Electrocardiographic abnormalities with quinine and artesunate combinations in comparison to quinine or artesunate alone in severe falciparum malaria

Authors

  • Anjali Tarai Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India
  • Kali Prasad Pattnaik Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India
  • Kumar Haraprasad Mishra Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20204089

Keywords:

Artesunate, Electrocardiogram, Quinine

Abstract

Background: In Multi drug resistant falciparum malaria anti-malarial combinations are frequently used i.e. Quinine and IV Artesunate. Quinine is associated with electrocardiographic disturbances. Artesunate in high dose produce QTC prolongation in animal models, so the electrocardiogram (ECG) is thoroughly studied.

Methods: Severe falciparum malaria cases 15 to 60 years were randomly allocated into 3 treatment regimens i.e. Artesunate, Quinine alone and their combination. Electrocardiographic recordings were taken periodically in 3 groups and compared statistically.

Results: The mean QTC interval is significantly prolonged in combination treatment group from 0.40+0.02 to 0.49+0.09 (P<0.05) ECG disturbance (44%). QTC prolongation was commonest (i.e. 27%) with electrolyte imbalance could produce life threatening cardiac arrhythmia (Polymorphic VT with Sr K+ 2.9). Artesunate alone was list prone (i.e. only 6%) Quinine though has comparatively more (i.e. 25%) but there is no life-threatening cardiac arrhythmia in artesunate and Quinine.

Author Biographies

Anjali Tarai, Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India

ASSOCIATE PROFESSOR

DEPT OF PHARMACOLOGY

Kali Prasad Pattnaik, Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India

 PROFESSOR & HOD

DEPT OF PHARMACOLOGY

Kumar Haraprasad Mishra, Department of Pharmacology, PRM Medical College and Hospital, Baripada Mayurbhanj, Affiliated to North Odisha University, Odisha, India

ASSISTANT PROFESSOR

DEPT OF PHARMACOLOGY

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Published

2020-09-22

How to Cite

Tarai, A., Pattnaik, K. P., & Mishra, K. H. (2020). Electrocardiographic abnormalities with quinine and artesunate combinations in comparison to quinine or artesunate alone in severe falciparum malaria. International Journal of Basic & Clinical Pharmacology, 9(10), 1520–1527. https://doi.org/10.18203/2319-2003.ijbcp20204089

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Section

Original Research Articles