HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Silamut, K. Articles by Warrell, D. A. Search for Related Content PubMed PubMed Citation Articles by Silamut, K. Articles by Warrell, D. A.

Binding of Quinine to Plasma Proteins in Falciparum Malaria

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 concentration; 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 = 0.011. 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.

Accepted for publication February 5, 1985.