Quinine (2)

quinine and its applications ....... importance of quinine as an antimalarial drug

1. QUININE Presented by : , Mahroosh abbasi ANTI-MALARIAL DRUG

2. Drug “Drug is a medicines or other substance which has a physiological effect when ingested or otherwise introduced into the body.”

3. Structure of QUININE

4. Background & Historical Perspectives Important medical discovery of 17 th century Component of bark of cinchona trees. In early 1600s it was referred as “Jesuits bark” “ cardinal’s bark” or “sacred bark.” Quina-quina trees in Andean Jungle. Introduction to Europe in 1638. Use before 1820 and in 1820.

5. EFFECTIVE CINCHONA ALKALOIDS AGAINST MALARIA

6. Properties of QUININE Aryl amino alcohol group of drugs . Basic compound. R apid action against intra- erythrocytic malarial parasites. Gametocytocidal . Analgesic properties. White crystalline. Insoluble in water . Bitter taste and levorotatory. Anti inflammatory.

7. Extraction of QUININE

8. Isolation of QUININE

9. OVERVIEW OF QUININE Distribution in our body. Treatment for uncomplicated malaria. Lower cure rate. Higher cure rate ( sulphadoxine-pyrimethamine , tetracycline or clindamycin). 2010 World health Organization 2009 by 31 African countries Quinine+Doxycycline+Tetracycline (2 nd line treatment) Quinine (2 nd line treatment)

10. Study site Year Sample size Drug Duration of follow-up Treatment outcome. Cure rate Comment Thailand 1984-85 66 children Quinine + Quinidine 28 Days Quinine 85% Quinidine 88% Treatment failures Brazil 1985 100 Children Mefloquine 1000 mg 3 days quinine+SP 42 Days MQ 96% Q3+SP 98% Gives good cure rate   Thailand 1994 102 Patients Mefloquine+tetracycline(MQT) 7 days quinine+tetracycline(Q7T7) 28 Days MQT 94% Q7T7 98% MQ+Tetra as effective as Q7T7 Cameroon 2005 30 children 5 days of quinine 14 Days 100% Perfect

11. Biosynthesis of QUNINE

12. Action of QUININE Mode of action Accumulation in lysosomes. Binds with heme . Physiological actions Kills parasites ‘ As a prophylactic to Prevent initial infection Heme -quinine complex Pharmacokinetics Absorption. (GI tract) Metabolism. (liver & excreted by kidneys)

13. Spectral study and forms of QUININE The UV absorption 350nm . Fluorescent emission peaks 460nm . Quinine is highly fluorescent in 0.1M sulfuric acid solution .

14. Uses of QUININE Side effects of QUININE Treat malaria & babesiosis . Treat malaria during pregnancy. Management of malaria in HIV. Management of severe malaria. Headache Ringing in ear, trouble seeing. Sweating. Chest pain, fast heartbeat. Lower back pain. Blood in urine. Deafness, low platelets, irregular heartbeat (severe side effects)

15. QUININE Poisoning

16. Society and culture Natural occurrence Bark of REMIJIA & CINCHONA. Regulation Banned by FDA later approved for treating malaria. Cutting agent Cocaine & heroine. Other animals Cryptocaryon irritans .

17. Conclusion In the near future, quinine will continue to play a significant role in the management of malaria. However, because of the frequent ACT stock outs, the rapid withdrawal of quinine as a treatment option for uncomplicated malaria cases is risky.