Quinine in the context of "Cinchona"

Needle sharing is the practice of intravenous drug-users by which a needle or syringe is shared by multiple individuals to administer intravenous drugs such as heroin, steroids, and hormones. This is a primary vector for blood-borne diseases which can be transmitted through blood (blood-borne pathogens). People who inject drugs (PWID) are at an increased risk for Hepatitis C (HCV) and HIV due to needle sharing practices. From 1933 to 1943, malaria was spread between users in the New York City area by this method. Afterwards, the use of quinine as a cutting agent in drug mixes became more common. Harm reduction efforts including safe disposal of needles, supervised injection sites, and public education may help bring awareness on safer needle sharing practices.

Medicinal plants, also called medicinal herbs, have been discovered and used in traditional medicine practices since prehistoric times. Plants synthesize hundreds of chemical compounds for various functions, including defense and protection against insects, fungi, diseases, against parasites and herbivorous mammals.

The earliest historical records of herbs are found from the Sumerian civilization, where hundreds of medicinal plants including opium are listed on clay tablets, c. 3000 BC. The Ebers Papyrus from ancient Egypt, c. 1550 BC, describes over 850 plant medicines. The Greek physician Dioscorides, who worked in the Roman army, documented over 1000 recipes for medicines using over 600 medicinal plants in De materia medica, c. 60 AD; this formed the basis of pharmacopoeias for some 1500 years. Drug research sometimes makes use of ethnobotany to search for pharmacologically active substances, and this approach has yielded hundreds of useful compounds. These include the common drugs aspirin, digoxin, quinine, and opium. The compounds found in plants are diverse, with most in four biochemical classes: alkaloids, glycosides, polyphenols, and terpenes. Few of these are scientifically confirmed as medicines or used in conventional medicine.

Rubiaceae (/ruːbiˈeɪsiːˌiː, -siˌaɪ/) is a family of flowering plants, commonly known as the coffee, madder, or bedstraw family. It consists of terrestrial trees, shrubs, lianas, or herbs that are recognizable by simple, opposite leaves with interpetiolar stipules and sympetalous actinomorphic flowers. The family contains about 14,200 species in about 615 genera, which makes it the fourth-largest angiosperm family by number of species. Rubiaceae has a cosmopolitan distribution; however, the largest species diversity is concentrated in the tropics and subtropics. Economically important genera include Coffea, the source of coffee; Cinchona, the source of the antimalarial alkaloid quinine; ornamental cultivars (e.g., Gardenia, Ixora, Pentas); and historically some dye plants (e.g., Rubia).

Alkaloids are a broad class of naturally occurring organic compounds that contain at least one nitrogen atom. Some synthetic compounds of similar structure may also be termed alkaloids.

Alkaloids are produced by a large variety of organisms including bacteria, fungi, plants, and animals. They can be purified from crude extracts of these organisms by acid-base extraction, or solvent extractions followed by silica-gel column chromatography. Alkaloids have a wide range of pharmacological activities including antimalarial (e.g. quinine), antiasthma (e.g. ephedrine), anticancer (e.g. homoharringtonine), cholinomimetic (e.g. galantamine), vasodilatory (e.g. vincamine), antiarrhythmic (e.g. quinidine), analgesic (e.g. morphine), antibacterial (e.g. chelerythrine), and antihyperglycemic activities (e.g. berberine). Many have found use in traditional or modern medicine, or as starting points for drug discovery. Other alkaloids possess psychotropic (e.g. psilocin) and stimulant activities (e.g. cocaine, caffeine, nicotine, theobromine), and have been used in entheogenic rituals or as recreational drugs. Alkaloids can be toxic (e.g. atropine, tubocurarine). Although alkaloids act on a diversity of metabolic systems in humans and other animals, they almost uniformly evoke a bitter taste.

Bernardino Ramazzini (Italian pronunciation: [bernarˈdino ramat'tsini]; 4 October 1633 – 5 November 1714) was an Italian physician.

Ramazzini, along with Francesco Torti, was an early proponent of the use of cinchona bark (from which quinine is derived) in the treatment of malaria. His most important contribution to medicine was his book on occupational diseases, De Morbis Artificum Diatriba ("Diseases of Workers").

The Iroquois use a wide variety of medicinal plants, including quinine, chamomile, ipecac, and a form of penicillin.

Tonic water is a carbonated soft drink in which quinine is dissolved. Originally used as a prophylactic against malaria, modern tonic water typically has a significantly lower quinine content and is often more sweetened than the original medicinal form. It is consumed for its distinctive bitter flavour.

Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target groups, young children and pregnant women. As of 2018, modern treatments, including for severe malaria, continued to depend on therapies deriving historically from quinine and artesunate, both parenteral (injectable) drugs, expanding from there into the many classes of available modern drugs. Incidence and distribution of the disease ("malaria burden") is expected to remain high, globally, for many years to come; moreover, known antimalarial drugs have repeatedly been observed to elicit resistance in the malaria parasite—including for combination therapies featuring artemisinin, a drug of last resort, where resistance has now been observed in Southeast Asia. As such, the needs for new antimalarial agents and new strategies of treatment (e.g., new combination therapies) remain important priorities in tropical medicine. As well, despite very positive outcomes from many modern treatments, serious side effects can affect some individuals taking standard doses (e.g., retinopathy with chloroquine, acute haemolytic anaemia with tafenoquine).

Specifically, antimalarial drugs may be used to treat malaria in three categories of individuals, (i) those with suspected or confirmed infection, (ii) those visiting a malaria-endemic regions who have no immunity, to prevent infection via malaria prophylaxis, and (iii) or in broader groups of individuals, in routine but intermittent preventative treatment in regions where malaria is endemic via intermittent preventive therapy. Practice in treating cases of malaria is most often based on the concept of combination therapy (e.g., using agents such as artemether and lumefantrine against chloroquine-resistant Plasmodium falciparum infection), since this offers advantages including reduced risk of treatment failure, reduced risk of developed resistance, as well as the possibility of reduced side-effects. Prompt parasitological confirmation by microscopy, or alternatively by rapid diagnostic tests, is recommended in all patients suspected of malaria before treatment is started. Treatment solely on the basis of clinical suspicion is considered when a parasitological diagnosis is not possible.

Bitterness, also known as bitter, is one of the most sensitive of tastes, and many experience it as unpleasant, sharp, or off-putting, but it is sometimes desirable and intentionally added via various bittering agents. Common bitter foods and drinks include coffee, unsweetened cocoa, South American mate, coca tea, Momordica charantia, unripe olives, citrus peel, some varieties of cheese, many plants in the Brassicaceae family, Taraxacum greens, Marrubium vulgare, wild chicory, and escarole. The ethanol in alcoholic beverages tastes bitter, as do the additional bittering ingredients found in some alcoholic beverages, including hops in beer and gentian in bitters. Quinine is also known for its bitter taste and is found in tonic water.

Bitterness is of interest to those studying evolution, as well as to various health researchers as a large number of naturally occurring bitter compounds are known to be toxic. The ability to detect bitter-tasting, toxic compounds at low thresholds is thought to serve an important protective function. Plant leaves often contain toxic compounds, and among leaf-eating primates there is a tendency to prefer immature leaves, which tend to be higher in protein and lower in fiber and toxins than mature leaves. Among humans, various food processing techniques are used worldwide to detoxify otherwise inedible foods and make them palatable. Furthermore, the use of fire, changes in diet, and avoidance of toxins have led to neutral evolution in human bitterness sensitivity. This has allowed for several loss-of-function mutations that have resulted in a reduced sensory capacity for bitterness in humans compared to other species.