The Mechanism of Death From Quinidine and a Method of Resuscitation; An Experimental Study

Gordon, Burgess; Matton, Marcel; Levine, Samuel A.

doi:10.1172/jci100027

Cited by 26 publications

(4 citation statements)

References 12 publications

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“…Artificial respiration was applied all through the experiments. The lethal dose ranged approximately between 60 and 200 mg per kg, and was, in general, inversely proportional to the rate of infusion as has already been described for cats (5).…”

supporting

confidence: 62%

Effect of Quinidine, Procaine Amide and Mersalyl on Lethal Dose of Ouabain in Isolated Dog Heart.

Fawaz

1955

Experimental Biology and Medicine

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Digitalis is often used in combination with one or more of the following drugs: quinidine, procaine amide, mercurial diuretics. The endeffect of a sufficiently large dose of digitalis is ventricular fibrillation. preceded, as a rule: by ventricular ectopic rhythms. Quinidine is used for the treatment of ventricular ectopic rhythms, even those that are produced by digitalis. On the other hand, textbooks attribute to quinidine the property of producing ventricular premature beats. ventricular tachycardia and ventricular fibrillation, in other words, precisely those effects which it is supposed to suppress or prevent. Procaine amide is used, like quinidine, to suppress ventricular ectopic rhythms including those produced by digitalis( 1 ) , but nobody has described an arrhythmia-producing effect by procaine amide. The combined use of the drugs mentioned above, particularly digitalis and quinidine, has been the subject of much debate and investigation ( 2 ) . It thus appeared desirable to study the quantitative aspects of these drug combinations using isolated hearts.Methods and materials. Dog heart-lung preparations were performed by the conventional procedure using pentobarbital anesthesia. The blood donors were anesthetized with chloroform. The blood volume was about 900 cc and the resistance was maintained a t 6.8 cm Hg. The method of Farah ( 3 . 3 ) was used in measuring the lethal dose of ouabain. The rate of infusion was not far from the "optimal" rate. i.e., the rate below which there is no further decrease in the lethal dose. In all experiments with intact dogs pentobarbital anesthesia was used with artificial respiration. The following brands of drugs were used: Ouabain, E. Merck, Darmstadt ; Quinidine sulfate, Jlallinckrodt, V.S.P. : Procaine amide. (Pronestyl) Squibb; Jlersalyl. (Gortulin) n'inthrop. *This study has been supported by a grant from -. -__-__ the American Heart Association.Results. Oiiabain controls. -4s controls we have utilized Farah's (3,4) results most of which were obtained in this laboratory. In addition, we have performed a few more experiments which are essentially in agreement with those of Farah (Table I).Small amounts of quinidine sulfate (20 mg or less) , when added to the venous reservoir of the heart-lung Ouabain + quinidine.

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supporting

confidence: 62%

Effect of Quinidine, Procaine Amide and Mersalyl on Lethal Dose of Ouabain in Isolated Dog Heart.

Fawaz

1955

Experimental Biology and Medicine

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“…Although motor and afferent nerve conduction studies have been normal during myasthenia in most patients, some electromyographic evidence for neuropathy has been reported (52, 66, 69). Cardiac muscle is similarly depressed (65) by quinolines as by quinidine, a related compound (70). Depression of Twaves of the electrocardiogram has been noted (71) as well as intraventricular heart block (52), both abnormalities are reversible.…”

Section: Mode Of Action Of Chloroquinementioning

confidence: 99%

“…It has been speculated that death results from depression of the central nervous system, but arterial hypotension is probably the result of direct action on arterial wall and cardiac muscle. Shock and acute myasthenia seem to precede coma or convulsions (70), and seizures may be related to cerebral anoxia (75). Acute intoxication appears to be reversible (76) if life functions can be effectively maintained.…”

Section: Mode Of Action Of Chloroquinementioning

confidence: 99%

An appraisal of chloroquine

Mackenzie

1970

Arthritis & Rheumatism

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“…In all likelihood, it is the same entity known to us today as Torsade de pointes (Tdp). Its arrhythmic etiology was suspected [3] and confirmed over the following 4 decades by multiple case reports of what was then called quinidine-induced ventricular fibrillation [5,6,7]. In 1966, the French cardiologist Francois Dessertenne [8] coined the term Torsades de pointes describing a form of polymorphic ventricular tachycardia with the peculiar characteristic of alternating QRS vectors above and below the isoelectric baseline.…”

mentioning

confidence: 99%