Key result
Intravenous quinidine gluconate in a patient with chronic active hepatitis showed altered pharmacokinetics, including an elimination half-life of 41.5 hours, suggesting dosing should be decreased.
Case Report (n=1)
No
Quinidine dosing should be markedly decreased in patients with severe liver dysfunction due to altered pharmacokinetics.
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This case supports caution with quinidine dosing in severe liver disease; leaves open systematic pharmacokinetic evaluation in hepatic impairment.
A 49-year-old female with chronic active hepatitis and ventricular ectopic activity was given i.v. 600 mg quindine gluconate (4·4 mg/kg). Quinidine plasma concentrations were analysed by high pressure liquid chromatography and plasma protein binding by equilibrium dialysis. The pharmacokinetic values were total body clearance 0·11 l/kg/hr, elimination half-life 41·5 hr, volume of the central compartment 2·26 l/kg, volume of distribution from the area under the curve 6·5 l/kg, and 19% unbound in plasma. Based on the limited information available, quinidine dosing should be markedly decreased in patients with severe liver dysfunction.
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Powell et al. (1982) conducted a case report in Chronic active hepatitis and ventricular ectopic activity (n=1). Quinidine gluconate was evaluated on Pharmacokinetic values (total body clearance, elimination half-life, volume of distribution, unbound in plasma). Intravenous quinidine gluconate in a patient with chronic active hepatitis showed altered pharmacokinetics, including an elimination half-life of 41.5 hours, suggesting dosing should be decreased.
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