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Quinine is a medication used to treat malaria and babesiosis. This includes the treatment of malaria due to Plasmodium falciparum that is resistant to chloroquine when artesunate is not available. Malaria resistance to quinine occurs in certain areas of the world. It is an alkaloid derived from the bark of the cinchona tree. The tree is most commonly found in South America, Central America, the islands of the Caribbean, and parts of the western coast of Africa.

Quinine is also the ingredient in tonic water that gives it its bitter taste. Quinine, when found in small doses in tonic water, is safe to consume. The first tonic waters contained powdered quinine, sugar, and soda water. Tonic water has since become a common mixer with liquor, the most well-known combination being gin and tonic. The U.S. Food and Drug Administration (FDA) allows tonic water to contain no more than 83 parts per million of quinine, because there can be side effects from quinine. People sometimes drink tonic water to treat nighttime leg cramps associated with circulatory or nervous system problems. However, this treatment is not recommended.

It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. 

Malaria parasites can enter the body through these mosquito bites, and then live in body tissues such as red blood cells or the liver. This medication is used to kill the malaria parasites living inside red blood cells. In some cases, you may need to take a different medication (such as primaquine) to kill the malaria parasites living in other body tissues. Both drugs may be needed for a complete cure and to prevent the return of infection (relapse). It acts by inhibiting heme polymerase, thereby allowing accumulation of its cytotoxic substrate, heme. As a schizonticidal drug, it is less effective and more toxic than chloroquine. The drugs interfere with the parasite's ability to break down and digest hemoglobin. Consequently, the parasite starves and/or builds up toxic levels of partially degraded hemoglobin in itself.

Dosage and length of treatment are based on your medical condition, country where you were infected, other medications you may be taking for malaria, and your response to treatment. The dosage in children is also based on weight. The common side effects of quinine intake include nausea, stomach cramps, diarrhea, vomiting, ringing in the ears, confusion and nervousness. The most serious side effects include bleeding problems, kidney damage, abnormal heartbeat and severe allergic reaction. You may be advised against taking quinine or drinking tonic water if you have an abnormal heart rhythm, especially a prolonged QT interval, have low blood sugar (because quinine can cause your blood sugar to drop), are pregnant, have kidney or liver disease, are taking medications, such as blood thinners, antidepressants, antibiotics, antacids, and statins.

On the occasion of its 3 years, Successful Journey, Journal of Clinical Pharmacology and Toxicology decided to provide a partial waiver on its article processing charges to promote quality research from across the nations of the globe to encourage the latest research in the field of Infections, Diseases and Medicine. Journal of Clinical Pharmacology and Toxicology also planning to release a special issue on its new approaches.

Regards

Mary Wilson

Editorial office

Journal of Clinical Pharmacology and Toxicology

E-mail: pharmatoxicol@eclinicalsci.com