Abstract
Objectives: The 4-Aminoquinoline, Chloroquine is still indicated for treatment of malaria fever due to sensitive Plasmodium species. The hypoglycemic effects of Chloroquine have been sparsely reported in human and animal models of type 2 diabetes and a widely held perception among health caregivers in this part of the world is that administering intramuscularly Chloroquine to fasting malaria patients could be complicated by syncope directly caused by hypoglycemia. This study investigated the effects of a single adult human intramuscular bolus of Chloroquine on the blood glucose level in fasting normoglycemic Wistar rats. Methods: Fifteen acclimatized adult male rats were randomly divided into three groups of 5 per group. Group I and II rats were fasted overnight and received 4.17 mg/kg of intramuscular Chloroquine in the morning. Group III rats were also fasted but received 1ml of sterile water injection. Fasting blood sugar level was determined immediately after injection and at 2 hour and 4 hour intervals using Accucheck glucometer. Results: The results were recorded as Mean ± SEM. The mean sugar levels of the groups were compared with each other within a given time point as well between the different time intervals within a given group using Student’s t test of significance. There were no observable statistical significant differences between the Mean blood glucose levels of the groups. Conclusion: The results of this study suggest that intramuscular Chloroquine injection in fasted normoglycemic rats did not lower significantly lower their blood glucose level and syncope in fasting adult humans immediately following treatment by this route was likely the result of a cardiovascular complication rather than from a Chloroquine-induced hypoglycemic effect.
Highlights
The 4-Aminoquinoline, Chloroquine is still effective for treating malaria fever due to sensitive Plasmodium species in many developing countries [1,2]
This study investigated the effect of a single bolus of intra-muscular Chloroquine, within the anti-malarial therapeutic dose range of adult humans, on the blood glucose levels of fasted Wistar rats to either validate or refute this mythical rapid-onset intramuscular Chloroquine-induced fatal hypoglycemic syncope
Chloroquine injection did not significantly lower the Mean blood glucose level in fasting rats compared to untreated controls (Mean ± SEM, P>0.05, Student t Test)
Summary
The 4-Aminoquinoline, Chloroquine is still effective for treating malaria fever due to sensitive Plasmodium species in many developing countries [1,2]. This is considered by a few health caregivers to be the consequence of an induced hypoglycemia following the intramuscular administration of the drug to fasting anorexic patients This fear of hypoglycemia rather than hypotension have sometimes resulted in caregivers delaying the commencement of prescribed Chloroquine injections in fasting patients, insisting that these patients must eat good meals before any commencement of prescribed treatment, even with intravenous dextrose infusion already set up and running. Both hypoglycemic and hyperglycemic effects of Chloroquine have been suggested in two reported in-vivo studies and changes in insulin release and clearance rates have been proposed as possible mechanisms of action, but the doses used in both of them did not simulate the dosing pattern in adult humans [10,11]. This study investigated the effect of a single bolus of intra-muscular Chloroquine, within the anti-malarial therapeutic dose range of adult humans, on the blood glucose levels of fasted Wistar rats to either validate or refute this mythical rapid-onset intramuscular Chloroquine-induced fatal hypoglycemic syncope
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