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(S)-[(2R,4S,5R)-5-ethenyl-1-azoniabicyclo[2.2.2]octan-2-yl]-(6-methoxyquinolin-4-yl)methanol;hydroxide

中文名称
——
中文别名
——
英文名称
(S)-[(2R,4S,5R)-5-ethenyl-1-azoniabicyclo[2.2.2]octan-2-yl]-(6-methoxyquinolin-4-yl)methanol;hydroxide
英文别名
——
(S)-[(2R,4S,5R)-5-ethenyl-1-azoniabicyclo[2.2.2]octan-2-yl]-(6-methoxyquinolin-4-yl)methanol;hydroxide化学式
CAS
——
化学式
C20H26N2O3
mdl
——
分子量
342.4
InChiKey
NGXLOCPSRZVKMI-VJAUXQICSA-N
BEILSTEIN
——
EINECS
——
  • 物化性质
  • 计算性质
  • ADMET
  • 安全信息
  • SDS
  • 制备方法与用途
  • 上下游信息
  • 反应信息
  • 文献信息
  • 表征谱图
  • 同类化合物
  • 相关功能分类
  • 相关结构分类

计算性质

  • 辛醇/水分配系数(LogP):
    2.35
  • 重原子数:
    25
  • 可旋转键数:
    4
  • 环数:
    5.0
  • sp3杂化的碳原子比例:
    0.45
  • 拓扑面积:
    46.6
  • 氢给体数:
    2
  • 氢受体数:
    5

ADMET

代谢
过量自杀患者中检测到了奎尼丁及其3-羟基代谢物的乳酸盐共轭物。
Lactate conjugates of quinidine and its 3-hydroxy metabolite were detected in overdose suicide patient.
来源:Hazardous Substances Data Bank (HSDB)
代谢
奎尼丁在肝脏中代谢,主要是通过羟基化生成3-羟基奎尼丁和2-喹尼啶酮。一些代谢产物具有抗心律失常活性。大约10-50%的剂量在24小时内以原药形式通过尿液排出(可能是通过肾小球滤过)。
Quinidine is metabolized in the liver, principally via hydroxylation to 3-hydroxyquinidine and 2-quinidinone. Some metabolites have antiarrhythmic activity. Approximately 10-50% of a dose is excreted in urine (probably by glomerular filtration) as unchanged drug within 24 hr.
来源:Hazardous Substances Data Bank (HSDB)
代谢
奎尼丁的代谢产物包括3-羟基奎尼丁N-氧化物、2'-氧代奎尼丁酮、脱甲基奎尼丁奎尼丁N-氧化物。尽管个体之间的代谢差异很大,但在奎尼丁引起的尖端扭转型室速的案例中,这些代谢产物似乎并不有助于心律不齐的形成。
Quinidine metabolites include 3-hydroxyquinidine N-oxide, 2'-oxoquinidinone, desmethylquinidine, and quinidine N-oxide. While metabolism is highly variable between individuals, at least in cases of quinidine-induced torsade de pointes, the metabolites do not appear to contribute to the formation of dysrhythmias.
来源:Hazardous Substances Data Bank (HSDB)
代谢
盐酸奎尼丁在肝脏中发生广泛的氧化代谢...其中一个代谢物,3-羟基奎尼丁,几乎和盐酸奎尼丁一样有效,能够阻断心脏的通道或延长动作电位。
Quinidine undergoes extensive hepatic oxidative metabolism... One metabolite, 3-hydroxyquinidine, is nearly as potent as quinidine in blocking cardiac sodium channels or prolonging action potentials.
来源:Hazardous Substances Data Bank (HSDB)
代谢
大多数前体药物是通过细胞色素P450 IIIA的作用在肝脏中被消除。
Most quindiidne is eliminated hepatically via the action of cytochrome P450 IIIA.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 毒性总结
识别:奎尼丁是一种IA类抗心律失常药物。物质来源:奎尼丁奎宁的D-异构体。奎尼丁是一种生物碱,可能来源于多种鸡纳树皮。鸡纳树皮含有0.25至3.0%的奎尼丁奎尼丁也可以从奎宁中制备。奎尼丁是一种无味、味道苦涩的粉末或白色结晶。硫酸奎尼丁是无色结晶,无味,味道苦涩。葡萄糖酸奎尼丁是一种无色、无味、味道苦涩的白色粉末。聚半乳糖醛酸奎尼丁是一种粉末。硫酸奎尼丁是一种白色粉末或无味结晶,味道苦涩。 适应症:描述:室性早搏和室性心动过速;室上性心律失常;心房扑动或心房颤动电转复后维持窦性心律。 人体暴露:主要风险和靶器官:心脏毒性是奎尼丁中毒的主要风险。奎尼丁可能诱导中枢神经系统症状。 临床效果概要:毒性效应通常在摄入后2至4小时内出现,但根据奎尼丁盐和制剂形式的不同,潜伏期可能会有所变化。症状可能包括心律失常(特别是在有基础心血管疾病的患者中)、神经毒性和呼吸抑制。 诊断:心脏干扰:心脏停搏、休克、传导障碍、室性心律失常、心电图变化、神经系统症状:耳鸣、嗜睡、晕厥、昏迷、抽搐、谵妄。呼吸抑制。奎尼丁浓度对于诊断可能有帮助,但对于临床管理没有用处。 禁忌症:对鸡纳生物碱过敏或特异体质;房室传导阻滞或完全性心脏阻滞;室内传导缺陷;无房性活动;洋地黄中毒;重症肌无力和外室性心律失常(尖端扭转型)。 注意事项包括以下内容:充血性心力衰竭、低血压、肾脏疾病、肝功能衰竭;同时使用其他抗心律失常药物;老年人及哺乳期妇女。 暴露途径:口服:口服吸收是中毒最常见的原因。 parenteral:静脉给药后中毒很少见,但在接受静脉注射奎尼丁治疗心律失常的患者中有报道。吸收途径:口服:奎尼丁几乎完全从胃肠道吸收。然而,由于肝脏的首过效应,绝对生物利用度约为摄入剂量的70至80%,且可能因患者和制剂而异。血浆峰浓度时间为硫酸奎尼丁1至3小时,葡萄糖酸奎尼丁3至6小时,聚半乳糖醛酸奎尼丁约6小时。缓释奎尼丁连续吸收8至12小时。parenteral:肌肉注射后奎尼丁的吸收可能不稳定且不可预测,可能由于药物在注射部位的沉淀而导致不完全吸收。其他研究表明,肌肉注射与口服吸收的速率没有差异。 分布途径:口服:蛋白结合:约70至80%的药物与血浆蛋白结合。慢性肝病患者血浆蛋白结合减少。组织:肝脏中奎尼丁浓度是血浆的10至30倍。骨骼肌和心肌、大脑和其他组织含有中间量。红细胞血浆分配系数为0.82。 生物半衰期途径:消除半衰期:半衰期约为6至7小时。在慢性肝病患者和老年人中增加。在充血性心力衰竭或肾功能衰竭中似乎没有改变。代谢:50至90%的奎尼丁在肝脏代谢为羟基化产物。代谢物包括3-羟基奎尼丁、2-氧化奎尼丁酮、0-去甲基奎尼丁奎尼丁-N-氧化物。主要代谢物是3-羟基奎尼丁,其效果与奎尼丁相似,可能部分负责观察到的抗心律失常效果。羟基奎尼丁的消除动力学似乎与奎尼丁相似。 消除途径:肾脏:尿液中未改变的排泄量变化,但约为给药剂量的17%。多达50%的奎尼丁剂量(未改变+代谢物)在给药后24小时内通过尿液排泄。肾排泄取决于尿液的pH。排泄与尿液pH成反比。在肾功能不全和充血性心力衰竭中排泄减少。肝脏:50至90%的奎尼丁剂量在肝脏代谢。胆汁:大约1至3%通过胆汁在粪便中排泄。乳汁:奎尼丁在乳汁中排泄。 作用方式毒动力学:奎尼丁减少心肌对电解质的通透性(膜稳定剂)并是一种一般性的心脏抑制剂。它具有负性肌力作用;抑制自发舒张期去极化;减慢传导;延长有效不应期;提高电阈值。这导致收缩力下降、传导性受损(房室和室内)和兴奋性降低,但可能存在异常刺激再入机制。奎尼丁具有抗胆碱能效应和周围血管扩张剂性质。在实验研究中观察到以下进展变化:心电图:心动过缓,PR间期
IDENTIFICATION: Quinidine is a class lA antiarrhythmic drug. Origin of the substance: Quinidine is the d- isomer of quinine. Quinidine is an alkaloid that may be derived from various species of Cinchona. Cinchona barks contain 0.25 to 3.0% quinidine. Quinidine is also prepared from quinine. Quinidine is a powder or white crystals, odorless with a bitter taste. Quinidine bisulfate is colorless crystals which is odorless and has a bitter taste. Quinidine gluconate is a white powder which is odorless and has a bitter taste. Quinidine poly-galacturonate is a powder. Quinidine sulfate is a white powder or odorless crystals with a bitter taste. Indications: Description: Premature ventricular extrasystoles and ventricular tachycardia; supraventricular arrhythmia; maintenance of sinus rhythm after cardioversion of atrial flutter or fibrillation. HUMAN EXPOSURE: Main risks and target organs: Cardio-toxicity is the main risk of quinidine poisoning. Quinidine may induce central nervous system symptoms. Summary of clinical effects: Toxic effects appear within 2 - 4 hours after ingestion but the delay may vary according to the quinidine salt and to the preparation forms. Symptoms may include disturbances of cardiac rhythm (especially in patients with underlying cardiovascular disease), neurotoxicity and respiratory depression. Diagnosis: Cardiac disturbances: circulatory arrest, shock, conduction disturbances, ventricular arrhythmias, ECG changes, Neurological symptoms: tinnitus, drowsiness, syncope, coma, convulsions, delirium. Respiratory depression. Quinidine concentrations may be helpful in diagnosis but are not useful for clinical management. Contraindications: Allergy or idiosyncrasy to cinchona alkaloids; atrioventricular or complete heart block; intraventricular conduction defects; absence of atrial activity; digitalis intoxication; myasthenia gravis and ventricular dysrhythmia of the torsades de pointes type Precautions include the following: Congestive heart failure, hypotension, renal disease, hepatic failure; concurrent use of other antiarrhythmic drugs; old age and breast-feeding. Routes of entry: Oral: Oral absorption is the most frequent cause of intoxication. Parenteral: Intoxication after IV administration is rare but has been reported in patients treated with IV quinidine for cardiac dysrhythmia. Absorption by route of exposure: Oral: Quinidine is almost completely absorbed from the gastrointestinal tract. However, because of hepatic first-pass effect, the absolute bioavailability is about 70 to 80% of the ingested dose and may vary between patients and preparations. The time to plasma peak concentration is 1 to 3 hours for quinidine sulfate, 3 to 6 hours for quinidine gluconate and about 6 hours for quinidine polygalacturonate. Sustained-release quinidine is absorbed continuously over 8 to 12 hours. Parenteral: Absorption of quinidine after intramuscular injection may be erratic and unpredictable with incomplete absorption of the administered dose, probably due to precipitation of drug at the site of injection. Other studies indicate no difference between the rate of quinidine absorption when given by intramuscular injection or oral absorption. Distribution by route of exposure: Oral: Protein binding: About 70 to 80% of the drug is bound to plasma protein. Plasma protein binding is decreased in patients with chronic liver disease. Tissue: Quinidine concentrations in liver are 10 to 30 times higher than those in plasma. Skeletal and cardiac muscle, brain and other tissues contain intermediate amounts. The red cell plasma partition ratio is 0.82. Biological half-life by route of exposure: Elimination half-life: The half-life is about 6 to 7 hours. It is increased in chronic liver disease and in the elderly. It does not appear to be altered in congestive heart failure or renal failure. Metabolism: 50 to 90% of quinidine is metabolized in the liver to hydroxylated products. Metabolites include 3-hydroxyquinidine, 2 oxoquinidinone, 0-desmethylquinidine, quinidine-N-oxide. The principal metabolite is 3 hydroxyquinidine which exerts similar effects to quinidine and may account for part of the observed antiarrhythmic effects. The elimination kinetics of hydroxyquinidine appear to be similar to those of quinidine. Elimination by route of exposure Kidney: The amount excreted unchanged in urine is variable but is about 17% of an administered dose. Up to 50% of a dose of quinidine (unchanged + metabolites) is excreted in urine within 24 hours after administration. Renal excretion is dependent upon the pH of the urine. Excretion varies inversely with urine pH. Excretion is reduced in renal insufficiency and in congestive heart failure. Liver: 50 to 90% of a dose of quinidine is metabolized in the liver. Bile: Approximately 1 to 3% is excreted in the feces via the bile. Breast milk: Quinidine is excreted in breast milk. Mode of action Toxicodynamics: Quinidine reduces the permeability of heart muscle to electrolytes (membrane stabilizer) and is a general cardiac depressant. It has a negative inotropic effect; inhibits the spontaneous diastolic depolarization; slow conduction; lengthens the effective refractory period; and raises the electrical threshold. This results in depression of contractility, impaired conductivity (atrioventricular and intraventricular) and decreased excitability but with possible abnormal stimulus re-entry mechanism. Quinidine has an anticholinergic effect and peripheral vasodilator properties. In experimental studies the following progression changes was observed: ECG: bradycardia, prolongation of the PR interval, lengthening of the QT interval, widening of the QRS with development of an idioventricular rhythm and then in ventricular standstill. Sometimes the terminal event was ventricular fibrillation. Blood pressure decreases progressively. A significant decrease of blood pressure was noted with the appearance of QRS widening and blood pressure was close to zero when slow idioventricular rhythm appeared. Electrolytes abnormalities: decrease in plasma concentrations of potassium, sodium and magnesium with the development of acidosis. Electrolytes: Hypokalaemia may occur and is probably related to an intracellular transport of potassium by a direct effect on cellular membrane permeability. Neurologic symptoms: Syncope and convulsions may represent a direct toxic effect on CNS or may be related to cerebral ischaemia due to circulatory or respiratory failure. Pharmacodynamics: Quinidine slows the rate of firing of the normal and of ectopic rhythmic foci; it raises the threshold for electrically induced arrhythmias; it protects against ventricular arrhythmias; and it prevents or terminates circus movement flutter. Teratogenicity: Quinidine has been implicated as a cause of light cranial nerve damage to the fetus at doses much larger than those needed to treat arrhythmias. Interactions: Several interactions have been reported. Quinidine has a synergistic action with warfarin (decrease of prothrombin level). Quinidine potentiates both non-depolarizing and depolarizing neuromuscular blocking agents. The cardiodepressant effects of other antiarrhythmic agents are increased by concurrent use of quinidine; amiodarone increases quinidine concentrations in the blood. Quinidine concentrations are reduced by: rifampicin, anticonvulsants, nifedipine and acetazolamide. Quinidine concentrations are increased by antacids, cimetidine, verapamil and amiodarone; the risk of quinidine toxicity is increased by terfenadine, astemizole, and thiazide and loop diuretics. Quinidine increases the plasma concentrations of propafenone and digoxin. Main adverse effects: Numerous adverse effects during quinidine therapy have been reported. Cardiovascular: Hypotension after IV administration; Syncope; proarrhythmic effect: "torsades de pointes"; and ECG: widening of QRS interval; prolongation of PR and QT intervals. CNS: Cinchonism: headache, fever, visual disturbances, mydriasis, tinnitus, nausea, vomiting and rashes. Gastrointestinal: Nausea, vomiting, diarrhoea, colic have been reported. Hepatic: Granulomatous hepatitis or hepatitis with centrilobular necrosis. Skin: Skin rashes with drug fever and photosensitivity may result. Hematologic: Thrombocytopenia (immunologic reaction) has been noted. Clinical effects: Acute poisoning: Ingestion: Severity of quinidine poisoning is related to the cardiotoxic effects. Symptoms appear usually within 2 to 4 hours and may include: cardiovascular symptoms: hypotension, cardiogenic shock, cardiac arrest. ECG may show: decrease of T wave; prolongation of QT and QRS intervals; atrioventricular block; ventricular dysrhythmia (torsade de pointes). Neurological symptoms: tinnitus, drowsiness, syncope, coma, convulsion, blurred vision and diplopia. Respiratory symptoms: hypoventilation and apnea. Cardiotoxicity may be enhanced if other cardiotoxic drugs have been ingested (antiarrhythmic drugs, tricyclic antidepressants). Parenteral exposure: After IV administration symptoms appear more rapidly. Chronic poisoning: Ingestion: The most relevant symptoms of chronic poisoning are: ECG disturbances; syncope due to ventricular dysrhythmia, (torsade de pointes) and cinchonism gastrointestinal disturbances Course, prognosis, cause of death: The usual course of quinidine poisoning is dominated by the cardiovascular disturbances which usually occur within 2 to 4 first hours but may first appear as late as 12 hours after exposure (and perhaps even later after ingestion of a slow- release preparation). Symptoms may last for 24 to 36 hours. Patients who survive 48 hours after acute poisoning are likely to recover. Death may result from cardiac arrest by asystole or electromechanical dissociation and, rarely, by ventricular fibrillation. Systematic description of clinical effects: Cardiovascular: Acute: Cardiovascular symptoms are the major features of quinidine toxicity. Tachycardia due to anticholinergic effects is usually observed initially or in moderate intoxication. In severe intoxication, bradycardia due to atrioventricular block may occur. Hypotension and shock: hypotension due to peripheral vasodilation is common. In severe intoxication, cardiogenic shock with increased central venous pressure is usually observed and is related to decreased cardiac contractility. Cardiac arrest may occur, which may be related to electromechanical dissociation, ventricular dysrhythmia or asystole. Cardiac dysrhythmias are common and may include: atrioventricular block, idioventricular rhythm, ventricular tachycardia and fibrillation, torsades de pointes. ECG changes are always present in symptomatic intoxication: repolarization abnormalities, decreased T wave, increase of U wave, prolongation of QT and PR intervals, widening of QRS complexes (> 0.08 sec), atrioventricular block. Syncope due to torsade de pointes may occur. Chronic: ECG changes with repolarization abnormalities, decreased T wave and increase of QT interval are a common feature during quinidine therapy. Syncope is related to transient torsade de pointes and occurs in 1 to 8% of patients receiving quinidine. The occurrence of torsade de pointes is not correlated with plasma quinidine levels but is favored by an increase in the QT interval. Respiratory: Acute: Respiratory depression or apnea is mostly associated with severe cardiac disturbances such as shock or ventricular dysrhythmia. Pulmonary edema with normal pulmonary capillary wedge pressure following an attempted suicide has been documented. Neurological: CNS: Acute: Drowsiness, delirium, coma and convulsions may appear without cardiac symptoms. However, cardiac failure should always be considered when CNS symptoms appear. Cinchonism may sometimes appear. Chronic: Cinchonism. Delirium has been reported. Peripheral nervous system: Chronic: Quinidine can potentiate the neuromuscular blocking action of some skeletal muscle relaxants and may cause the return of respiratory paralysis if it is given shortly after recovery from neuromuscular blockade. Autonomic nervous system: Acute: Quinidine has an anticholinergic effect. However, this effect is usually limited to the vagal system. Skeletal and smooth muscle: Chronic: An increase in serum concentrations of skeletal muscle enzymes has been reported in a man treated with quinidine. Gastrointestinal: Acute: Nausea and vomiting may occur. Chronic: Gastrointestinal toxicity (nausea, vomiting, diarrhea and colic) is the most frequent side effect of quinidine. Hepatic: Chronic: Hepatotoxicity has been reported, with an increase in serum concentrations of transaminases, LDH, alkaline phosphatase, and cholestasis. Renal: Acute: No direct nephrotoxic effect has been reported. Acute renal failure related to cardiogenic shock may occur. Dermatological: Chronic: Skin lesions have been attributed to the use of quinidine and include skin rash, photosensitivity and lichen planus. Eye, ear, nose, throat: local effects: Acute: Cinchonism is rarely observed in acute poisonings. Toxic amblyopia, scotoma and impaired color perception may occur at toxic doses. Chronic: Chronic cumulative overdose may cause cinchonism: headache, tinnitus, vertigo, mydriasis, blurred vision, diplopia, photophobia, deafness, and corneal deposits have been reported in a patient who took quinidine for two years. Hematological: Chronic: Thrombocytopenia and hemolytic anemia of immunologic origins have been reported. Immunological: Chronic: Quinidine may cause several immunologic mediated reactions: thrombocytopenia, hemolytic anemia, angioneurotic edema, skin rash, fever. Metabolic: Acid-base disturbances: Acute: Metabolic acidosis may occur in severe intoxication with shock. Fluid and electrolyte disturbances: Acute: Hypokalemia is frequently observed. Special risks: Pregnancy: Chronic: Quinidine has been implicated as a cause of cranial nerve damage to the fetus at doses much larger than those needed to treat arrhythmia. In a neonate born to a woman taking quinidine throughout pregnancy, serum levels were equal to that of the mother. The child's ECG was normal and there was no evidence of teratogenicity. Breast-feeding: Chronic: Quinidine is present in breast milk at levels slightly lower than serum levels. The dose of quinidine received by an infant taking 1l of milk would be below therapeutic doses. However, breast-feeding is not recommended because of potential quinidine accumulation in the immature newborn liver.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 肝毒性
长期使用奎尼丁治疗与血清酶平升高有关,但这种情况通常较轻,无症状,即使不调整剂量也会自行限制。此外,还有许多关于对奎尼丁急性过敏反应的报道,其中包括肝脏受累。这些反应通常在治疗1到2周后出现,但在重新开始使用奎尼丁或在再次挑战后24小时内也可能出现。临床表现特点是疲劳、恶心、呕吐、弥漫性肌肉痛、关节痛和高热。早期血液检查显示血清转酶和碱性磷酸平升高,以及轻度黄疸,即使在停用奎尼丁后,黄疸也可能在几天内加深。血清酶升高的模式通常是胆汁淤积性或混合型。皮疹不常见,尽管存在其他过敏反应的迹象(发热、关节痛),但嗜酸性粒细胞增多并不典型。通常不会发现自身抗体。肝脏活检通常显示轻度损伤和小上皮样肉芽肿,这在系统性过敏反应期间在许多器官中常见。奎宁奎尼丁的光学异构体,主要用于抗疟疾治疗,也会引起类似的肝脏损伤的临床特征。近年来,归因于奎尼丁的肝脏损伤的报道很少,可能是因为现在很少使用它。
Chronic therapy with quinidine is associated with a low rate of serum enzyme elevations, which are usually mild, asymptomatic and self limited even without alteration in dose. In addition, there have been many reports of acute hypersensitivity reactions to quinidine that include hepatic involvement. The reactions usually arise after 1 to 2 weeks of therapy, but can appear within 24 hours of restarting quinidine or with rechallenge. The clinical features are marked by fatigue, nausea, vomiting, diffuse muscle aches, arthralgias and high fever. Blood testing at an early stage shows increases in serum aminotransferase and alkaline phosphatase levels as well as mild jaundice, which can deepen for a few days even after stopping quinidine. The pattern of serum enzymes elevations is typically cholestatic or mixed. Rash is uncommon and eosinophilia is not typical, despite the presence of other signs of hypersensitivity (fever, arthralgias). Autoantibodies are not typically found. Liver biopsies usually show mild injury and small epithelioid granulomas, as are often found in many organs during systemic hypersensitivity reactions. A similar clinical signature of liver injury occurs with quinine, an optical isomer of quinidine that is used predominantly as an antimalarial agent. In recent years, there have been few reports of liver injury attributed to quinidine, probably because it is now rarely used.
来源:LiverTox
毒理性
  • 相互作用
普萘洛尔奎尼丁的组合导致了通过减少运动心率以及QTc和PR间期的延长来测量的β-阻断作用的增加...奎尼丁通过抑制脱布里索喹同工酶而选择性地抑制普萘洛尔的代谢。奎尼丁产生的普萘洛尔浓度增加导致了β-阻断作用的增加。
The combination of propranolol and quinidine resulted in increased beta-blockade measured by reduction in exercise heart rate and prolongation of the QTc and PR intervals ... quinidine stereoselectively inhibits the metabolism of propranolol through inhibition of the debrisoquin isozyme. The increased concentration of propranolol produced by quinidine results in increased beta-blockade.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 相互作用
乙酰螺旋霉素呋塞米(利尿剂)增加了奎尼丁的脂溶性以及肾小管的再吸收,从而延长了其治疗效果...但不会使尿液碱化...。
Ethacrynic acid and furosemide /diuretics/ increase lipid solubility and tubular reabsorption of quinidine and thus prolong its therapeutic effects/ ...but will not alkalinize urine... .
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 相互作用
奎尼丁可能增强非去极化肌松药和去极化肌松药的效果,如潘库、琥珀酰胆碱和管箭毒碱。甲基硫酸新斯的明似乎不能逆转这些效果。
Quinidine may potentiate the effects of both nondepolarizing and depolarizing skeletal muscle relaxants such as pancuronium bromide, succinylcholine chloride, and tubocurarine chloride. Neostigmine methylsulfate does not appear to reverse these effects.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
去氢奎尼丁的分布容积在健康的年轻成年人中为2至3升/公斤,但在充血性心力衰竭患者中可能减少至0.5升/公斤,或在肝硬化的患者中增加到3或5升/公斤。在浓度2至5毫克/升(6.5至16.2微摩尔/升)时,去氢奎尼丁与血浆蛋白结合的比例(主要与α1-酸性糖蛋白和白蛋白结合)在成人和较大儿童中为80至88%,但在孕妇中较低,在婴儿和新生儿中可能低至50至70%。因为α1-糖蛋白平在应激反应中会增加,所以在急性心肌梗死等情况下,总去氢奎尼丁的血清平可能会显著升高,尽管未结合(活性)药物的血清含量可能保持正常。在慢性肾衰竭中,蛋白质结合也会增加,但当进行血液透析时给予肝素,结合会突然下降至或低于正常平。
The volume of distribution of quinidine is 2 to 3 L/kg in healthy young adults, but this may be reduced to as little as 0.5 L/kg in patients with congestive heart failure, or increased to 3 or 5 L/kg in patients with cirrhosis of the liver. At concentrations of 2 to 5 mg/L (6.5 to 16.2 umol/L), the fraction of quinidine bound to plasma proteins (mainly to (alpha)1-acid glycoprotein and to albumin) is 80 to 88% in adults and older children, but it is lower in pregnant women, and in infants and neonates it may be as low as 50 to 70%. Because (alpha)1-glycoprotein levels are increased in response to stress, serum levels of total quinidine may be greatly increased in settings such as acute myocardial infarction, even though the serum content of unbound (active) drug may remain normal. Protein binding is also increased in chronic renal failure, but binding abruptly descends toward or below normal when heparin is administered for hemodialysis.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
基本上口服给药后完全吸收;最大效果在1-3小时内出现,并持续6-8小时。如果重复剂量在这个间隔内给予,血浆浓度会有大的波动。...肌肉注射给药...葡萄糖酸钙在30-90分钟内达到峰值效果。
...Essentially completely absorbed after oral admin; max effects occur within 1-3 hr, and persist for 6-8 more hr. Large fluctuations in plasma concentration... if repeated doses are given at this interval. ...IM admin... gluconate yields peak effects in 30-90 min.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
所有给药的化合物都通过肾脏排泄,大约10-50%在24小时内以未改变的奎尼丁形式出现在尿液中。
...All administered compound is excreted by kidney, and about 10-50% appears in urine as unchanged quinidine, within 24 hr.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
硫酸盐在60至90分钟内迅速吸收。聚半乳糖醛酸盐在5至6小时内达到奎尼丁浓度高峰;葡萄糖酸盐的胃肠道吸收是中间的(高峰3-4小时)。
The bioavailability of quinidine is 70 to 80% after oral use but varies between individuals and preparations. The sulfate salt is rapidly absorbed in 60 to 90 minutes. Polygalacturonate salts produce peak quinidine concentrations in 5 to 6 hours; gastrointestinal absorption of gluconate salts is intermediate (peak 3-4 hours).
来源:Hazardous Substances Data Bank (HSDB)

文献信息

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