"Quinidine": instructions for use, composition, description and reviews

Why do we need such a tool as "Quinidine"? Instructions for use, price, reviews and the purpose of this drug will be presented below. Also you will learn about what pharmacological properties are characteristic for this drug, whether it causes side effects and whether it has any prohibitions to use.

Composition, form, description

In what form do pharmaceutical companies produce the drug "Quinidine"? Instructions for use, attached to this tool, says that it can be purchased in the form of flat and round tablets. They have a prolonged action and are covered with a film membrane.

The main ingredient of this medicine is quinidine sulfate. The instruction, the description of the preparation do not give any information about additional substances.

Pharmacology of medicament

What are the tablets "Quinidine"? Instructions for use, description, reviews report that this is a remedy for arrhythmia of class IA. It is able to slow down the process of Na ion transport through the fast channels of cardiomyocyte cell walls, and also to reduce the limiting rate of depolarization and to increase the duration of the action potential and the refractory (effective) time interval.

Taking this medication weakens the excitability of the myocardium, slows down the automatism and conductivity in AV-nodes, the bundle of His, atria and other structures. Also, the agent under consideration has a vagolytic effect, exhibits an m-holin-blocking effect, reduces the activity (contractile) of the heart muscle and causes a decrease in blood pressure.

Properties of the medicine

What is remarkable about such a medicine as "Quinidine"? Instruction for use notes that it can have a negative inotropic effect. This is due to a slowdown in the process of transformation of internal energy in the mitochondria. With regard to the antiarrhythmic properties of the drug, they are associated with the presence of an amide molecule in the structure of the active substance.

According to experts, against the background of taking this medication the excitation and the rate of its spread significantly decrease, which is connected with the influence of the active component of the drug on the process of depolarization.

Suppressing m-holinoretseptory, this drug stimulates AV-conduction. In therapeutic dosages, he exhibits antihypertensive properties associated with a decrease in the tone of peripheral veins and arteries, as well as with a negative inotropic effect.

One can not help saying that this medication is capable of demonstrating a local irritant effect. It also has analgesic and antipyretic properties, which are associated with a depressing effect on the brain.

Pharmacokinetic features

Is the active substance of the drug absorbed, such as quinidine sulfate? Instruction for use informs that the intake of this oral preparation contributes to its greatest concentration in the blood after 95 minutes.

The reaction of this medication with proteins is about 77-80%. Its biotransformation takes place in the liver. At the same time, some derived derivatives have a cardiotonic effect.

The half-life of this remedy is approximately 7 hours. It is evacuated mainly by the kidneys. With acidification of urine, the excretion of the drug is enhanced, and with its alkalization, it is inhibited.

From what appoint?

What indications for use is the drug "Quinidine"? Instruction for use asserts that the purpose of this drug is justified only in the following cases:

• Atrial tachycardia, AV-tachycardia, suprasystolic and ventricular, fibrillation and atrial flutter;
• To prevent attacks of tachycardia (ventricular and supraventricular), as well as ventricular fibrillation;
• After cardioversion for the purpose of maintaining the rhythm of the sinuses.

Prohibitions to use

What conditions of the patient forbid using the drug "Quinidine"? Instructions for use (the price of this medication is listed below) reports such contraindications as:

• Shock cardiogenic;
• AV-blockade (third or second degree);
• Purpura thrombocytopenic, developed after taking the drug;
• Disorders (severe) of intraventricular conduction;
• Blockade of the bundle;
• Intoxication with glycosides, which is accompanied by a violation of conductivity;
• An allergic reaction to the drug;
• Myasthenia gravis.

Medication "Quinidine": instructions for use

Take this medicine inside, 60 minutes before or 125 minutes after the meal, with a full glass of water. If you want to reduce the irritant effect of the drug on the mucous membrane of the digestive tract, then the water must be replaced with milk.

The drug of prolonged action is not recommended to chew or break.

The standard dosage of the tablets in question is 200-300 mg four times a day. With nadzheludochkovoy tachycardia (with paroxysms) this amount is increased to 400-600 mg every 3 hours until complete relief of paroxysm. With atrial fibrillation, medication is taken at 200 mg every 2 hours (5-8 times a day). The maintenance dose is 200-300 mg four times a day.

Alternative scheme of therapy: 400 mg (if the attack was not stopped, then 200 mg) every 60 minutes until the complete stopping of the attack or until a total dosage of 1 g.

In the absence of side effects after the first dose with subsequent admission, the amount of medication should be increased to 600 mg. Take the drug over 4 grams per day is prohibited.

Method of use for children

In what dose do children administer the drug "Quinidine Durulfs"? Instructions for use, reviews of pediatricians say that the standard dosage of this remedy for babies is 6 mg / kg 5 times a day. Only an experienced doctor should prescribe the medication, strictly according to the indications.

Side effects

What negative consequences can occur after using the drug "Quinidine Durules"? Instructions for use, the description of this medicine, speak of the following adverse reactions:

• Asthenia, widening of the segment QRS, myasthenia gravis;
• Ectopic ventricular extrasystole, hearing loss;
• Loss of appetite, ventricular fibrillation, arterial thromboembolism, lowering blood pressure;
• Visual impairment, 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.

Cases of overdose

What symptoms of overdose can the drug "Quinidine Dyuruls" cause? Instruction, expert reviews speak about such manifestations as ringing in the ears, depression of cardiac work, lowering of blood pressure, dizziness, atrial flutter, diplopia, quinidine shock, hearing loss.

To eliminate such conditions, the affected person is prescribed gastric lavage, oxygen supply, hypertensive drugs, electrocardiostimulation, hemodialysis and IVL.

Drug Interactions

How does the drug interact with a substance such as quinine? Instructions for use (price, reviews about the drug will be presented at the end of the article) reports that this combination increases the toxicity of both drugs.

Also tablets "Quinidine" interact with the following drugs:

• Antiarrhythmic drugs intensify cardiodepressive action.
• Anticholinesterase drugs and potassium-containing drugs enhance the effect of "quinidine".
• Anticonvulsant medications reduce the content of "quinidine" in the blood, and also reduce its effectiveness due to the stimulation of its metabolism.
• Laxatives reduce the effectiveness and concentration of the drug in the blood.
• Drugs that alkalize urine increase the risk of developing toxic reactions.
• "Amiloride" and "Amiodarone" drugs decrease the effectiveness of "Quinidine" and extend its segment QT, respectively.
• Acetylsalicylic acid increases the duration of bleeding, promotes petechiae and bleeding from the digestive system.
• Medications "Warfarin" and "Verapamil" - the anticoagulant effect of the first increases and the rate of excretion of the latter decreases.
• The drug "Haloperidol" - increases its content in the blood, and the risk of developing side reactions increases.
• Drugs "Hydroxysin" and "Dextromethorphan" - increases the likelihood of severe arrhythmia with the first, and the content in the blood of the second.

Special Information

With special care, the described drug is recommended for use in chronic heart failure 2-3 stages, tachyarrhythmias (ventricular) with lengthening of the QT segment, weakness of the sinus node, AV blockade of the 1st degree, bronchial asthma, thyrotoxicosis, arterial hypotension, acute infectious diseases, emphysema , Zakratougolnoy glaucoma, hypokalemia, liver failure, thrombocytopenia, prostate hyperplasia, renal failure chronic, 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 needs to correct the symptoms of hypokalemia and heart failure.

During the therapy, it is required to constantly monitor the ECG, peripheral blood analysis data and hemodynamic parameters.

Similar means, price

There are a lot of analogues in this preparation. Specialists refer to them the following means: "Kinidin Durules", "Bretilat", "Novokainamid", "Etatsizin", "Lidocaine", "Amiocordin", "Propanorm", "Amiodarone", "Verapamil", "Propranolol", "Ritmonorm ".

As for the prices of such drugs as "Quinidine" and "Quinidine Durules", the residents of our country are not known because these medications 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 medicine under consideration? According to them, this remedy manifests itself as a very effective antiarrhythmic drug that treats diseases such as ventricular and supraventricular tachycardias 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 in the pharmaceutical market appeared more safe and effective, as well as inexpensive analogues, which are actively used for the same indications. In this case, experts argue that quinidine sulfate continues to be used as a constituent of a multicomponent substance in many antiarrhythmic drugs.