why is quinine so important

Precautions

grapefruit, cinnamon, lemon, lime, oranges, ginger, raisins, honey, pepper and basil. Heat up 1 grapefruit and eat its pulp. Grapefruit contains quinine-like substances, which in turn is effective in treating malaria. Boil some freshly ground black pepper and 1 tsp of cinnamon in 1 cup of water.

What food contain quinine?

• Difficulty breathing or swallowing
• disturbed color perception
• double vision
• hives
• increased sweating
• muscle aches
• night blindness
• reddening of the skin, especially around ears
• ringing or buzzing in the ears
• swelling of the eyes, face, inside of the nose, fingers, feet, or lower legs

What are the effects of quinine on the body?

Using this medication improperly or without the advice of a doctor can result in serious side effects or death. Quinine may also be used for purposes not listed in this medication guide. Quinine can cause serious side effects on your heart, kidneys, or blood cells.

Is too much quinine bad for You?

For many people it can be dangerous, including those with heart conditions or those who are pregnant. For people who are healthy, ingesting the amount of quinine in tonic water is regarded as safe. But you shouldn't be self medicating with quinine pills (or tonic water, for that matter). Bottom Line

Is quinine safe to take?

Why is quinine so important to humans?

Quinine is used to treat malaria caused by Plasmodium falciparum. Plasmodium falciparum is a parasite that gets into the red blood cells in the body and causes malaria. Quinine works by killing the parasite or preventing it from growing.

Does quinine have any health benefits?

Other than its use as an antimalarial drug, quinine doesn't have any health benefits. While quinine in tonic water has been used as a home remedy for nighttime leg cramps and muscle pain, there's no evidence that it works.

Why did doctors stop prescribing quinine?

In early 2007, FDA banned all prescription quinine products other than Qualaquin. FDA acted in this manner because of a perception that quinine is not effective for this condition and that its risk potential far exceeds its efficacy potential.

What is quinine effective treatment for?

quinine, drug obtained from cinchona bark that is used chiefly in the treatment of malaria, an infection caused by the protozoan parasite Plasmodium, which is transmitted to humans by the bite of various species of mosquitoes.

What are the dangers of quinine?

Among the most serious potential side effects associated with quinine are: bleeding problems. kidney damage. abnormal heartbeat....If you do have a reaction, it may include:nausea.stomach cramps.diarrhea.vomiting.ringing in the ears.confusion.nervousness.

Why does quinine help leg cramps?

Quinine sulfate at a dose of 200–300 mg at night has been used for many years to treat nocturnal leg cramps. Usually idiopathic, these muscle cramps are common, particularly in older patients. Quinine may help by decreasing the excitability of the motor end-plate and increasing the muscle refractory period.

Does quinine help you sleep?

The results showed that quinine significantly increased the time spent in wakefulness and decreased the time spent in slow wave sleep along the 24h of polygraphic recording.

Does quinine help inflammation?

“We found that quinine reduced the levels of the inflammatory molecule interleukin-1β, which is known to cause fever.” Unfortunately, quinine and many other anti-inflammatory medications used to treat excessive inflammatory responses have an array of negative side effects.

Does drinking tonic water with quinine help leg cramps?

A. Tonic water—and the quinine it contains—have been promoted for preventing leg cramps for decades despite the lack of evidence that they are effective.

What drugs should not be taken with quinine?

Other medications can affect the removal of quinine from your body, which may affect how quinine works. Examples include cimetidine, erythromycin, ketoconazole, phenytoin, rifampin, HIV protease inhibitors (such as lopinavir, ritonavir), urinary alkalinizers such as sodium bicarbonate, among others.

Who should not drink tonic water?

People with the metabolic disorder glucose-6-phosphate dehydrogenase deficiency (G6PD) should also avoid it. For the rest of us, from a health perspective, alcohol is a much more worrisome mixed-drink ingredient than tonic.

Does quinine affect the heart?

Conclusions: Use of quinine was common and associated with increased mortality in heart failure, especially if administered together with β-blockers and shortly after treatment initiation.

Why do they put quinine in tonic water?

Tonic water is a soft drink containing quinine, which gives it a bitter taste. Quinine is a common treatment for malaria. Some people believe that it can also help with leg cramps and restless legs syndrome. Quinine comes from the bark of the cinchona tree.

How much quinine should you take a day?

Adults and children 16 years of age and older—648 milligrams (mg) (2 capsules) every 8 hours for 7 days. Children younger than 16 years of age—Use and dose must be determined by your doctor.

Who should not drink tonic water?

People with the metabolic disorder glucose-6-phosphate dehydrogenase deficiency (G6PD) should also avoid it. For the rest of us, from a health perspective, alcohol is a much more worrisome mixed-drink ingredient than tonic.

Is quinine good for arthritis?

It has antioxidant and anti-inflammatory properties. Research suggests it may help reduce arthritis pain and inflammation.

Before Taking This Medicine

You should not use this medication if you have ever had an allergic reaction to quinine or similar medicines such as mefloquine or quinidine, or if...

How Should I Take quinine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.Take with f...

What Happens If I Miss A Dose?

Take the missed dose as soon as you remember. If you are more than 4 hours late for your dose, skip the missed dose and take the medicine at your n...

What Should I Avoid While Taking quinine?

Avoid taking other anti-malaria medications without your doctor's advice. This includes chloroquine, halofantrine, and mefloquine.Avoid using antac...

What Other Drugs Will Affect quinine?

Many drugs can interact with quinine. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start...

How long does quinine treatment last?

Even with seven-day treatment durations, evaluations of different quinine dosage regimens have revealed interesting trends. Doses of 10 mg/kg/day given twice daily for 7 days were associated with day 28 treatment failure rates as high as 30%[37]. Increasing the quinine dosage to 15 mg/kg/day or 20 mg/kg/day improved treatment outcomes, with failure rates ranging from 8% to 14%[37], although potential increases in toxicity with higher dosages are a concern. The treatment regimen currently recommended in sub-Saharan Africa is 10 mg/kg of the base given 8 hourly for 7 days. This regimen was associated with a lower rate of recurrent infections on day 28 (6.3%) compared to the 10 mg/kg twice daily regimen (16.1%)[44].

How is quinine absorbed?

Quinine is rapidly absorbed both orally and parenterally, reaching peak concentrations within 1-3 hours[8] . It is distributed throughout the body fluids and is highly protein bound, mainly to alpha-1 acid glycoprotein. The binding capacity in plasma is concentration dependent, but also depends on the levels of alpha-1 acid glycoprotein, which therefore makes comparisons between different studies difficult[9]. Quinine readily crosses the placental barrier and is also found in cerebral spinal fluid. Excretion is rapid - 80% of the administered drug is eliminated by hepatic biotransformation and the remaining 20% is excreted unchanged by the kidney [10-12]. The half-life of quinine ranges between 11-18 hours [13,14]. Several pharmacokinetic characteristics of quinine differ according to the age of the subject and are also affected by malaria. The volume of distribution is less in young children than in adults, and the rate of elimination is slower in the elderly than in young adults. In patients with acute malaria the volume of distribution is reduced and systemic clearance is slower than in healthy subjects; these changes are proportional to the severity of the disease. As a result, plasma quinine levels are higher in patients with malaria. Protein binding of quinine is increased in patients with malaria as a result of an increased circulating concentration of alpha-1 acid glycoprotein [15].

What is the bark of a cinchona tree used for?

Purified quinine then replaced the bark as the standard treatment for malaria [5]. Quinine and other cinchona alkaloids including quinidine, cinchonine and cinchonidine are all effective against malaria. The efficacies of these four alkaloids were evaluated in one of the earliest clinical trials, conducted from 1866 to 1868 in 3600 patients using prepared sulfates of the alkaloids. With the main outcome measure of "cessation of febrile paroxysms", all four alkaloids were found to be comparable, with cure rates of >98%[6]. However, after 1890 quinine became the predominantly used alkaloid, mainly due to a change in supply from South American to Javan cinchona bark, which contained a higher proportion of quinine [7]. Quinine remained the mainstay of malaria treatment until the 1920s, when more effective synthetic anti-malarials became available. The most important of these drugs was chloroquine, which was extensively used, especially beginning in the 1940s [6]. With heavy use, chloroquine resistance developed slowly. Resistance of Plasmodium falciparum to chloroquine was seen in parts of Southeast Asia and South America by the late 1950s, and was widespread in almost all areas with falciparum malaria by the 1980s. With increasing resistance to chloroquine, quinine again played a key role, particularly in the treatment of severe malaria [6]. To-date quinine continues to play a significant role in the management of malaria. This review, discusses the historical role of quinine, considers its current usage, and provides insight into the appropriate future use of quinine for the treatment of malaria. Information was obtained by searching published literature in the National Library of Medicine via Pub Med and MEDLINE search engines for research articles, reviews, books, and other reports. Identification of published reports was done using key word searches such as quinine and malaria treatment, quinine and drug resistance, quinine in pregnancy, quinine and antibiotic combinations, and quinine and HIV/TB infected populations.

What are the side effects of quinine?

The side effects commonly seen at therapeutic concentrations are referred to as cinchonism, with mild forms including tinnitus, slight impairment of hearing, headache and nausea. Impairment of hearing is usually concentration dependent and reversible [17]. More severe manifestations include vertigo, vomiting, abdominal pain, diarrhea, marked auditory loss, and visual symptoms, including loss of vision. Hypotension may occur if the drug is given too rapidly, and venous thrombosis may occur following intravenous injections [10]. Intramuscular administration is painful and may cause sterile abscesses. Hypoglycaemia is yet another common side effect of quinine therapy [15,18] and is a particular problem in pregnant women[19]. Hypoglycaemia has been reported to occur in up to 32% of patients receiving quinine therapy[18]. However in more recent studies, hypoglycaemia occurred in only 3% of adults and 2.8% of African children receiving quinine [20,21]. Less frequent but more serious side effects of quinine therapy include skin eruptions, asthma, thrombocytopaenia, hepatic injury and psychosis [22].

What is Quinine used for?

Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria

Which setting has no quinine resistance?

Equatorial Guinea, setting with no quinine resistance

Is quinine an anti-malarial?

Quinine remains an important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and the availability of more efficacious anti-malarial drugs. This article reviews the historical role of quinine, considers its current usage and provides insight into its appropriate future use in the treatment of malaria. In light of recent research findings intravenous artesunate should be the first-line drug for severe malaria, with quinine as an alternative. The role of rectal quinine as pre-referral treatment for severe malaria has not been fully explored, but it remains a promising intervention. In pregnancy, quinine continues to play a critical role in the management of malaria, especially in the first trimester, and it will remain a mainstay of treatment until safer alternatives become available. For uncomplicated malaria, artemisinin-based combination therapy (ACT) offers a better option than quinine though the difficulty of maintaining a steady supply of ACT in resource-limited settings renders the rapid withdrawal of quinine for uncomplicated malaria cases risky. The best approach would be to identify solutions to ACT stock-outs, maintain quinine in case of ACT stock-outs, and evaluate strategies for improving quinine treatment outcomes by combining it with antibiotics. In HIV and TB infected populations, concerns about potential interactions between quinine and antiretroviral and anti-tuberculosis drugs exist, and these will need further research and pharmacovigilance.

What Is the Use of Quinine Today?

Quinine has a few different medicinal properties such as anti-fever, anti-arrhythmic, analgesic and anti-inflammatory properties. But one needs to be careful when it comes to usage of the quinine. It is very important to follow instructions from a medical professional or doctor. The instructions for quinine usage need to be followed accurately and entirely.

What Are the Side Effects of Quinine?

Quinine can, when injected intravenously, be very toxic and can possibly trigger chinchonism, a condition that leads to symptoms such as skin flushing, ringing ears, nausea, headache, rashes, vertigo, and diarrhea. It can even lead to death in severe cases, as extremely high doses are toxic to the heart. Another thing you should be aware of is that quinine injected to muscles may even cause paralysis that can last permanently.

What is Quinine used for?

It can also be found in smaller amounts in regular tonic water. In the present time, quinine is used to treat arthritis and lupus in the form of hydroxychloroquine. Quinine is an effective muscle relaxant and can be mixed with medicine for a cramps treatment of muscle injuries.

What was the purpose of the Cinchona tree?

Cinchona trees served as a very practical source of quinine. During II World War, feeling the pressure of so many deaths, scientific research was conducted with the aim of discovering whether the synthetic production of quinine was a viable option.

Where does quinine come from?

Quinine is a white crystaline alkaloid that naturally occurs in the bark of the Cinchona tree, although quinine can synthetically be produced in a lab as well. The Quechua Indians of Peru and Bolivia discovered the Cinchona tree; these peoples were aware of the medicinal properties of quinine.

When was quinine first discovered?

The first trial of synthesized quinine was done by William Henry Perkin in 1856.

Is quinine safe for malaria?

Even if using quinine carries a certain risk, quinine is a fantastic medication for malaria and some other medical conditions .

What is the chiral moiety of quinine?

Quinine (and quinidine) are used as the chiral moiety for the ligands used in Sharpless asymmetric dihydroxylation as well as for numerous other chiral catalyst backbones. Because of its relatively constant and well-known fluorescence quantum yield, quinine is used in photochemistry as a common fluorescence standard.

What causes tonic water to fluoresce under black light?

Tonic water, in normal light and ultraviolet " black light ". The quinine content of tonic water causes it to fluoresce under black light.

What is quinine used for?

Quinine is a medication and cutting agent used to cut illicit narcotics such as heroin; it has also been used to treat malaria and babesiosis. This includes the treatment of malaria due to Plasmodium falciparum that is resistant to chloroquine when artesunate is not available. While sometimes used for restless legs syndrome, quinine is not recommended for this purpose due to the risk of serious side effects. It can be taken by mouth or intravenously. Malaria resistance to quinine occurs in certain areas of the world. Quinine is also the ingredient in tonic water that gives it its bitter taste.

Why is gin and tonic so popular?

According to tradition, because of the bitter taste of anti- malarial quinine tonic, British colonials in India mixed it with gin to make it more palatable, thu s creating the gin and tonic cocktail, which is still popular today.

When did quinine stop being sold?

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 marketing of over-the-counter quinine as a treatment for nocturnal leg cramps.

Where did Quinine originate?

Quinine was first isolated in 1820 from the bark of a cinchona tree, which is native to Peru. Bark extracts had been used to treat malaria since at least 1632 and it was introduced to Spain as early as 1636 by Jesuit missionaries from the New World. It is on the World Health Organization's List of Essential Medicines.

What happens if you take quinine?

Quinine can cause unpredictable serious and life-threatening blood and cardiovascular reactions including low platelet count and hemolytic-uremic syndrome / thrombotic thrombocytopenic purpura (HUS/TTP), long QT syndrome and other serious cardiac arrhythmias including torsades de pointes, blackwater fever, disseminated intravascular coagulation, leukopenia, and neutropenia. Some people who have developed TTP due to quinine have gone on to develop kidney failure. It can also cause serious hypersensitivity reactions include anaphylactic shock, urticaria, serious skin rashes, including Stevens–Johnson syndrome and toxic epidermal necrolysis, angioedema, facial edema, bronchospasm, granulomatous hepatitis, and itchiness.

What diseases were resistant to chloroquine?

During the 1960s several strains of the malarial parasite Plasmodium falciparum developed resistance to the synthetic drugs, particularly the highly valued chloroquine. The parasite remained sensitive, however, to quinine, which had to be reinstated in various parts of the world as the drug of choice despite the side effects that sometimes occur when the necessarily large doses of quinine are given. Prolonged administration of quinine may produce toxic symptoms such as deafness, disturbances in vision, rash, and gastrointestinal symptoms.

What is Quinine used for?

Quinine, drug obtained from cinchona bark that is used chiefly in the treatment of malaria, an infection caused by the protozoan parasite Plasmodium , which is transmitted to humans by the bite of various species of mosquitoes.

What was the only treatment for malaria?

During the 300 years between its introduction into Western medicine and World War I, quinine was the only effective remedy for malaria; as a specific treatment for this disease, quinine benefited a great many people.

When was quinine first used?

Quinine was first synthesized in a laboratory in 1944; however, synthesis of the drug on a commercial scale is not economically feasible.

Which is more effective, chloroquine or quinine?

Some of them, such as chloroquine, are more effective than quinine in suppressing the growth of the blood forms of the malarial parasite; others, such as primaquine, act upon both the blood and tissue stages of the parasite, thus producing complete cures and preventing relapses.

Does quinine help with malaria?

Administration of quinine dramatically improves the condition of a person with malaria ; the parasites promptly disappear from the blood, and the symptoms of the disease are quickly alleviated. When quinine treatment is terminated, however, many recovered patients experience another attack of malaria several weeks later.

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What Is Quinine?

Quinine is a bitter chemical present in the bark of cinchona trees, which are native to South America. Multiple species of the genus Cinchona produce the chemical. It's used as a medicine to treat malaria. It's also used in much lower doses to provide the bitter taste of tonic water.

Should You Take Quinine?

Doctors can still prescribe quinine, but the FDA has only approved its use for the treatment of malaria. In all other cases, it believes that the risks outweigh any possible benefits. If your doctor suggests that you take the medication, you should ask for detailed information about the benefits and dangers of taking the drug for your health problem.

What is the bark of a cinchona tree?

The bark of the trees is sometimes known as Jesuits' bark or powder. The Jesuits introduced the plant to Europe from South America. Until the 1940s, quinine from the bark of a cinchona tree was the best treatment for malaria. The purified medication is still used to treat the disease, but other drugs are often preferred when they are available. The intact bark of the cinchona tree contains other biologically active chemicals in addition to quinine. Scientists are exploring these chemicals.

How do mosquitoes develop?

Stages in the Mosquito's Body 1 The gametocytes become male or female gametes inside the mosquito. 2 A male and female gamete join to form an ookinete. 3 The ookinete enters the lining of the mosquito's gut and becomes an oocyst. 4 The oocyst produces new sporozoites. 5 The sporozoites migrate to the mosquito's salivary glands, enabling the life cycle to repeat.

Why is tonic water considered a tonic?

In British colonial times, tonic water had a much higher quinine content than today and was used to treat malarial symptoms. It really was a “tonic” water. Quinine is so bitter that drinking tonic water can cause vomiting unless the solution is very dilute or unless the chemical's taste is masked by sugar and flavorings.

Why does tonic water glow?

If a glass of tonic water is exposed to sunlight, it emits a faint blue glow. The action of the ultraviolet rays in sunlight on the quinine in the tonic water is responsible for this glow. Quinine is fluorescent. A fluorescent substance emits light of one color when it's exposed to light of another color (or to another form of electromagnetic radiation). If tonic water is exposed to a stronger UV light source than sunlight, it will emit a brighter glow.

How do sporozoites reproduce?

Once the sporozoites have entered the body of their host, they invade the liver cells. Here they reproduce, producing merozoites. The merozoites enter red blood cells. Inside the blood cells, the parasites continue to multiply. The cells eventually burst open, releasing new parasites, which can then infect more cells. Infected red blood cells all open at about the same time, releasing toxins that cause the victim to experience the typical chills, fever, headache, and muscle pain of malaria.

What causes quinine to fail?

Treatment failures with quinine could also be explained by varying pharmacokinetic profiles of the drug. It is known that quinine pharmacokinetic properties and therapeutic responses vary with age, pregnancy, immunity and disease severity [ 99 ]. Also, as patients recover from malaria, there is usually an expansion of the volume of distribution and an increase in systemic clearance of quinine resulting in a decline in the average concentration of quinine in plasma [ 100 ]. These variations may lead to drug levels that may be inadequate to completely clear infection. The possibility that pharmacokinetic factors may explain quinine treatment failure was initially raised about 20 years ago when a Thai patient who had fatal severe malaria and apparent RIII resistance was found to have abnormally low levels of quinine despite adequate dosing [ 101 ]. Additional evidence for the impact of unusual quinine pharmacokinetics on treatment outcomes was provided by a more recent study describing early treatment failure in a patient with severe malaria with an abnormally high volume of distribution and increased quinine clearance, resulting in abnormally low quinine concentrations [ 102 ]. A few studies have proposed that an increase in the quinine dosage after the third day could compensate for declines in plasma drug levels during recovery, especially in areas with resistant P. falciparum [ 99 ]. However, this is not routinely practiced. Despite these anecdotal observations, there is little evidence for large variations in quinine pharmacokinetics [ 103] and the exact role that variations in drug levels play in quinine treatment responses is unclear.

What is the best treatment for severe malaria?

The treatment of severe malaria requires prompt, safe, and effective intravenous anti-malarial drugs. Over the years, quinine has been the mainstay in the treatment of severe malaria and still remains the first line drug in most African countries [ 24 ].

How is quinine absorbed?

Quinine is rapidly absorbed both orally and parenterally, reaching peak concentrations within 1-3 hours [ 8 ]. It is distributed throughout the body fluids and is highly protein bound, mainly to alpha-1 acid glycoprotein. The binding capacity in plasma is concentration dependent, but also depends on the levels of alpha-1 acid glycoprotein, which therefore makes comparisons between different studies difficult [ 9 ]. Quinine readily crosses the placental barrier and is also found in cerebral spinal fluid. Excretion is rapid - 80% of the administered drug is eliminated by hepatic biotransformation and the remaining 20% is excreted unchanged by the kidney [ 10 – 12 ]. The half-life of quinine ranges between 11-18 hours [ 13, 14 ]. Several pharmacokinetic characteristics of quinine differ according to the age of the subject and are also affected by malaria. The volume of distribution is less in young children than in adults, and the rate of elimination is slower in the elderly than in young adults. In patients with acute malaria the volume of distribution is reduced and systemic clearance is slower than in healthy subjects; these changes are proportional to the severity of the disease. As a result, plasma quinine levels are higher in patients with malaria. Protein binding of quinine is increased in patients with malaria as a result of an increased circulating concentration of alpha-1 acid glycoprotein [ 15 ].

What is the bark of a cinchona tree used for?

Purified quinine then replaced the bark as the standard treatment for malaria [ 5 ]. Quinine and other cinchona alkaloids including quinidine, cinchonine and cinchonidine are all effective against malaria. The efficacies of these four alkaloids were evaluated in one of the earliest clinical trials, conducted from 1866 to 1868 in 3600 patients using prepared sulfates of the alkaloids. With the main outcome measure of "cessation of febrile paroxysms", all four alkaloids were found to be comparable, with cure rates of >98% [ 6 ]. However, after 1890 quinine became the predominantly used alkaloid, mainly due to a change in supply from South American to Javan cinchona bark, which contained a higher proportion of quinine [ 7 ]. Quinine remained the mainstay of malaria treatment until the 1920s, when more effective synthetic anti-malarials became available. The most important of these drugs was chloroquine, which was extensively used, especially beginning in the 1940s [ 6 ]. With heavy use, chloroquine resistance developed slowly. Resistance of Plasmodium falciparum to chloroquine was seen in parts of Southeast Asia and South America by the late 1950s, and was widespread in almost all areas with falciparum malaria by the 1980s. With increasing resistance to chloroquine, quinine again played a key role, particularly in the treatment of severe malaria [ 6 ]. To-date quinine continues to play a significant role in the management of malaria. This review, discusses the historical role of quinine, considers its current usage, and provides insight into the appropriate future use of quinine for the treatment of malaria. Information was obtained by searching published literature in the National Library of Medicine via Pub Med and MEDLINE search engines for research articles, reviews, books, and other reports. Identification of published reports was done using key word searches such as quinine and malaria treatment, quinine and drug resistance, quinine in pregnancy, quinine and antibiotic combinations, and quinine and HIV/TB infected populations.

What is the greatest problem faced by malaria control programs worldwide?

Quinine resistance. Parasite drug resistance is probably the greatest problem faced by malaria control programs worldwide and is an important public health concern. Over the years, malaria parasites have developed resistance to a number of commonly used anti-malarial drugs.

What is Quinine used for?

Quinine, as a component of the bark of the cinchona (quina-quina) tree, was used to treat malaria from as early as the 1600s, when it was referred to as the "Jesuits' bark," " cardinal's bark," or "sacred bark.".

What was the first successful use of quinine?

Background and historical perspective. The discovery of quinine is considered the most serendipitous medical discovery of the 17th century [ 1] and malaria treatment with quinine marked the first successful use of a chemical compound to treat an infectious disease [ 2 ].

Overview

Uses

Contraindications

Adverse effects

Mechanism of action

Chemistry

History

Society and culture