Side Effects of quinidine: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Quinidine has been used to prevent life-threatening arrhythmias in inherited heart rhythm disorders such as Brugada syndrome and short QT syndrome. 3 , 17 , 24 It has also been used to prevent atrial fibrillation and flutter, a type of irregular heartbeat. 3 The effectiveness of quinidine has been shown in small studies, but its use is limited due to the high incidence of side effects. 3 , 14 , 12

Reasons for side effects

Side effects of quinidine are due to its pharmacological action. Quinidine inhibits sodium and potassium channels, which regulate the electrical activity of the heart. By blocking these channels, the electrical activity of the heart becomes unstable, making it easier for arrhythmias to occur. 3 , 14 Quinidine is also metabolized in the liver, and this process can produce toxic metabolites. 12

Common Side Effects

QT prolongation

Quinidine can cause QT prolongation, which is a lengthening of the electrical activity of the heart. QT prolongation can increase the risk of ventricular arrhythmias. 16 , 23 , 14 This risk may be higher in women and older adults. 23

Gastrointestinal symptoms

Quinidine can cause gastrointestinal symptoms. These symptoms may include nausea, vomiting, diarrhea, and loss of appetite.

Liver damage

Quinidine can cause liver damage. Symptoms of liver damage may include jaundice, abdominal pain, and fatigue. 12

Hearing loss

Quinidine can cause hearing loss. Symptoms of hearing loss may include tinnitus and difficulty hearing.

Allergic reaction

Quinidine can cause allergic reactions. Symptoms of allergic reactions may include rash, hives, and difficulty breathing. 12

Side Effects Management

QT prolongation

To reduce the risk of QT prolongation, quinidine dosage needs to be carefully adjusted. 23 Patients should also undergo regular electrocardiogram examinations. 16

Gastrointestinal symptoms

To reduce gastrointestinal symptoms, quinidine should be taken with food. Patients should also eat light meals and drink fluids frequently.

Liver damage

To reduce the risk of liver damage, patients should undergo regular liver function tests. 12 If symptoms of liver damage appear, consult your doctor immediately. 12

Hearing loss

If symptoms of hearing loss appear, consult your doctor immediately.

Allergic reaction

If symptoms of an allergic reaction appear, consult your doctor immediately. 12 Patients should also inform their doctor of any history of allergies to quinidine. 12

Comparison of Studies

Similarities

Most studies have shown that quinidine is effective in treating inherited heart rhythm disorders such as Brugada syndrome and short QT syndrome. 3 , 17 , 24 However, these studies have also shown that quinidine has a high incidence of side effects. 3 , 14 , 12

Differences

There are differences in the effectiveness and incidence of side effects of quinidine across studies. 3 , 17 , 24 This is likely due to differences in research methodology and patient populations. 3 , 17 , 24

Considerations for real-life application

Quinidine can cause serious side effects, so it is important to take it as prescribed by your doctor. 3 , 14 , 12 You should also have regular check-ups while taking quinidine. 3 , 14 , 12

Limitations of Current Research

Many studies on quinidine are small studies. Therefore, it is difficult to generalize the results of these studies. 3 Also, there are few long-term studies on quinidine. Therefore, the long-term effects of quinidine are not yet fully understood. 3

Future Research Directions

Large-scale and long-term studies on quinidine are needed. 3 New therapies are also needed to reduce the side effects of quinidine. 3

Conclusion

Quinidine may be effective in treating inherited heart rhythm disorders such as Brugada syndrome and short QT syndrome, but it can cause serious side effects. 3 , 17 , 24 If you are considering taking quinidine, talk to your doctor to understand the risks and benefits. 3 , 17 , 24

Literature analysis of 25 papers
Positive Content
15
Neutral Content
3
Negative Content
7
Article Type
3
0
1
7
25
1.

ALSUntangled #71: Nuedexta.

Author: SunYuyao, BenatarMichael, Mascías CadavidJavier, EnnistDave, WicksPaul, StaatsKim, BeauchampMorgan, JhootySartaj, PatteeGary, BrownAndrew, BertoriniTulio, BarkhausPaul, BrombergMark, CarterGreg, BedlackRichard, LiXiaoyan

Improved bulbar function
Mild to moderate side effects

This review supports the consideration of Nuedexta, a combination drug originally approved for pseudobulbar affect, as a potential treatment for bulbar dysfunction in ALS patients, with or without pseudobulbar affect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Emotional and Neuropsychiatric Disorders Associated with Alzheimer's Disease.

Author: HeilmanKenneth M, NadeauStephen E

Reduce agitation
Reduce psychosis
Serious side effects

This review explores the treatment of emotional experience disorders in patients with Alzheimer's disease, focusing on pharmacological approaches and highlighting recent advancements in the treatment of psychosis and agitation/aggression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Study of Tissue-Specific Reactive Oxygen Species Formation by Cell Membrane Microarrays for the Characterization of Bioactive Compounds.

Author: ElexpeAne, NietoNerea, Fernández-CuétaraClaudia, Domínguez-FernándezCeltia, Morera-HerrerasTeresa, TorrecillaMaría, MiguélezCristina, LasoAntonio, OchoaEneko, BailenMaría, González-ColomaAzucena, Angulo-BarturenIñigo, AstigarragaEgoitz, Barreda-GómezGabriel

Safety profile
Oxidative damage

This study evaluated the safety profile of six antimalarial drugs and two essential oils against toxicity mediated by oxidative stress. The drugs were tested on cell membranes isolated from human tissues and showed specific behavior according to the tissue type. Atovaquone and quinidine produced the highest percentage of superoxide formation, while doxycycline produced the lowest.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Efficacy and tolerability of quinidine as salvage therapy for monomorphic ventricular tachycardia in patients with structural heart disease.

Author: DeshmukhAmrish, LarsonJohn, GhannamMichael, SaeedMohammed, CunnaneRyan, GhanbariHamid, LatchamsettyRakesh, CrawfordThomas, JongnarangsinKrit, PelosiFrank, ChughAman, OralHakan, MoradyFred, BogunFrank, LiangJackson J

Improved VT cycle length
Gastrointestinal side effects
Limited efficacy
Neurologic side effects
QT prolongation
Rash
Thrombocytopenia

Quinidine therapy was found to have limited tolerability and long-term efficacy in the management of amiodarone-refractory scar-related monomorphic ventricular tachycardia (MMVT).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Safety of Memantine in Combination with Potentially Interactive Drugs in the Real World: A Pharmacovigilance Study Using the Japanese Adverse Drug Event Report (JADER) Database.

Author: SatoKenichiro, ManoTatsuo, IwataAtsushi, TodaTatsushi

Alzheimer's disease treatment
Memantine interactions

Memantine is an NMDA receptor antagonist used to treat Alzheimer's disease. It should be used with caution in combination with amantadine or dextromethorphan due to potential interactions that may increase adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Biocomputational Prediction Approach Targeting FimH by Natural SGLT2 Inhibitors: A Possible Way to Overcome the Uropathogenic Effect of SGLT2 Inhibitor Drugs.

Author: MashraqiMutaib M, ChaturvediNavaneet, AlamQamre, AlshamraniSaleh, BahnassMosa M, AhmadKhurshid, AlqosaibiAmany I, AlnamshanMashael M, AhmadSyed Sayeed, BegMirza Masroor Ali, MishraAbha, ShaikhSibhghatulla, RizviSyed Mohd Danish

Diabetes treatment
Urinary tract infection prevention
Urinary tract infection

Three natural SGLT2 inhibitors, formononetin, (+)-pteryxin, and quinidine, showed strong interactions with FimH protein, a key target for preventing urinary tract infections (UTIs). These compounds demonstrate potential as SGLT2 inhibitors with add-on FimH inhibition potential, potentially reducing the risk of UTI-related side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report.

Author: YoungFletcher Graham, NguyenDiep

Pseudobulbar affect is a distressing and underdiagnosed neuropsychiatric disorder characterized by inappropriate laughing and crying. This abstract discusses the current understanding of the disorder and its treatment, highlighting the need for further research on effective pharmacological interventions.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Quinidine hypersensitivity: a side effect of a forgotten antiarrhythmic.

Author: El-KhatibLayan, AlrayesHussayn, SallamOmar, ElbannaAhmed

Liver toxicity

This case report describes a 69-year-old woman with recurrent ventricular tachycardia who experienced acute liver toxicity after taking quinidine. Discontinuation of quinidine resulted in resolution of symptoms and lab abnormalities, leading to a diagnosis of quinidine hypersensitivity.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Quinidine-A legacy within the modern era of antiarrhythmic therapy.

Author: Vitali SerdozLaura, RittgerHarald, FurlanelloFrancesco, BastianDirk

Antiarrhythmic activity
Proarrhythmia

This review discusses the pharmacological properties of quinidine and its role in the treatment of life-threatening arrhythmic storms in patients with congenital arrhythmogenic syndromes. Quinidine has been used to treat cardiac arrhythmias since the early 20th century, but its use has declined due to side effects. However, it remains an important drug in the treatment of arrhythmic storms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

The arrhythmogenic cardiotoxicity of the quinoline and structurally related antimalarial drugs: a systematic review.

Author: HaeuslerIlsa L, ChanXin Hui S, GuérinPhilippe J, WhiteNicholas J

Malaria treatment
Hypotension
QT interval prolongation
Torsade de Pointes

This review discusses the cardiovascular safety profiles of quinoline and structurally related antimalarial drugs, highlighting the need to review their safety profiles due to their increasing use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Drug-induced lupus: Traditional and new concepts.

Author: VaglioAugusto, GraysonPeter C, FenaroliParide, GianfredaDavide, BoccalettiValeria, GhiggeriGian Marco, MoroniGabriella

DIL treatment
DIL

This article discusses drug-induced lupus (DIL), a spectrum of drug-induced reactions characterized by features similar to idiopathic systemic lupus erythematosus (SLE). The authors emphasize the importance of early recognition and discuss the emerging evidence of newer agents, such as TNFα inhibitors, as potential triggers for DIL.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Drug-induced QT Interval Prolongation in the Intensive Care Unit.

Author: EtchegoyenCecilia Villa, KellerGuillermo Alberto, MradSebastian, ChengSixuan, Di GirolamoGuillermo

Drug-induced LQTS

This study addresses drug-induced QT interval prolongation, the most common acquired cause of Long QT syndrome (LQTS), which is characterized by an extended duration of the ventricular repolarization. This syndrome increases the risk for polymorphic ventricular tachycardia and sudden death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Hydroquinidine Prevents Life-Threatening Arrhythmic Events in Patients With Short QT Syndrome.

Author: MazzantiAndrea, MaragnaRiccardo, VacantiGaetano, KostopoulouAnna, MarinoMaira, MonteforteNicola, BloiseRaffaella, UnderwoodKatherine, TibolloValentina, PaganEleonora, NapolitanoCarlo, BellazziRiccardo, BagnardiVincenzo, PrioriSilvia G

Reduced cardiac events
Gastrointestinal intolerance

Hydroquinidine therapy is associated with a lower incidence of life-threatening arrhythmic events in patients with short QT syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Precision therapy for epilepsy due to <i>KCNT1</i> mutations: A randomized trial of oral quinidine.

Author: MullenSaul A, CarneyPatrick W, RotenAnnie, ChingMichael, LightfootPaul A, ChurilovLeonid, NairUmesh, LiMelody, BerkovicSamuel F, PetrouSteven, SchefferIngrid E

Cardiac Side Effects

Quinidine, a potassium channel blocker, showed no efficacy in treating severe epilepsy caused by gain-of-function mutations in the potassium channel gene. In a small, single-center trial, quinidine was associated with dose-limiting cardiac side effects, even at low serum levels, suggesting that it may be ineffective and carry substantial cardiac risks in this patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

The QUIDAM study: Hydroquinidine therapy for the management of Brugada syndrome patients at high arrhythmic risk.

Author: AndorinAntoine, GourraudJean-Baptiste, MansouratiJacques, FouchardSwanny, le MarecHervé, MauryPhilippe, MaboPhilippe, HermidaJean-Sylvain, DeharoJean-Claude, DelasalleBéatrice, EsnaultSimon, SadoulNicolas, DavyJean-Marc, LeenhardtAntoine, KlugDidier, DefayePascal, BabutyDominique, SacherFrédéric, ProbstVincent

Arrhythmia prevention
Gastrointestinal side effects
QTc interval prolongation
Repolarization dispersion

This study investigated the effectiveness of hydroquinidine (HQ) in preventing life-threatening ventricular arrhythmia in high-risk patients with Brugada syndrome (BrS) who were implanted with an implantable cardioverter-defibrillator (ICD). The study found that HQ was effective in preventing arrhythmia, but that frequent side effects, mainly gastrointestinal, led to discontinuation of the therapy in many patients. This suggests that HQ may not be a viable alternative to ICD implantation for the prevention of life-threatening ventricular arrhythmia in BrS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

22.

[Drug-induced acute kidney injury].

Author: DerungsAdrian

Nephrotoxicity

This article provides an overview of drug-induced nephrotoxicity, covering common nephrotoxic drugs, mechanisms of injury, and risk factors.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

24.

Management of Brugada Syndrome: Thirty-Three-Year Experience Using Electrophysiologically Guided Therapy With Class 1A Antiarrhythmic Drugs.

Author: BelhassenBernard, RahkovichMichael, MichowitzYoav, GlickAharon, ViskinSami

Brugada syndrome
Effective AAD treatment
No arrhythmic events
Side effects

Electrophysiologically guided class 1A antiarrhythmic drug treatment was effective for patients with Brugada syndrome.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

25.

[Efficacy and safety of allapinine and quinidine bisulphate in the treatment of patients with persistent atrial fibrillation after cardioversion].

Author: RakhmanovaM M, SokolovS F

Treatment of persistent atrial fibrillation
Side effects

This study compared the safety and effectiveness of two drugs, allapinine and quinidine bisulphate, for treating persistent atrial fibrillation after cardioversion. Both drugs were effective in restoring normal heart rhythm, but allapinine had fewer side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Russian

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