Quinidine is indicated for atrial fibrillation and flutter, and life-threatening ventricular arrhythmia. Optimal serum concentrations are in the range of 2.0 to 5.0 mcg/mL, with toxicity apparent at levels > or =6.0 mcg/mL. Symptoms of toxicity (cinchonism) include tinnitus, light-headedness, premature ventricular contractions, and atrioventricular block. Gastrointestinal distress is a frequent side effect, which becomes more severe and is associated with nausea and vomiting at higher drug concentrations.
The half-life of quinidine is 6 to 8 hours, and the drug lacks any significant active metabolites. Physiologic processes that generally reduce hepatic metabolism and renal clearance increase serum quinidine levels, while comedication with cytochrome p450 (CYP) enzyme inducers enhances clearance and results in lower blood concentrations.
- Sample of blood serum
- We perform the test daily