Catalog of Herbs
James A. Duke in Handbook of Medicinal Herbs, 2018
Quinine wine has long been regarded as a powerful tonic. Cinchona does have astringent, bitter tonic, analgesic, and anesthetic properties along with the antimalarial, antiarrhythmic, and febrifugal characters. Quinine is used in collyria as an anesthetic, astringent bactericide. Quinine sulfate is used to treat colds and leg cramps.29 Quinine inhibits meat decay and yeast fermentation.17 Morton adds that a mixture of quinine and urea hydrochloride (59% quinine) is injected as a sclerosing agent for internal hemorrhoids, hydrocele, varicose veins, and pleural vacities after thoracoplasty. Quinidine is also used to treat hiccups.17 In 1973 0.18% (2,758,000) of all prescriptions in the U.S. (1.532 billion) contained quinidine.98 As a matter of fact, more than 25% of all prescriptions contained one or more active constituents obtained from seed plants. Powdered bark used as a dentifrice, cinchona, extracts in hair tonics, promotes, and stimulates hair growth. Quinic and cinchona extracts are used in tonic waters, bitters, and liqueurs (up to 278 ppm red cinchona extract in alcoholic beverages); also, in baked goods, candies, condiments, frozen dairy desserts, and relishes.29 Cinchona bark is still used for tanning after extraction of the alkaloids.17
Antimicrobials during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
The two major antimalarial drugs are chloroquine and quinine. Chloroquine is the primary drug used for the treatment of malaria, as well as for chemoprophylaxis in pregnant women who must travel to endemic areas (Diro and Beydoun, 1982). Although there have been no studies of infants whose mothers were treated for malaria during pregnancy with chloroquine, one study reported no increased frequency of congenital anomalies among 169 infants whose mothers received weekly low doses of the drug for malaria prophylaxis during pregnancy (Wolfe and Cordero, 1985). Quinine is used primarily for chloroquine-resistant falciparum malaria. Although there are no large studies regarding its use during pregnancy, increased malformations have been reported when large doses were used to attempt abortion (Nishimura and Tanimura, 1976). Quinine sulfate tablets have also been utilized for leg cramps, but their efficacy is unproven. Although not recommended for the treatment of leg cramps during pregnancy, the antimalarial quinines should not be withheld in the seriously ill pregnant woman with chloroquine-resistant malaria.
Quinine and Quinidine
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
The precise mechanism of action of quinine against Plasmodium species is not known. It appears to inhibit the digestion of hemoglobin by malarial parasites. In vitro, the quinoline group of anti-malarials prevent the spontaneous polymerization of hematin to hemozoin (beta-hematin or malarial pigment) (Egan et al., 1994). It also has been demonstrated to inhibit the vacuolar ATPase of P. falciparum food vacuoles (Choi and Mego, 1988); this mechanism appears to be independent of its alkalinization of the food vacuole (Ginsburg et al., 1989). Other targets have also been suggested based on in vitro studies in bacterial and human cells (Munoz et al., 1996; Misra et al., 1997).
The human organic cation transporter OCT1 and its role as a target for drug responses
Published in Drug Metabolism Reviews, 2019
Nicolas Brosseau, Dindial Ramotar
Likewise, OCT1 can transport several therapeutic drugs such as (i) quinine used for treating malaria, (ii) anti-retroviral drugs lamivudine, zalcitabine, pentamidine, and trimethoprim, (iii) metformin for controlling blood sugar in diabetic patients and trospium, an anticholinergic hydrophilic quaternary amine used for treating overactive bladder syndrome, and (iv) the anticancer drugs imatinib, anthracyclines, oxaliplatin and sorafenib (Chen and Nelson 2000; van Montfoort et al. 2001; Wang DS et al. 2003; Ishiguro et al. 2005; Kimura et al. 2005; Yonezawa et al. 2006; Zhang S et al. 2006; Giannoudis et al. 2008; Jung et al. 2008; Sogame et al. 2009; Herraez et al. 2013; Andreev et al. 2016; Deutsch et al. 2019). While imatinib is used for treating chronic myeloid leukemia, anthracyclines are active against several types of deadly cancers including ovarian and acute myeloid leukemia, and sorafenib is used for targeting hepatocellular carcinomas. It is noteworthy that despite the high similarities of human OCT1 with rat OCT1 (Figure 6), these transporters uniquely transport one substrate and not another. For example, the rat OCT1 is capable of transporting pramipexol, but not the human OCT1 and instead the function is assigned to the human OCT2 (Ishiguro et al. 2005; Diao et al. 2010).
Antimalarial drugs for treating and preventing malaria in pregnant and lactating women
Published in Expert Opinion on Drug Safety, 2018
Makoto Saito, Mary Ellen Gilder, Rose McGready, François Nosten
The adverse symptoms of quinine are collectively called cinchonism, which affects almost all patients [16]. This leads to poor adherence particularly among the pregnant women in the first trimester when morning sickness peaks. The actual adherence without supervision is thought to be poor [7]. The prevalence of tinnitus in pregnant patients on quinine is reported to be from 35% to 85% in > 450 patients assessed in seven studies [11–13,15,17–19]. A meta-analysis reported that the risks of tinnitus (pooled RR 4.70, 95% CI 1.20–18.39, five RCTs), vomiting (pooled RR 2.01, 95%CI 1.23–3.30, five RCTs) and dizziness (pooled RR 1.51, 95% CI 1.02–2.25, three RCTs) were higher than those of artemisinin-based treatment [10]. Nausea and anorexia are also more common with quinine than artemether-lumefantrine (AL) in an open-label RCT [12]. The risk of quinine related hypoglycemia is higher in pregnant women than the general population, particularly in cases with severe malaria [20,21]. For uncomplicated malaria, two studies reported that hypoglycemia was observed in 17% (4/24) [18] – 72% (21/29) [14], but symptomatic hypoglycemia was rare (0/246) [17]. To reduce side effects under-dosing treatment by prescribing twice daily dosing or only five days is potentially harmful and likely to induce resistance [7,18]. In a study in Uganda, QTc prolongation (Fridericia corrected QTc > 440 ms) was observed on day 2 in 1% (2/149) of the patients [12].
Artesunate alleviates the inflammatory response of ulcerative colitis by regulating the expression of miR-155
Published in Pharmaceutical Biology, 2021
Zhao-Bin Yang, Lu-Zhen Qiu, Quan Chen, Jian-Dong Lin
Artesunate (ART) is a water-soluble semisynthetic derivative of the sesquiterpene lactone compound artemisinin (Li et al. 2019). It has been used to treat severe malaria with desirable outcome for a number of years. Most importantly, it is considered to be safe with minimal side effects than quinine (a traditionally prescribed drug to treat severe malaria) (Dondorp et al. 2010; Kunte and Kunwar 2011). Studies have also shown that it has activities other than being antimalarial, such as antitumor, anti-inflammatory, as well as antioxidative properties (Zhao and Song 1989; Zuo et al. 2016). In a study aimed at evaluating the role of ART and its possible mechanism of action in DSS-induced colitis, it was reported that ART alleviated UC via down-regulation of inflammatory and apoptotic markers by regulating the TLR4/nuclear factor (NF)-κB signalling pathway (Chen et al. 2019), suggesting that ART has anti-inflammatory properties. However, how it suppresses inflammatory responses at the molecular level still needs to elucidate.
Related Knowledge Centers
- Artesunate
- Babesiosis
- Chloroquine
- Malaria
- Plasmodium Falciparum
- Tinnitus
- Cramp
- Side Effect
- Intravenous Therapy
- Tonic Water