Quinine

Quinine was the first effective treatment for malaria and now is also used to treat lupus and arthritis. Its use for malaria has been stopped because the use of antihistamines It's natural form is from the bark of the cinchona tree, the bark is dried and then ground into a fine powder and used in liquid form. It is naturally a white crystal having inflammatory, pain-killing, and fever-reducing properties.Quinine also has been used as an effective muscle relaxant mostly to stop shivers in very low temperatures. It is very sensitive to UV rays because of its very conjugated resonance structure. The flavor of tonic water and Schweppes’ bitter lemon is composed of quinine. There has been problems resulted in taking the natural source medication such as cinchonism and a good number of death which caused regulations of the over the counter use of this source for any means. Quinine is also used as a cutting agent in street drugs such as heroin and cocaine. Quinine is also used in photo-chemistry as a common fluorescence standard because of its relatively constant and well-known fluorescence quantum yield. It can also be used as a treatment for Cryptocaryon irritants infection of marine aquarium fish. Quinine should not be used to treat or prevent nighttime leg cramps. It has not been shown to be effective in that purpose and can cause life-threatening side effects; such as severe bleeding problems, kidney damage, irregular heart beat and severe allergic reactions. The formula for quinine is C20H24N2O2. It has a molar mass of 324.417. It has two rings: an aromatic quinolone and a bicyclic quinuclidine.

History
The major example of where one could find quinine would be in the bark of a cinchona tree. The Spanish had obtained it in the Andes in the mid-1600s, where they discovered that it worked against malaria. Soon, most Europeans associated this remedy in terms of the cure of tumors. They believed that what they called "spasms of the blood" caused the intermittent fevers of malaria and that cinchona bark fixed this malfunction by increasing the flow of the blood and promoted the well-being of the muscular system.

Adverse effects

However, Quinine is no longer recommended as the first line of treatment for Malaria because it may have adverse effects. Quinine can, in therapeutic doses, cause cinchonism; in rare cases, it may even cause death (usually by pulmonary edema). The development of mild cinchonism is not a reason for stopping or interrupting quinine therapy and the patient should be reassured. Blood glucose levels and electrolyte concentrations must be monitored when quinine is given by injection. The patient should ideally be in cardiac monitoring when the first quinine injection is given (these precautions are often unavailable in developing countries where malaria is endemic).

Abortifacient
Despite popular belief, quinine is not an effective abortification (abortion pill) (in the US, quinine is listed as Pregnancy category D). Pregnant women who take toxic doses of quinine will suffer from renal failure before experiencing any kind of quinine-induced abortion. Indeed, quinine is the only drug recommended by the WHO as first-line treatment for uncomplicated malaria in pregnancy

Hearing impairment
Some studies have related the use of quinine and hearing impairment, in particular high-frequency loss, but it has not been conclusively established whether such impairment is temporary or permanent.

Regulation by the United States Food and Drug Administration
From 1969 to 1992, the US Food and Drug Administration (FDA) received 157 reports of health problems related to quinine use, including 23 which had resulted in death. In 1994, the FDA banned the use of over-the-counter (OTC) quinine as a treatment for nocturnal leg cramps. Pfizer Pharmaceuticals had been selling the brand name Legatrin for this purpose. Doctors may still prescribe quinine, but the FDA has ordered firms to stop marketing unapproved drug products containing quinine. The FDA is also cautioning consumers about off-label use of quinine to treat leg cramps. Quinine is approved for treatment of malaria, but is also commonly prescribed to treat leg cramps and similar conditions. Because malaria is life-threatening, the risks associated with quinine use are considered acceptable when used to treat that affliction. Though Legatrin was banned by the FDA for the treatment of leg cramps, drug manufacturer URL Mutual has branded a quinine-containing drug named "Qualaquin". Qualaquin is marketed as a treatment for malaria and is sold in the United States only by prescription. In 2004, the CDC reported only 1,347 confirmed cases of malaria in the United States. It is regulated by the US food and drug administration.