Gluconate
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It is an alkaloid from Cinchona bark the dextroisomer of quinine & has been noted to suppress 'rebellious palpitation' Quinidine increases threshold for excitation and reduces conduction velocity, thus limits the spread of arrhythmia.
INDICATIONS: Atrial fibrillation or flutter, paroxysmal supra ventricular tachycardia. Ventricular premature beats & ventricular tachycardia. Maintenance of sinus rhythm following electro conversion.
DOSAGE: 200-300 mg 3-4 times daily. Initially give test dose.
CONTRA-INDICATIONS: Not recommended for children, Myasthenia gravis, Intolerance or idiosyncrasy to quinidine, heart block, C.H.F. and hypotensive states. History of embolism.
Special Praceaution: Renal dysfunctions.
Paediatric: Not recommended.
Pregnancy: No serious effect reported.
Lactation: Not recommended.
Elderly: Reduced dosage necessary.
SIDE-EFFECTS: Higher doses can cause A.V. dissociation, nausea, vomiting, diarrhea, cinchonism (ringing in ear, deafness, vertigo, headache, and visual disturbances), angioedema, asthma & vascular collapse.
DRUG INTERACTIONS: Cimetidine, erythromycin inhibits the hepatic metabolism of quinidine, interaction with beta-blockers causes sinus bradycardia. Amiodarone may increase the plasma concentration of quinidine. Phenobarbitone and rifampicin decreases its effects. Hyperkalemia increases effect of quinidine.