Why is a drug like Quinidine necessary? Instructions for use, price, reviews and purpose of this drug will be presented below. You will also learn about the pharmacological properties characteristic of this medicine, whether it causes side effects and whether it has any prohibitions on its use.
Composition, form, description
In what form do pharmaceutical companies produce Quinidine? The instructions for use attached to this tool say that it can be purchased in the form of flat and round tablets. They have a prolonged effect and are film-coated.
The main ingredient of this medication is quinidine sulfate. Instructions, a description of the drug do not give any information about additional substances.
Pharmacology of the drug
What are quinidine tablets? Instructions for use, description, reviews report that this is a remedy for class IA arrhythmias. It can slow down the transfer of Na ions through the fast channels of the cell walls of cardiomyocytes, as well as reduce the marginal depolarization rate and increase the duration of the action potential and refractory (effective) time period.
Taking this medication weakens myocardial excitability, slows down automatism and conduction in the AV nodes, the bundle of His, atria and other structures. Also, the drug in question has a vagolytic effect, exhibits an m-anticholinergic effect, reduces the activity (contractile) of the heart muscle and causes a decrease in blood pressure.
Drug properties
How remarkable is a medicine like Quinidine? Instructions for use note that it is able to have a negative inotropic effect. This happens as a result of a slowdown in the process of conversion of internal energy in mitochondria. As for the antiarrhythmic properties of the drug, they are associated with the presence of an amide group molecule in the structure of the active substance.
According to experts, while taking this medication, the excitation and the rate of its spread are significantly reduced, which is associated with the effect of the active component of the drug on the depolarization process.
By suppressing m-cholinergic receptors, the drug in question stimulates AV conduction. In therapeutic dosages, it exhibits hypotensive properties associated with a decrease in the tone of peripheral veins and arteries, as well as with a negative inotropic effect.
It can not be said that this medication is able to demonstrate a locally irritating effect. It also has analgesic and antipyretic properties that are associated with a depressing effect on the brain.
Pharmacokinetic features
Is an active substance such as quinidine sulfate absorbed? Instructions for use informs that taking this oral product contributes to its highest concentration in the blood after 95 minutes.
The reaction of this medication with proteins is about 77-80%. Its biotransformation occurs in the liver. At the same time, some formed derivatives have a cardiotonic effect.
The half-life of this agent is approximately 7 hours. It is evacuated mainly by the kidneys. When urine is acidified, the release of the drug increases, and when it is alkalized, it is inhibited.
What is prescribed?
What are the indications for use of the drug "Quinidine"? The instruction for use states that the purpose of this drug is justified only in the following cases:
- with atrial tachycardia, AV tachycardia, extrasystole of the supraventricular and ventricular, attacks of flickering and atrial flutter;
- to prevent attacks of tachycardia (ventricular and supraventricular), as well as ventricular fibrillation;
- after the implementation of cardioversion in order to maintain the rhythm of the sinuses.
Prohibitions to use
What conditions of the patient are forbidden to use the medicine "Quinidine" Instructions for use (the price of this medication is indicated below) reports on such contraindications of the drug as:
- cardiogenic shock;
- AV block (third or second degree);
- thrombocytopenic purpura, developed after taking the drug;
- disorders (severe) of intraventricular conduction;
- His bundle blockade;
- glycoside intoxication, which is accompanied by a violation of conductivity;
- an allergic reaction to the drug;
- myasthenia gravis.
Medication "Quinidine": instructions for use
This remedy should be taken orally, 60 minutes before or 125 minutes after the meal, with a full glass of water. If you want to reduce the irritating effect of the drug on the mucous membrane of the digestive tract, then the water must be replaced with milk.
Long-acting drug is not recommended to chew or break.
The standard dosage of the tablets in question is 200ā300 mg four times a day. In supraventricular tachycardia (with paroxysms), this amount is increased to 400-600 mg every 3 hours until the paroxysm is completely stopped. With atrial fibrillation, the medication is taken 200 mg every 2 hours (5-8 times a day). In this case, the maintenance dose is 200-300 mg four times a day.
Alternative treatment regimen: 400 mg (if the attack has not been stopped, then 200 mg) every 60 minutes until the attack is completely stopped or until the total dosage of 1 g is reached.
In the absence of side effects after the first dose with subsequent administration, the amount of medication should be increased to 600 mg. Take the drug over 4 g per day is prohibited.
Method of application for children
At what dose is the drug āQuinidine Dyurulsā prescribed for children? Instructions for use, reviews of pediatricians say that the standard dosage of this product for babies is 6 mg / kg 5 times a day. Only an experienced doctor should prescribe the medication, strictly according to indications.
Side effects
What negative consequences can occur after using the quinidine durules medication? Instructions for use, a description of this drug indicate the following adverse reactions:
- asthenia, extension of the QRS segment, myasthenia gravis;
- ectopic ventricular extrasystole, hearing loss;
- loss of appetite, ventricular fibrillation, arterial thromboembolism, decreased blood pressure;
- visual disturbances, ventricular tachycardia, paroxysmal, tinnitus,
- asystole;
- nausea, sinus bradycardia, hepatitis, abdominal pain, confusion;
- gastralgia, headache, vomiting, thrombocytopenia, diarrhea, dizziness, hemolytic anemia;
- fever, lupus-like syndrome, skin rash.
Overdose cases
What symptoms of an overdose can the Quinidine Dyuruls medication cause? Instructions, reviews of experts speak of such manifestations as tinnitus, oppression of cardiac work, decreased blood pressure, dizziness, atrial flutter, diplopia, quinidine shock, hearing loss.
To eliminate such conditions, the victim is prescribed gastric lavage, oxygen supply, hypertensive drugs, pacemaker, hemodialysis and mechanical ventilation.
Drug interaction
How does the drug in question interact with a substance such as quinine? Instructions for use (price, reviews about the medication will be presented at the end of the article) reports that such a combination increases the toxicity of both drugs.
Quinidine tablets also interact with the following drugs:
- Antiarrhythmic drugs enhance cardiodepressive effect.
- Anticholinesterase drugs and potassium-containing drugs enhance the effect of Quinidine.
- Anticonvulsant drugs reduce the content of Quinidine in the blood, as well as reduce its effectiveness due to stimulation of its metabolism.
- Laxatives reduce the effectiveness and concentration of the drug in the blood.
- Urine alkalizing drugs increase the risk of toxic reactions.
- Amilorid and Amiodaron preparations decrease the effectiveness of Quinidine and lengthen its QT segment, respectively.
- Acetylsalicylic acid increases the duration of bleeding, promotes petechiae and bleeding from the digestive system.
- Medicines "Warfarin" and "Verapamil" - the anticoagulant effect of the first is enhanced and the rate of elimination of the second is reduced.
- The drug "Haloperidol" - increases its content in the blood, and also increases the risk of adverse reactions.
- Medications "Hydroxysin" and "Dextromethorphan" - increases the likelihood of severe arrhythmias when taking the first, as well as the content in the blood of the second.
Special information
With extreme caution, the described drug is recommended for use in chronic heart failure of stage 2ā3, tachyarrhythmia (ventricular) with lengthening of the QT segment, sinus node weakness, AV blockade of the first degree, bronchial asthma, thyrotoxicosis, arterial hypotension, acute infectious diseases, emphysema , angle-closure glaucoma, hypokalemia, liver failure, thrombocytopenia, prostate hyperplasia, chronic renal failure, lactation, psoriasis and pregnancy.
People with myocarditis, as well as other myocardial diseases, when taking Quinidine, require regular medical supervision. Before starting treatment, the patient must correct the symptoms of hypokalemia and heart failure.
In the process of therapy, it is necessary to constantly monitor the ECG, peripheral blood analysis data and hemodynamic parameters.
Similar means, price
There are a lot of analogues of the drug in question. Experts attribute the following funds to them: āKinidin Durulesā, āBretilateā, āNovokainamidā, āEtatsizinā, āLidocaineā, āAmiocordinā, āPropanormā, āAmiodaroneā, āVerapamilā, āPropranololā, āRitmonormā ".
As for the prices of medicines such as Quinidine and Quinidine Durules, they are unknown to the inhabitants of our country because these medicines are no longer sold in Russia. However, they can be purchased in Ukraine. The cost of drugs in this country is about 540 and 670-679 hryvnia, respectively, which is equal to 1380 and 1760-1780 rubles.
Reviews
What do doctors and other specialists say about the medication in question? According to them, this remedy manifests itself as a very effective antiarrhythmic drug that treats diseases such as ventricular and supraventricular tachycardia well and quickly enough. However, it should be noted that it is not possible to find quinidine tablets in Russian pharmacies. This is due to the fact that this medication was excluded from free circulation and is no longer used in hospitals. Doctors explain this situation by the fact that safer and more effective, as well as inexpensive analogues, which are actively used for the same indications, have appeared on the pharmaceutical market. At the same time, experts argue that quinidine sulfate continues to be used as a component of a multicomponent substance in many antiarrhythmic drugs.