Summary and Conclusions
Chloroquine administered intravenously to rabbits has an immediate and direct action on the heart muscle. Following doses of 15 mgm to 40 mgm of base per kg of body weight administered within from one second to 24 minutes the following consecutive ECG changes occurred: deformation of the S-T segment and deformation and flattening of the T wave, prolongation of the Q-T interval, prolongation of the P Q interval, widening of the QRS complex, complete atrio-ventricular block, ventricular standstill, ventricular extrasystoles, ventricular tachycardia, ventricular fibrillation. The immediate causes of deaths were ventricular arrest or fibrillation. The respiratory arrest was only secondary, probably due to anoxia of the respiratory center.
With temporary interruption of the chloroquine infusion even serious ECG changes passed very quickly and seemed to depend on the immediate concentration of the drug in the blood flowing through the myocardium.
This action of chloroquine on the heart may have accounted for sudden deaths in poisonings from ingestion of larger doses of the drug in man. Intravenous administration of chloroquine to man is thought to be hazardous. Even increasing the daily amount of the drug given by mouth may not be without risk.
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Kubašta, M., Vykydal, M., Zmeškal, A. et al. Cardiotoxicity of chloroquine in rabbits. Arch. Toxikol. 22, 373–380 (1967). https://doi.org/10.1007/BF00577589
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DOI: https://doi.org/10.1007/BF00577589