Publication: Binding of quinine to plasma proteins in falciparum malaria
Issued Date
1985-01-01
Resource Type
ISSN
00029637
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2-s2.0-0022388582
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.34, No.4 (1985), 681-686
Suggested Citation
K. Silamut, N. J. White, S. Looareesuwan, D. A. Warrell Binding of quinine to plasma proteins in falciparum malaria. American Journal of Tropical Medicine and Hygiene. Vol.34, No.4 (1985), 681-686. doi:10.4269/ajtmh.1985.34.681 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/30793
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Title
Binding of quinine to plasma proteins in falciparum malaria
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Abstract
Plasma protein binding of quinine was measured in 12 patients with cerebral malaria on the first and seventh day of treatment, and in 7 patients with uncomplicated falciparum malaria on admission and also one month later. Binding was significantly higher and therefore the proportion of free drug was lower in cerebral malaria patients (free:total quinine concentrations; 7.2 ± 3.5%, mean ± SD, on admission; 7.4 ± 5.3% on day 7) compared with uncomplicated malaria patients on admission (10.2 ± 5.8%) or following recovery (11.0 ± 5.5%, n=6) P=0.001. Binding was significantly correlated with the red cell/total concentration ratio r=0.56, P<0.0001. The ratio of cerebrospinal fluid to free (unbound) plasma quinine was 0.55 ± 0.33 which suggests that quinine does not freely cross the blood brain barrier. These findings are relevant to the interpretation of total plasma or serum concentration, and may explain the rarity of serious quinine toxicity in severe falciparum malaria.