Problems for Discussion - 2 - Quinine and the Antimalarial agents

A 26 year-old female presents 3-hours after ingesting 30 quinine 300 mg tablets (9 g). She is slightly drowsy and has vomited several times. She complains of headache and ringing in the ears. Her heart rate is 100 bpm and blood pressure 105/65 mmHg. Her 12-lead ECG shows sinus tachycardia with normal conduction intervals.

1. What is your risk assessment?
2. What are your priorities for the immediate management of this patient?
3. What is the potential role(s) for activated charcoal in this case?
4. The next day in the ICU the patient wakes and complains of dim and blurred vision. What is the diagnosis?
5. What is the management?
6. What is the prognosis?

A 14-month-old male who weighs 9 kg is found with his father’s malaria tablets. He has potentially ingested two 250 mg (each contains 155 mg chloroquine; 310 mg; 34 mg/kg).

1. What is your risk assessment?
2. How would you manage this child?