# E-DRUG: Quinine

**URL:** <https://talk.edrugplus.org/t/e-drug-quinine/542>\
**Category:** e-drug\
**Created:** [March 28, 1997, 6:47pm UTC](https://talk.edrugplus.org/t/e-drug-quinine/542 "1997-03-28T18:47:58Z")\
**Posts on this page:** 1\
**Page:** 1

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**Author:** ![Dr\_Eberhard\_W\_Lisse1](https://avatars.discourse-cdn.com/v4/letter/d/59ef9b/32.png) [@Dr\_Eberhard\_W\_Lisse1](https://talk.edrugplus.org/u/Dr_Eberhard_W_Lisse1)\
**Post date:** [March 28, 1997, 6:47pm UTC](https://talk.edrugplus.org/t/e-drug-quinine/542/1 "1997-03-28T18:47:58Z")

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S.K.

> > In St Francis Hospital, the i.v. route is used in these patients and  
> > quinine is given continuously as a drip at a dose of 30mg/kg/24hours.  
> > This protocol demands a great effort of the nursing staff, in putting  
> > up the i.v.-lines and in supervising the continuation of the treatment.

We do it as 600mg in 200 ml D5W over 4 hours every 8 hours (which translates  
to 30mg/kg/24h). I got two patients on this at this very moment. Sticking  
the drip is a once only affair as it is kept open with D5W or 1/2NSD5 with  
additional glucose added. Supervising of the treatment is not much work.

> > In a recent paper in Postgraduate Doctor (vol 18, no 3, pp 60 - 65),  
> > authors from Kilifi, Kenya advocate the use of i.m. quinine in  
> > children with severe tropical malaria.

I don't like it. (I have passed this on to the man, and will report back)

> > This has several advantages like saving nurses' time and the cost of  
> > iv-fluids, but it is uncertain whether the therapeutic effect is  
> > similar to the i.v. route.

IV fluids are more for the (re)hydration and quinine is hypoglycemic  
so you'd need them anyway.

I refuse to accept that the saving in nurses' time outweighs the  
dangers.

> TheWHO in its publication WHO MODEL PRESCRIBING INFORMATION series Drugs  
> Used in Parasitic Diseases (second edition)1995 mentions that IM quinine  
> can be used IM where facilities for intravenous infusion do not  
> exist.The dose is the same as the IV dose.

Exactly, "where facilities do not exist".

> We decided to use IM quinine because it was easier, cheaper and much more  
> managable for the staff. We have had no changes in mortality after shift  
> to IM quinine.

greetings, el

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