions with numerous prescription drugs, such as potentiating the anticoagulant effects of warfarin.[4]

Mechanism of action[edit]

Quinine is used for its toxicity to the malarial pathogen, Plasmodium falciparum, by interfering with the parasite's ability to dissolve and metabolize hemoglobin.[4][33] As with other quinoline antimalarial drugs, the precise mechanism of action of quinine has not been fully resolved, although in vitro studies indicate it inhibits nucleic acid and protein synthesis, and inhibits glycolysis in P. falciparum.[4] The most widely accepted hypothesis of its action is based on the well-studied and closely related quinoline drug, chloroquine. This model involves the inhibition of hemozoinbiocrystallization in the heme detoxification pathway, which facilitates the aggregation of cytotoxicheme.[medical citation needed] Free cytotoxic heme accumulates in the parasites, causing their deaths.[34] Quinine may target the malaria purine nucleoside phosphorylase enzyme.[35]

Chemistry[edit]

The UV absorption of quinine peaks around 350 nm (in UVA). Fluorescent emission peaks at around 460 nm (bright blue/cyan hue).[36] Quinine is highly fluorescent (quantum yield ~0.58) in 0.1 Msulfuric acid solution.[27][28] The 3D structure of quinine can be viewed using QRChem.net.

Synthesis[edit]

Main article: quinine total synthesis

Cinchona trees remain the only economically practical source of quinine. However, under wartime pressure during World War II, research towards its synthetic production was undertaken. A formal chemical synthesis was accomplished in 1944 by American chemists R.B. Woodward and W.E. Doering.[37] Since then, several more efficient quinine total syntheses have been achieved,[38] but none of them can compete in economic terms with isolation of the alkaloid from natural sources. The first synthetic organicdye, mauveine, was discovered by William Henry Perkin in 1856 while he was attempting to synthesize quinine.

Biosynthesis[edit]

In the first step of quinine biosynthesis, the enzyme strictosidine synthase catalyzes a stereoselective Pictet–Spengler reaction between tryptamine and secologanin to yield strictosidine.[39][40] Suitable modification of strictosidine leads to an aldehyde. Hydrolysis and decarboxylation would initially remove one carbon from the iridoid portion and produce corynantheal. Then the tryptamine side-chain were cleaved adjacent to the nitrogen, and this nitrogen was then bonded to the acetaldehyde function to yield cinchonaminal. Ring opening in the indole heterocyclic ring could generate new amine and keto functions. The new quinoline heterocycle would then be formed by combining this amine with the aldehyde produced in the tryptamine side-chain cleavage, giving cinchonidinone. For the last step, hydroxylation and methylation gives quinine.[41][42]

History[edit]

See also: History of malaria

19th-century illustration of Cinchona calisaya

Quinine was used as a muscle relaxant by the Quechua people, who are indigenous to Peru, Bolivia and Ecuador, to halt shivering.[43] The Quechua would mix the ground bark of cinchona trees with sweetened water to offset the bark's bitter taste, thus producing something similar to tonic water.[44]

Spanish Jesuit missionaries were the first to bring cinchona to Europe. The Spanish had observed the Quechua's use of cinchona and were aware of the medicinal properties of cinchona bark by the 1570s or earlier: Nicolás Monardes (1571) and Juan Fragoso (1572) both described a tree, which was subsequently identified as the cinchona tree, whose bark was used to produce a drink to treat diarrhea.[45] Quinine has been used in unextracted form by Europeans since at least the early 17th century.[46]

A popular story of how it was brought to Europe by the Countess of Chinchon was debunked by medical historian Alec Haggis around 1941.[47] During the 17th century, malaria was endemic to the swamps and marshes surrounding the city of Rome. It had caused the deaths of several popes, many cardinals and countless common Roman citizens. Most of the Catholic priests trained in Rome had seen malaria victims and were familiar with the shivering brought on by the febrile phase of the disease.

The Jesuit Agostino Salumbrino (1564–1642),[48] an apothecary by training who lived in Lima (now in present-day Peru), observed the Quechua using the bark of the cinchona tree to treat such shivering. While its effect in treating malaria (and malaria-induced shivering) was unrelated to its effect in controlling shivering from rigors, it was a successful medicine against malaria. At the first opportunity, Salumbrino sent a small quantity to Rome for testing as a malaria treatment.[49] In the years that followed, cinchona bark, known as Jesuit's bark or Peruvian bark, became one of the most valuable commodities shipped from Peru to Europe. When King Charles II was cured of malaria at the end of the 17th Century with quinine, it became popular in London.[50] It remained the antimalarial drug of choice until the 1940s, when other drugs took over.[51]

The form of quinine most effective in treating malaria was found by Charles Marie de La Condamine in 1737.[52][53] In 1820, French researchers Pierre Joseph Pelletier and Joseph Bienaimé Caventou first isolated quinine from the bark of a tree in the genus Cinchona – probably Cinchona officinalis – and subsequently named the substance.[54] The name was derived from the original Quechua (Inca) word for the cinchona tree bark, quina or quina-quina, which means "bark of bark" or "holy bark". Prior to 1820, the bark was dried, ground to a fine powder, and mixed into a liquid (commonly wine) in order to be drunk. Large-scale use of quinine as a malaria prophylaxis started around 1850. In 1853 Paul Briquet published a brief history and discussion of the literature on "quinquina".[55]

Quinine played a significant role in the colonization of Africa by Europeans. The availability of quinine for treatment had been said to be the prime reason Africa ceased to be known as the "white man's grave". A historian said, "it was quinine's efficacy that gave colonists fresh opportunities to swarm into the Gold Coast, Nigeria and other parts of west Africa".[56]

To maintain their monopoly on cinchona bark, Peru and surrounding countries began outlawing the export of cinchona seeds and saplings in the early 19th century. The Dutch government persisted in its attempts to smuggle the seeds, and by the late 19th century the Dutch grew the plants in Indonesian plantations. Soon they became the main suppliers of the tree. In 1913 they set up the Kina Bureau, a cartel of cinchona producers charged with controlling price and production.[57] By the 1930s Dutch plantations in Java were producing 22 million pounds of cinchona bark, or 97% of the world's quinine production.[56] U.S. attempts to prosecute the Kina Bureau proved unsuccessful.[57]

During World War II, Allied powers were cut off from their supply of quinine when Germany conquered the Netherlands, and Japan controlled the Philippines and Indonesia. The US had obtained four million cinchona seeds from the Philippines and began operating cinchona plantations in Costa Rica. Additionally, they began harvesting wild cinchona bark during the Cinchona Missions. Such supplies came too late. Tens of thousands of US troops in Africa and the South Pacific died of malaria due to the lack of quinine.[56] Despite controlling the supply, the Japanese did not make effective use of quinine, and thousands of Japanese troops in the southwest Pacific died as a result.[58][59][60][61]

Quinine remained the antimalarial drug of choice until after World War II. Since then, other drugs that have fewer side effects, such as chloroquine, have largely replaced it.[62]

Bromo Quinine were brand namecold tablets containing quinine, manufactured by Grove Laboratories. They were first marketed in 1889 and available until at least the 1960s.[63]

Conducting research in central Missouri, Dr. John S. Sappington independently developed an anti-malaria pill from quinine. Sappington began importing cinchona bark from Peru in 1820. In 1832, using quinine derived from the cinchona bark, Sappington developed a pill to treat a variety of fevers, such as scarlet fever, yellow fever, and influenza in addition to malaria. These illnesses were widespread in the Missouri and Mississippi valleys. He manufactured and sold "Dr. Sappington's Anti-Fever Pills" across Missouri. Demand became so great that within three years, Dr. Sappington founded a company known as Sappington and Sons to sell his pills nationwide.[64]

Society and culture[edit]

Natural occurrence[edit]

The bark of Remijia contains 0.5–2% of quinine. The bark is cheaper than bark of Cinchona. As it has an intense taste, it is used for making tonic water.[65]

Regulation in the US[edit]

From 1969, to 1992, the US Food and Drug Administration (FDA) received 157 reports of health problems related to quinine use, including 23 which had resulted in death.[66] In 1994, the FDA banned the marketing of over-the-counter quinine as a treatment for nocturnal leg cramps. PfizerPharmaceuticals had been selling the brand name Legatrin for this purpose. Also sold as a Softgel (by SmithKlineBeecham) as Q-vel.[citation needed] Doctors may still prescribe quinine, but the FDA has ordered firms to stop marketing unapproved drug products containing quinine. The FDA is also cautioning consumers about off-label use of quinine to treat leg cramps.[15][16] Quinine is approved for treatment of malaria, but was also commonly prescribed to treat leg cramps and similar conditions. Because malaria is life-threatening, the risks associated with quinine use are considered acceptable when used to treat that affliction.[67]

Though Legatrin was banned by the FDA for the treatment of leg cramps, the drug manufacturer URL Mutual has branded a quinine-containing drug named Qualaquin. It is marketed as a treatment for malaria and is sold in the United States only by prescription. In 2004, the CDC reported only 1,347 confirmed cases of malaria in the United States.[68]

Cutting agent[edit]

Quinine is sometimes detected as a cutting agent in street drugs such as cocaine and heroin.[69]

Other animals[edit]

Quinine is used as a treatment for Cryptocaryon irritans (commonly referred to as white spot, crypto or marine ich) infection of marine aquarium fish.[70]

References[edit]

  1. ^"Quinine International". Drugs.com. 2 November 2020. Retrieved 8 November 2020.
  2. ^ ab"Quinine Use During Pregnancy". Drugs.com. 25 March 2020. Retrieved 13 August 2020.
  3. ^ ab"Qualaquin (quinine) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Archived from the original on 2 February 2014. Retrieved 29 January 2014.
  4. ^ abcdefghijklmnopqrst"Quinine sulfate". Drugs.com. 20 February 2020. Retrieved 14 May 2020.
  5. ^Esu EB, Effa EE, Opie ON, Meremikwu MM (June 2019). "Artemether for severe malaria". The Cochrane Database of Systematic Reviews. 6: CD010678. doi:10.1002/14651858.CD010678.pub3. PMC 6580442. PMID 31210357.
  6. ^Olmsted J, Williams GM (1997). Chemistry: The Molecular Science. Jones & Bartlett Learning. p. 137. ISBN . Archived from the original on 15 September 2016.
  7. ^Willcox M (28 June 2004). Traditional Medicinal Plants and Malaria. CRC Press. p. 231. ISBN .
  8. ^Cechinel-Filho V (2012). Plant bioactives and drug discovery : principles, practice, and perspectives. Hoboken, N.J.: John Wiley & Sons. p. 2. ISBN . Archived from the original on 4 March 2016.
  9. ^Staines HM, Krishna S (2011). Treatment and Prevention of Malaria : Antimalarial Drug Chemistry, Action and Use. [S.l.]: Springer Verlag. p. 45. ISBN .
  10. ^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  11. ^World Health Organization (2006). "Guidelines for the treatment of malaria"(PDF). World Health Organization. Archived from the original(PDF) on 5 August 2009. Retrieved 10 August 2009.
  12. ^Dondorp A, Nosten F, Stepniewska K, Day N, White N (2005). "Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial". Lancet. 366 (9487): 717–25. doi:10.1016/S0140-6736(05)67176-0. PMID 16125588. S2CID 173027.
  13. ^Reyburn H, Mtove G, Hendriksen I, von Seidlein L (July 2009). "Oral quinine for the treatment of uncomplicated malaria"(PDF). BMJ. 339: b2066. doi:10.1136/bmj.b2066. PMID 19622550. S2CID 206891479.
  14. ^Achan J, Tibenderana JK, Kyabayinze D, Wabwire Mangen F, Kamya MR, Dorsey G, D'Alessandro U, Rosenthal PJ, Talisuna AO (July 2009). "Effectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial". BMJ. 339: b2763. doi:10.1136/bmj.b2763. PMC 2714631. PMID 19622553.
  15. ^ ab"FDA Drug Safety Communication: New risk management plan and patient Medication Guide for Qualaquin (quinine sulfate)". U.S. Food and Drug Administration (FDA). 7 August 2010. Archived from the original on 19 February 2011. Retrieved 21 February 2011.
  16. ^ ab"Serious risks associated with using Quinine to prevent or treat nocturnal leg cramps (September 2012)". U.S. Food and Drug Administration (FDA). 31 August 2012. Archived from the original on 22 October 2016. Retrieved 19 January 2020.
  17. ^"Quinine for Night-Time Leg Cramps". Consumer Reports. Retrieved 20 January 2020.
  18. ^Barennes H, Pussard E, Mahaman Sani A, Clavier F, Kahiatani F, Granic G, Henzel D, Ravinet L, Verdier F (May 1996). "Efficacy and pharmacokinetics of a new intrarectal quinine formulation in children with Plasmodium falciparum malaria". British Journal of Clinical Pharmacology. 41 (5): 389–95. doi:10.1046/j.1365-2125.1996.03246.x. PMC 2042609. PMID 8735679.
  19. ^Barennes H, Balima-Koussoubé T, Nagot N, Charpentier JC, Pussard E (May 2006). "Safety and efficacy of rectal compared with intramuscular quinine for the early treatment of moderately severe malaria in children: randomised clinical trial". BMJ. 332 (7549): 1055–9. doi:10.1136/bmj.332.7549.1055. PMC 1458599. PMID 16675812.
  20. ^Centers for Disease Control and Prevention (April 1991). "Treatment with quinidine gluconate of persons with severe Plasmodium falciparum infection: discontinuation of parenteral quinine from CDC Drug Service". MMWR. Recommendations and Reports. 40 (RR-4): 21–3. PMID 1850497.
  21. ^Magill A, Panosian C (July 2005). "Making antimalarial agents available in the United States". The New England Journal of Medicine. 353 (4): 335–7. doi:10.1056/NEJMp058167. PMID 16000347.
  22. ^Charming C (2006). Miss Charming's Guide for Hip Bartenders and Wayout Wannabes. USA: Sourcebooks, Inc. p. 189. ISBN .
  23. ^"Gin and Tonic: The fascinating story behind the invention of the classic English cocktail". India.com. 17 March 2017. Retrieved 8 June 2019.
  24. ^Ballestero JA, Plazas PV, Kracun S, Gómez-Casati ME, Taranda J, Rothlin CV, Katz E, Millar NS, et al. (September 2005). "Effects of quinine, quinidine, and chloroquine on alpha9alpha10 nicotinic cholinergic receptors". Molecular Pharmacology. 68 (3): 822–9. doi:10.1124/mol.105.014431. PMID 15955868. S2CID 26907917.
  25. ^"Food Additive Status List". U.S. Food and Drug Administration. U.S. Department of Health and Human Services. Retrieved 9 October 2017.
  26. ^"COMMISSION IMPLEMENTING REGULATION (EU) No 872/2012". EUR-Lex. Official Journal of the European Union. Retrieved 9 October 2017.
  27. ^ abLakowicz, Joseph R. (2006). "2. Instrumentation for Fluorescence Spectroscopy". Principles of Fluorescence Spectroscopy (3rd ed.). Springer Science & Business Media. p. 54. ISBN .
  28. ^ abPrahl, Scott. "Quinine sulfate". OMLC. Retrieved 16 August 2013.
  29. ^ abcLiles NW, Page EE, Liles AL, Vesely SK, Raskob GE, George JN (May 2016). "Diversity and severity of adverse reactions to quinine: A systematic review". American Journal of Hematology. 91 (5): 461–6. doi:10.1002/ajh.24314. PMID 26822544.
  30. ^"Off-label use of sildenafil in valvular heart disease should be avoided". Clinical Pharmacist. 2017. doi:10.1211/cp.2017.20203778. ISSN 2053-6178.
  31. ^ abcde"US label: quinine sulfate"(PDF). FDA. April 2013. Archived(PDF) from the original on 20 January 2017.
  32. ^Jamaludin A, Mohamad M, Navaratnam V, Selliah K, Tan SC, Wernsdorfer WH, Yuen KH (February 1988). "Relative bioavailability of the hydrochloride, sulphate and ethyl carbonate salts of quinine". British Journal of Clinical Pharmacology. 25 (2): 261–3. doi:10.1111/j.1365-2125.1988.tb03299.x. PMC 1386482. PMID 3358888.
  33. ^Wishart, David S.; Djombou Feunang, Yannick; Guo, An Chi; Lo, Elvis J.; Marcu, Ana; Grant, Jason R.; Sajed, Tanvir; Johnson, Daniel; Li, Carin; Sayeeda, Zinat; Assempour, Nazanin; Iynkkaran, Ithayavani; Liu, Yifeng; Maciejewski, Adam; Gale, Nicola; Wilson, Alex; Chin, Lucy; Cummings, Ryan; Le, Diana; Pon, Allison; Knox, Craig; Wilson, Michael. "Quinine | DrugBank Online". DrugBank. 5.0.
  34. ^Foley M, Tilley L (February 1997). "Quinoline antimalarials: mechanisms of action and resistance". International Journal for Parasitology. 27 (2): 231–40. doi:10.1016/s0020-7519(96)00152-x. PMID 9088993.
  35. ^Lowe D (22 January 2019). "Quinine's Target". Science. Retrieved 28 January 2019.
  36. ^"Basic Concepts in Fluorescence". Archived from the original on 13 September 2012.
  37. ^Woodward R, Doering W (1944). "The Total Synthesis of Quinine". J Am Chem Soc. 66 (849): 849. doi:10.1021/ja01233a516.
  38. ^Kaufman TS, Rúveda EA (2005). "Die Jagd auf Chinin: Etappenerfolge und Gesamtsiege". Angewandte Chemie International Edition (in German). 117 (6): 876–907. Bibcode:2005AngCh.117..876K. doi:10.1002/ange.200400663.
  39. ^Treimer JF, Zenk MH (November 1979). "Purification and properties of strictosidine synthase, the key enzyme in indole alkaloid formation". European Journal of Biochemistry. 101 (1): 225–33. doi:10.1111/j.1432-1033.1979.tb04235.x. PMID 510306.
  40. ^Mizukami H, Nordlöv H, Lee SL, Scott AI (August 1979). "Purification and properties of strictosidine synthetase (an enzyme condensing tryptamine and secologanin) from Catharanthus roseus cultured cells". Biochemistry. 18 (17): 3760–3. doi:10.1021/bi00584a018. PMID 476085.
  41. ^Medicinal natural products : a biosynthetic approach (3rdition ed.). Wiley. pp. 380–381. ISBN .
  42. ^O'Connor SE, Maresh JJ (August 2006). "Chemistry and biology of monoterpene indole alkaloid biosynthesis". Natural Product Reports. 23 (4): 532–47. doi:10.1039/b512615k. PMID 16874388.
  43. ^Flückiger, Friedrick A.; Daniel, Hanbury (1874). "Cortex Cinchonæ". Pharmacographia: A History of the Principal Drugs of Vegetable Origin, Met with in Great Britain and British India. London: Macmillan and Co. pp. 302–331.
  44. ^Hobbs K, West D (2020). The Story of Trees : and how they changed the way we live. illustrated by Thibaud Hérem. London: Laurence King. p. 148. ISBN .
  45. ^See:
    • Ortiz Crespo, Fernando Ignacio (1995). "Fragoso, Monardes and pre-Chinchonian knowledge of Cinchona". Archives of Natural History. 22 (2): 169–181. doi:10.3366/anh.1995.22.2.169. ISSN 0260-9541.
    • Stuart, David C. (2004). Dangerous Garden: The Quest for Plants to Change Our Lives. Cambridge, MA: Harvard University Press. p. 28. ISBN .
    • Monardes, Nicolás (1580). Primera y segunda y tercera partes de la Historia medicinal, de las cosas que se traen de nuestras Indias Occidentales, que sirven en Medicina (in Spanish). Seville, Spain: Fernando Díaz. pp. 74–75. [From the new kingdom, there is brought a bark, which is said to be from a tree, which is very large: it is said that it bears leaves in the form of a heart, and that it bears no fruit. This tree has a thick bark, very solid and hard, that in this and in its color looks much like the bark of the tree that is called guayacán: on the surface, it has a thin, discontinuous whitish film throughout it: it has bark more than one finger thick, solid and heavy: which, when tasted, has a considerable bitterness, like that of the gentian: it has in its taste a considerable astringency, with some aromaticity, because at the end of chewing it, one breathes with a sweet odor. The Indians hold this bark in high regard, and use it for all sorts of diarrhea, that are with blood [i.e., bloody] and without it. The Spanish [who are] tired of this disease, on the advice of the Indians, have used this bark and have healed many of those with it. They take as much as a small bean, make [it into] powder, take it in red wine or in appropriate water, if they have fever or illness: it must be taken in the morning on an empty stomach, three or four times: otherwise, using the order and regimen that suits those who have diarrhea.]
    • Fragoso, Juan (1572). Discursos de las cosas aromaticas, arboles y frutales, y de otras muchas medicinas simples que se traen de la India Oriental y que sirven al uso de medicina [Discourse on fragrant things, trees and fruits, as well as many other ordinary medicines that have been brought from India and the Orient and are of use to medicine] (in Spanish). Madrid, Spain: Francisco Sánchez. p. 35. [In the new world, there is a big tree that bears leaves in the form of a heart, and lacks fruit. It has two barks, one [is] thick, very solid, [and] hard, which in substance as well as in color is much like guayacan [i.e., lignum vitae]: the other is thinner and whitish, which is bitter with some styptic [i.e., astringent] quality: and besides this, it is aromatic. Our Indians regard it highly, because they use it against any diarrheas, taking a weight of a dram or a bit more of the powder, mixing it in mineral water, or red wine.]
  46. ^Achan J, Talisuna AO, Erhart A, Yeka A, Tibenderana JK, Baliraine FN, Rosenthal PJ, D'Alessandro U (May 2011). "Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria". Malaria Journal. 10: 144. doi:10.1186/1475-2875-10-144. PMC 3121651. PMID 21609473.
  47. ^Stephanie Pain (15 September 2001). "The Countess and the cure". New Scientist.
  48. ^Alonso de Andrade (3 August 1642). "Vida del Devoto Hermano Agustin Salumbrino" [The life of the devout Brother Agustin Salumbrino]. Varones ilustres en santidad, letras y zelo de las almas de la Compañía de Jesús [Illustrious men in holiness, letters, and zeal for souls of the Society of Jesus]. Varones ilustres de la Compañía de Jesús (in Spanish). 5. Original series by Juan Eusebio Nieremberg. Madrid, Spain: José Fernandez de Buendía (published 1666). pp. 612–628. p. 612: [Brother Agustino Salumbrino was born in the year 1564 in the city of Forlì in Romagna]
  49. ^See:
    • Medina Rodríguez, Francisco; Aceves Ávila, Francisco Javier; Moreno Rodríguez, José (2007). "Precisions on the History of Quinine". Reumatología Clínica. Letters to the Editor. 3 (4): 194–196. doi:10.1016/S2173-5743(07)70246-0. ISSN 2173-5743.
    • Torres Saldamando, Enrique (June 1882). "El P. Diego de Torres Vazquez". Los antiguos jesuitas del Perú (in Spanish). Lima, Peru: Imprenta Liberal. pp. 180–181. p. 181: [In the following year [i.e., 1631] there went to Europe the procurators Father Alonso Messia Venegas and Father Hernando de Leon Garavito, taking a great quantity of cinchona bark, knowledge of which the Jesuits spread throughout the world.]
    • Bailetti, Alberto. "Capítulo 10: La Condesa de Chinchón". LA MISIÓN DEL JESUITA AGUSTÍN SALUMBRINO, la malaria y el árbol de quina. [Late in the afternoon of the 31st of May, 1631, the royal armada set sail in the direction of Panama, carrying its multimillion [dollar] cargo of gold and silver.
      On one of the ships traveled the Jesuit procurators Fathers Alonso Messia and Hernando León Garavito, guarding the cases of powdered cinchona bark, prepared by Salumbrino. After almost 20 days of sailing, medicine arrived in the city of Panama, where it was transloaded onto mules. It then traveled the malarial isthmus as far as Portobelo, thence to Cartagena [in Colombia] and Havana. It then traveled to Sanlúcar de Barrameda in Seville, [Spain]. […] Finally it followed the road to Rome and to its final destination, the Hospital of the Holy Spirit]
  50. ^Rocco F (2004). Quinine: malaria and the quest for a cure that changed the world. New York, NY: Perennial.
  51. ^Loren H (2000). Quinine and Quarantine.
  52. ^Charles Marie de la Condamine (29 May 1737). "Sur l'arbre du quinquina". Histoire de l'Académie royale des sciences. Imprimerie Royale (published 1740). pp. 226–243.
  53. ^De Jussieu accompanied de la Condamine on the latter's expedition to Peru: Joseph de Jussieu (1737). Description de l'arbre à quinquina. Paris: Société du traitement des quinquinas (published 1934).
  54. ^Pelletier PJ, Caventou JB (1820). "Recherches Chimiques sur les Quinquinas" [Continuation: Chemical Research on Quinquinas]. Annales de Chimie et de Physique (in French). Crochard. 15: 337–365. The authors name quinine on page 348: " …, nous avons cru devoir la nommer quinine, pour la distinguer de la cinchonine par un nom qui indique également son origine." ( …, we thought that we should name it "quinine" in order to distinguish it from cinchonine by means of a name that also indicates its origin.)
  55. ^Briquet, P. (1853). Traité thérapeutique du quinone et de ses préparations (in French). Paris: L. Martinet.
  56. ^ abcConner, Clifford D. (2005). A People's History of Science: Miners, Midwives, and 'Low Mechanicks'. New York: Nation Books. pp. 95–96. ISBN . Also cites Porter, Roy (1998). The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W. W. Norton. pp. 465–466. ISBN .
  57. ^ abShah S (2010). The Fever: How Malaria Has Ruled Humankind for 500,000 Years. Farrar, Straus and Giroux. p. 94.
  58. ^Louis Morton (1953). "29". The Fall of the Philippines. Washington, D.C.: United States Army. p. 524. Archived from the original on 25 May 2017.
  59. ^Alan Hawk. "Remembering the war in New Guinea: Japanese Medical Corps – malaria". Archived from the original on 22 November 2011.
  60. ^Lt. Gen. Leonard D. Heaton, ed. (1963). "8". Preventive Medicine in World War II: Volume VI, Communicable Diseases: Malaria. Washington, D.C.: Department of the Army. pp. 401 and 434. Archived from the original on 29 January 2012.
  61. ^"Notes on Japanese Medical Services". Tactical and Technical Trends (36). 1943. Archived from the original on 14 October 2011.
  62. ^Shah S (2010). The Fever: How Malaria Has Ruled Humankind for 500,000 Years. Farrar, Straus and Giroux. p. 102.
  63. ^"Medicine: What's Good for a Cold?". Time. 22 February 1960. Archived from the original on 26 July 2010. Retrieved 27 April 2010.
  64. ^"John. S Sappington". Historic Missourians. State Historical Society of Missouri.
  65. ^Hobhouse H (2004). Šest rostlin, které změnily svět (in Czech). Prague: Akademie věd České republiky. p. 59. ISBN .
  66. ^"FDA Orders Stop to Marketing of Quinine for Night Leg Cramps". FDA Consumer Magazine. U.S. Food and Drug Administration (FDA). July–August 1995. Archived from the original on 15 January 2008. Retrieved 31 July 2009.
  67. ^"FDA Orders Unapproved Quinine Drugs from the Market and Cautions Consumers About Off-Label Use of Quinine to Treat Leg Cramps" (Press release). U.S. Food and Drug Administration (FDA). 11 December 2006. Archived from the original on 28 July 2009. Retrieved 31 July 2009.
  68. ^Skarbinski J, James EM, Causer LM, Barber AM, Mali S, Nguyen-Dinh P, Roberts JM, Parise ME, Slutsker L, Newman RD (May 2006). "Malaria surveillance--United States, 2004"(PDF). MMWR Surveill Summ. 55 (SS-4): 23–37. PMID 16723971.
  69. ^"Microgram Bulletin, DIMETHYLTRYPTAMINE AND ECSTASY MIMIC TABLETS (ACTUALLY CONTAINING 5-METHOXY-METHYLISOPROPYLTRYPTAMINE) IN OREGON"(PDF). U.S. Department of Justice. Drug Enforcement Administration. October 2009. p. 79. Archived from the original(PDF) on 17 October 2012. Retrieved 22 September 2012.
  70. ^Porritt, Michael. "Cryptocaryon irritans". Reef Culture Magazine (1 ed.). Archived from the original on 24 October 2009. Retrieved 9 July 2009.

Further reading[edit]

  • Schroeder-Lein G (2008). The encyclopedia of Civil War medicine. Armonk, NY: Sharpe, Inc.
  • Hobhouse, Henry (2005) [1986]. Seeds of Change: Six Plants That Transformed Mankind. Berkeley, CA: Counterpoint. ISBN .
  • Stockwell HR (1982). "Aeromedical considerations of malaria prophylaxis with mefloquine hydrochloride". Aviation, Space, and Environmental Medicine. 3 (10): 1011–13. PMID 6983345.
  • Wolff RS, Wirtschafter D, Adkinson C (June 1997). "Ocular quinine toxicity treated with hyperbaric oxygen". Undersea & Hyperbaric Medicine. 24 (2): 131–4. PMID 9171472.
  • Slater L (2009). War and disease : biomedical research on malaria in the twentieth century. New Brunswick, NJ: Rutgers University Press.
  • Lloyd, Henry D. (June 1884). "Lords of Industry". The North American Review. University of Northern Iowa. 138 (331): 535–553. ISSN 0029-2397. JSTOR 25118388.
  • World Health Organization (2015). Guidelines for the treatment of malaria, 3rd ed (3rd ed.). World Health Organization (WHO). hdl:10665/162441. ISBN .

External links[edit]

Look up quinine in Wiktionary, the free dictionary.
  • Quinine at the Drug Information Portal
  • Quinine at the International Programme on Chemical Safety
Sours: https://en.wikipedia.org/wiki/Quinine

Quinine (Cinchona officinalis) – 2oz Extract

A sleepless night because of pain again?

This wonderful tree bark has long been used to address nighttime leg cramps and for many other things. Cinchona bark contains quinine, which is a medicine used to treat malaria. It also contains quinidine which is a medicine used to treat heart palpitations (arrhythmias).

Enjoy the benefits of this wonderful tree bark with HERBALICIOUS Quinine Extracts!

Health benefits of this product

  • Is used for the treatment of leg cramps caused by vascular spasm. For more than 50 years, quinine, quinidine, and hydroquinine have been used to prevent muscle cramps.
  • May treat bloating, fullness, and other stomach problems.
  • Promotes the release of digestive juicesthus improving digestion .
  • It’s used for blood vessel disorders including hemorrhoids and varicose veins.

Characteristics

2 Fl oz liquid extract

Organic, natural product. No GMOs, no fillers or binders, and no gluten.

Made in USA

Usage and dose

Consult your physician about the dose suitable for you.

Weight4 oz
Dimensions10 × 10 × 2 in

Only logged in customers who have purchased this product may leave a review.

Sours: https://herbalicious.online/product/quinine-tincture-extract-quinine-liquid-cinchona-officinalis-dried-bark-herbal-supplement/
  1. Tensorflow train model
  2. Eurorack module kit
  3. Engineers funny pictures

Quinine 2 oz. Liquid Extract

Quinine (Cinchona officinalis) Liquid Extract. Ecologically wildcrafted bark. 

Suggested Use: Take 20-40 drops 2 times daily in a small amount of water. 

Ingredients: Quinine bark extractives, pure cane alcohol (USP 50%–60%), and osmotic water. Minimum dry herb potency ratio: 1:3. Glass bottle with glass dropper (2 oz. net weight). One dropperful is approx. 20 drops. 

Caution: Not for use during pregnancy or lactation. If you are taking medications or have a medical condition, consult with a health care professional before use. Keep this product out of the reach of children.

NOTE:For those who need to minimize their intake of alcohol, most of the content will evaporate by leaving the drops in hot water for 30 minutes.

Alternatively, teas, decoctions, capsules, and powder extracts are devoid of alcohol and can be used in place of liquid extracts.

 

Sours: https://www.rainpharm.com/quinine-2-oz-liquid-extract.html
Serendipity - \

Quinine in Tonic Water: What Is It and Is It Safe?

Overview

Quinine is a bitter compound that comes from the bark of the cinchona tree. The tree is most commonly found in South America, Central America, the islands of the Caribbean, and parts of the western coast of Africa. Quinine was originally developed as a medicine to fight malaria. It was crucial in reducing the death rate of workers building the Panama Canal in the early 20th century.

Quinine, when found in small doses in tonic water, is safe to consume. The first tonic waters contained powdered quinine, sugar, and soda water. Tonic water has since become a common mixer with liquor, the most well-known combination being gin and tonic. The U.S. Food and Drug Administration (FDA) allows tonic water to contain no more than 83 parts per million of quinine, because there can be side effects from quinine.

Today, people sometimes drink tonic water to treat nighttime leg cramps associated with circulatory or nervous system problems. However, this treatment is not recommended. Quinine is still given in in small doses to treat malaria in tropical regions.

Benefits and uses of quinine

Quinine’s primary benefit is for the treatment of malaria. It’s not used to prevent malaria, but rather to kill the organism responsible for the disease. When used to treat malaria, quinineis given in a pill form.

Quinine is still in tonic water, which is consumed around the world as a popular mixer with spirits, such as gin and vodka. It’s a bitter beverage, though some manufacturers have tried to soften the taste a little with added sugars and other flavors.

Side effects and risks

Quinine in tonic water is diluted enough that serious side effects are unlikely. If you do have a reaction, it may include:

  • nausea
  • stomach cramps
  • diarrhea
  • vomiting
  • ringing in the ears
  • confusion
  • nervousness

However, these are more common side effects for quinine taken as a medication. Among the most serious potential side effects associated with quinine are:

Keep in mind that these reactions are primarily linked to quinine, the medication. You would have to drink about two liters of tonic water a day to consume a day’s dose of quinine in pill form.

Who should avoid quinine?

If you’ve had a bad reaction to tonic water or quinine in the past, you should not try it again. You may also be advised against taking quinine or drinking tonic water if you:

  • have an abnormal heart rhythm, especially a prolonged QT interval
  • have low blood sugar (because quinine can cause your blood sugar to drop)
  • are pregnant
  • have kidney or liver disease
  • are taking medications, such as blood thinners, antidepressants, antibiotics, antacids, and statins (these medications may not preclude you from taking quinine or drinking tonic water, but you should tell your doctor about these and any other medications you take if you’re prescribed quinine)

Where else can you find quinine?

While a gin and tonic and vodka and tonic are staples at any bar, tonic water is becoming a more versatile beverage. It’s now mixed with tequila, brandy, and just about any other alcoholic beverage. Citrus flavors are often added, so if you see the term “bitter lemon” or “bitter lime,” you know the drink includes tonic water with a sour fruit flavor added.

However, tonic water isn’t just used to mix with spirits. Chefs may include tonic water in batter when frying seafood or in desserts that also include gin and other liquors.

Takeaway

If tonic water is your mixer of choice, you’re probably safe to have a little now and then. But don’t drink it thinking it will cure nighttime leg cramps or conditions such as restless leg syndrome. The science isn’t there for tonic water or quinine to treat these conditions. See a doctor instead and explore other options. But if you’re traveling to a part of the world where malaria is still a threat, ask about the use of quinine to treat the disease if you’re unfortunate enough to contract it.

Sours: https://www.healthline.com/health/quinine-in-tonic-water

Extract quinine liquid

You will be fine, I will come to you every day. And then, when you are discharged, we will go to the sea, just you and I, do you want. We will swim in warm water and bask in the sun!" - The sofa again smiled encouragingly, Vika is still The sofa took another.

Home Recipe For Hydroxychloroquine (HCQ) , cool down the liquid with LID on

Stroking my battered ass. Then he began to hang clothespins on my poles, it was a feeling. I'll tell you. Having finished with the clothespins, he took the whip and began to whip me on the chest, this was something completely unexpected for me, before that.

You will also like:

Afraid to miss me again. It was very pleasant for me. Suddenly he changed his face and said in dismay - Aaa.



1010 1011 1012 1013 1014