MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

 Critical Care

Generic Name: Quinidine Gluconate
Trade Name:  
Action: Type IA antiarrhythmic
Indications: Atrial flutter and fibrillation
Paroxysmal ventricular tachycardia
Premature atrial and ventricular contractions
Administration Guidelines:
Usual Dosage Range and Route

LOADING DOSE: 500 to 1000 mg / 100 ml D5W (OVER 30 to 60 minutes) blood pressures should be checked every 5-10 minutes during administration of loading doses

*loading dose is usually given prior to starting maintenance*

maintenance: Quinidine gluconate sustained released tablets 324 mg po t.i.d.

Standard Concentrations: 2 G / 250 ml
Special Considerations: - Loading dose infusion must be administered via an infusion pump

- QRS and QTc intervals must be measured prior to loading dose and every 4 hours during maintenance infusion. Physician must be notified of a 25% increase or greater over baseline

- After loading dose has been administered, maintenance therapy should be continued with oral therapy. Continuous infusions should not be used due to severe cardiac side effects

- *Intravenous infusions are associated with severe hemodynamic instability and should be reserved for patients in which alternative therapy is absolutely contraindicated.

Precautions and Side Effects: - Hypotension

- Prolonged QRS AND QTC

- Trombocytopenia

- Bradycardia, Heart Block

- Ventricular Irritability, Torsades de pointes

-Cinchonism

 

revised 09/03