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Intravenous Toxicity of Atabrine (Atebrin)¹

Mayer (1) reported no side-effects from intravenous injection of atabrine in 7 patients, given up to 0.3 gram at a dose in 9 cc. of distilled water. Eckhardt (2) found in one patient 0.3 gram tolerated, but the following day 0.4 gram was followed two hours later by violent vomiting, collapse, rapid weak pulse, anxiety, and stupor; he was revived by hot black coffee; there were no sequelae. Eckhardt (2) and Mayer (1) both recommend that not over 0.2 gram be given at one dose. In an article (3) seen only in abstract kindly supplied by the manufacturers of atabrine, the authors suggest not using higher doses by vein than 0.2 gram, nor higher total dose daily by vein than 0.3 gram, and further advise against injecting the whole daily dose of 0.3 gram at one time. Appelbaum and Gelfand (4) treated estivo-autumnal malarial coma in 3 patients with atabrine by vein.

Received November 14, 1934.
¹ Read at a Joint Session of the American Society of Tropical Medicine and the National Malaria Committee at San Antonio, Texas, November 15, 1934.