Sunday September 20, 1998 - Question 9

A 60 year-old female presents to the emergency department complaining of a “faint feeling” and dizziness.  Upon examination her heart rate is 58 beats per minute and blood pressure is 101 / 60 mm Hg.  Her medications include sustained-release diltiazem (Cardizem CD), isosorbide mononitrate (ISMO), and lisinopril (Zestril).  She reports a history of chronic insomnia and restless legs, for which she periodically self-medicates with quinine sulfate.  The patient reports using one or two quinine sulfate capsules at bedtime for the last two weeks.

Which of the following statements concerning the above case is true?

A. Quinine may inhibit CYP3A4.
B. Quinine and isosorbide mononitrate should not be used together.
C. Lisinopril may inhibit the metabolism of quinine.
D. Quinine sulfate is FDA approved for treatment of nocturnal leg cramps.
E. Diltiazem and isosorbide mononitrate should not be used together.
 
 

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