Signs and symptoms
Symptoms of mild cinchonism (which may occur from standard therapeutic doses of quinine) include flushed and sweaty skin, ringing of the ears (tinnitus), blurred vision, impaired hearing, confusion, reversible high-frequency hearing loss, headache, abdominal pain, rashes, lichenoid photosensitivity
, vertigo, dizziness, dysphoria, nausea and vomiting, and diarrhea.Large doses of quinine may lead to severe symptoms of cinchonism: skin rashes, deafness (reversible), somnolence, diminished visual acuity or blindness, anaphylactic shock, and disturbances in cardiac rhythm or conduction, death from cardiotoxicity. Quinine overdose can also result in a rare form of hypersensitivity reaction termed blackwater fever that results in massive hemolysis, hemoglobinemia, hemoglobinuria, and renal failure.
Patients treated with quinine may also suffer from hypoglycemia (especially if administered intravenously) and hypotension (low blood pressure). In very high doses (higher than those used to treat malaria) during the first trimester of pregnancy quinine may act as an abortifacient, or cause birth defects, especially deafness.
Most symptoms of cinchonism (except in severe cases) are reversible and disappear once quinine is withdrawn.
External links
- IPCS INTOX databank entry for quinine
- Side effect of quinine for nocturnal cramps - letter printed in the British Medical Journal with a photograph of hands affected by lichenoid photosensitivity
- Effects of Quinine on the Excitability and Voltage-Dependent Currents of Isolated Spiral Ganglion Neurons in Culture
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Last updated on Tuesday October 07, 2008 at 16:13:22 PDT (GMT -0700)
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