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Titolo:
Quinine disposition in globally malnourished children with cerebral malaria
Autore:
Pussard, E; Barennes, H; Daouda, H; Clavier, F; Sani, AM; Osse, M; Granic, G; Verdier, F;
Indirizzi:
CHU Bicetre, Serv Pharmacol, F-94275 Le Kremlin Bicetre, France CHU Bicetre Le Kremlin Bicetre France F-94275 Le Kremlin Bicetre, France INSERM, U13, Paris, France INSERM Paris FranceINSERM, U13, Paris, France CHU Bichat, Inst Med & Epidemiol Africaines & Trop, Paris, France CHU Bichat Paris France ed & Epidemiol Africaines & Trop, Paris, France CHU Niamey, Cooperat Francaise, Niamey, Niger CHU Niamey Niamey NigerCHU Niamey, Cooperat Francaise, Niamey, Niger CHU Niamey, Fac Sci Sante, Niamey, Niger CHU Niamey Niamey NigerCHU Niamey, Fac Sci Sante, Niamey, Niger CHU Niamey, Serv Biochim, Niamey, Niger CHU Niamey Niamey NigerCHU Niamey, Serv Biochim, Niamey, Niger
Titolo Testata:
CLINICAL PHARMACOLOGY & THERAPEUTICS
fascicolo: 5, volume: 65, anno: 1999,
pagine: 500 - 510
SICI:
0009-9236(199905)65:5<500:QDIGMC>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMODIUM-FALCIPARUM MALARIA; PLASMA-PROTEIN BINDING; YOUNG AFRICAN CHILDREN; ALPHA-1-ACID GLYCOPROTEIN; MALAWIAN CHILDREN; PARENTERAL QUININE; OPTIMAL REGIMENS; PHARMACOKINETICS; CHLOROQUINE; METABOLISM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Pussard, E CHU,Bicetre, Serv Pharmacol, 78 Rue Gen Leclerc, F-94275 Le Kremlin Bicetre CHU Bicetre 78 Rue Gen Leclerc Le Kremlin Bicetre France F-94275
Citazione:
E. Pussard et al., "Quinine disposition in globally malnourished children with cerebral malaria", CLIN PHARM, 65(5), 1999, pp. 500-510

Abstract

Background: Both malnutrition and malaria affect drug disposition:and are frequent among children in the tropics. We assessed their respective influence on quinine distribution. Methods forty children were divided into 4 groups: children with normal nutritional status without (group 1) or with (group 2) cerebral malaria, and malnourished children without (group 3) or with (group 4) cerebral malaria. All children received an infusion of 8 mg/kg of a combination solution of cinchona alkaloids that contained 96.1% quinine, 2.5% quinidine, 0.68% cinchonine, and 0.67% cinchonidine (corresponding to 4.7 mg/kg quinine base), The children with malaria then received repeated infusions every 8 hours for3 days, Pharmacokinetic profiles of plasma and erythrocyte quinine were determined during the first 8 hours, together with quinine protein binding. Additional measurements of plasma quinine concentrations were used to simulate quinine concentrations profiles in children with malaria with and without malnutrition. Clinical recovery and parasitemia clearance times were determined in the children with malaria. Results: Compared with control children, malaria and malnutrition increased plasma concentrations of quinine and reduced both the volume of distribution and the total plasma clearance. Simultaneously, alpha(1)-glycoprotein plasma concentrations and protein-bound fraction of the drug were increased. Erythrocyte quinine concentrations correlated strongly with free plasma quinine but not with the extent of parasitemia, Similar effective and nontoxic quinine concentration profiles were obtained in malaria with and without malnutrition. Conclusions Severe global malnutrition and cerebral malaria have a similareffect on quinine pharmacokinetics in children, Moderate malnutrition doesnot potentiate cerebral malaria-mediated modifications of quinine disposition, These results suggest that current parenteral quinine regimens can be used, unmodified, to treat children with both malaria and malnutrition.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/05/20 alle ore 11:46:00