Quinine And Quinidine

Quinine remains a mainstay for treating attacks of chloroquine- and multidrug-resistant P. falciparum malaria (Table 39-2). Multidrug therapy with other antimalarials is supplanting quinine regimens because of increasing resistance of P. falciparum to quinine together with its toxicity. Both quinine and quinidine are obtained from natural sources and contain a quinoline group attached through a secondary alcohol linkage to a quinuclidine ring (Figure 39-3). A methoxy side chain is attached to the quinoline ring and a vinyl to the quinuclidine. They differ only in the steric configuration at two of the three asymmetrical centers. Quinidine is both somewhat more potent as an antimalarial and more toxic than quinine.

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