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1

Zdun, Sylwia, Klaudia Walczak, Weronika Gaweł, Zuzanna Wesołowska, Przemysław Jędruszczak, Natalia Grzywna, Sylwia Nemeczek, Konrad Merkisz, Jakub Grzybowski, and Patrycja Walczak. "Side effects of long-term treatment with chloroquine for rheumatoid arthritis - a review of the literature." Journal of Education, Health and Sport 13, no. 2 (December 28, 2022): 165–71. http://dx.doi.org/10.12775/jehs.2023.13.02.023.

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Background: Chloroquine is a 4-aminoquinoline derivative. Initially the substance was used as an antimalarial drug, but now chloroquine is also used to treat connective tissue diseases. It is a widely used drug in rheumatological diseases, especially in rheumatoid arthritis and systemic lupus erythematosus. A number of side effects have been reported in the public literature among patients using this drug. This article reviews side effects during long-term treatment of patients with rheumatoid arthritis. Materials and methods: A review of the literature available in the PubMed database was performed, using the key words: "Chloroquin" ; "Chloroquin rheumatoid" ; "Chloroquin toxicity" ; "Chloroquine" ; "Chloroquine rheumatoid" ; "Chloroquine toxicity". Results: Chloroquine is a quinine derivative, originally used in the prevention and treatment of malaria. It is now being successfully used to treat patients with certain connective tissue diseases, including rheumatoid arthritis. A number of publications have described various side effects of this drug. Serious and major problems arise from the drug's toxicity with long-term use, such as in the treatment of rheumatoid arthritis. Long-term use of the drug results in retinopathy and cardiotoxicity (conduction disturbances, cardiomyopathy). The available literature also mentions neuromyotoxicity which is rarely reported by patients. Conclusion: Long-term use of chloroquine carries serious side effects. The main complications of long-term use of the drug affect the visual, cardiovascular and nervous systems. The use of chloroquine in patients with rheumatoid arthritis should emphasize the need for accurate dosing and periodic cardiovascular, ophthalmologic and neurologic monitoring.
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2

Blackard, W. G., R. M. Smith, and L. Jarett. "Insulin processing by cultured hepatocytes." American Journal of Physiology-Endocrinology and Metabolism 250, no. 2 (February 1, 1986): E148—E155. http://dx.doi.org/10.1152/ajpendo.1986.250.2.e148.

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The chloroquine-sensitive and chloroquine-insensitive steps in insulin degradation by cultured hepatocytes have been explored by employing low temperature to retard processing. Under standard conditions (90 min association and 60 min dissociation) chloroquine inhibited insulin degradation at 15 degrees C but not at 37 degrees C. However, if the association and dissociation periods were short so that only early degradation was examined, marked inhibition of insulin degradation by chloroquine could also be observed at 37 degrees C. This inhibitory effect was observed only during the first 15 min, being masked by increased insulin degradation subsequently. An increase in slowly dissociable insulin, as well as a twofold increase in volume density of multivesicular bodies (MVB), occurred in the presence of chloroquine at both 37 and 15 degrees C. Rapid insulin processing from the slowly dissociable compartment at 37 degrees C masked chloroquine's effect on insulin processing under usual conditions at that temperature. At physiological temperature the chloroquine-sensitive step is not obligatory for insulin degradation by hepatocytes.
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3

Ridley, R. G., W. Hofheinz, H. Matile, C. Jaquet, A. Dorn, R. Masciadri, S. Jolidon, et al. "4-aminoquinoline analogs of chloroquine with shortened side chains retain activity against chloroquine-resistant Plasmodium falciparum." Antimicrobial Agents and Chemotherapy 40, no. 8 (August 1996): 1846–54. http://dx.doi.org/10.1128/aac.40.8.1846.

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We have synthesized several 4-aminoquinolines with shortened side chains that retain activity against chloroquine-resistant isolates of Plasmodium falciparum malaria (W. Hofheinz, C. Jaquet, and S. Jolidon, European patent 94116281.0, June 1995). We report here an assessment of the activities of four selected compounds containing ethyl, propyl, and isopropyl side chains. Reasonable in vitro activity (50% inhibitory concentration, < 100 nM) against chloroquine-resistant P. falciparum strains was consistently observed, and the compounds performed well in a variety of plasmodium berghei animal models. However, some potential drawbacks of these compounds became evident upon in-depth testing. In vitro analysis of more than 70 isolates of P. falciparum and studies with a mouse in vivo model suggested a degree of cross-resistance with chloroquine. In addition, pharmacokinetic analysis demonstrated the formation of N-dealkylated metabolites of these compounds. These metabolites are similarly active against chloroquine-susceptible strains but are much less active against chloroquine-resistant strains. Thus, the clinical dosing required for these compounds would probably be greater for chloroquine-resistant strains than for chloroquine-susceptible strains. The clinical potential of these compounds is discussed within the context of chloroquine's low therapeutic ratio and toxicity.
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4

&NA;. "Chloroquine see Proguanil/chloroquine." Reactions Weekly &NA;, no. 287 (February 1990): 6. http://dx.doi.org/10.2165/00128415-199002870-00013.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1391 (March 2012): 16. http://dx.doi.org/10.2165/00128415-201213910-00057.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 696 (April 1998): 6. http://dx.doi.org/10.2165/00128415-199806960-00015.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 711 (July 1998): 7. http://dx.doi.org/10.2165/00128415-199807110-00020.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 726 (November 1998): 7. http://dx.doi.org/10.2165/00128415-199807260-00020.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 729 (November 1998): 7. http://dx.doi.org/10.2165/00128415-199807290-00020.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 741 (March 1999): 7. http://dx.doi.org/10.2165/00128415-199907410-00021.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 760 (July 1999): 6. http://dx.doi.org/10.2165/00128415-199907600-00013.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1166 (August 2007): 8. http://dx.doi.org/10.2165/00128415-200711660-00025.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1180 (December 2007): 10. http://dx.doi.org/10.2165/00128415-200711800-00027.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1189 (February 2008): 12. http://dx.doi.org/10.2165/00128415-200811890-00037.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1121 (September 2006): 9. http://dx.doi.org/10.2165/00128415-200611210-00026.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1148 (April 2007): 13. http://dx.doi.org/10.2165/00128415-200711480-00042.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1358 (July 2011): 12–13. http://dx.doi.org/10.2165/00128415-201113580-00042.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1359 (July 2011): 13. http://dx.doi.org/10.2165/00128415-201113590-00042.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1359 (July 2011): 13. http://dx.doi.org/10.2165/00128415-201113590-00043.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1364 (August 2011): 14. http://dx.doi.org/10.2165/00128415-201113640-00052.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1374 (October 2011): 13–14. http://dx.doi.org/10.2165/00128415-201113740-00038.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 546 (April 1995): 6. http://dx.doi.org/10.2165/00128415-199505460-00023.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 547 (April 1995): 4. http://dx.doi.org/10.2165/00128415-199505470-00006.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 559 (July 1995): 5. http://dx.doi.org/10.2165/00128415-199505590-00008.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 560 (July 1995): 7. http://dx.doi.org/10.2165/00128415-199505600-00014.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 564 (August 1995): 5. http://dx.doi.org/10.2165/00128415-199505640-00008.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 592 (March 1996): 5. http://dx.doi.org/10.2165/00128415-199605920-00013.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 432 (December 1992): 7. http://dx.doi.org/10.2165/00128415-199204320-00031.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 434 (January 1993): 7. http://dx.doi.org/10.2165/00128415-199304340-00025.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 445 (April 1993): 6. http://dx.doi.org/10.2165/00128415-199304450-00016.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 456 (June 1993): 6. http://dx.doi.org/10.2165/00128415-199304560-00028.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 468 (September 1993): 5. http://dx.doi.org/10.2165/00128415-199304680-00024.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 636 (February 1997): 6. http://dx.doi.org/10.2165/00128415-199706360-00017.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 650 (May 1997): 6. http://dx.doi.org/10.2165/00128415-199706500-00014.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 671 (October 1997): 8. http://dx.doi.org/10.2165/00128415-199706710-00018.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1406 (June 2012): 14–15. http://dx.doi.org/10.2165/00128415-201214060-00043.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1411 (July 2012): 15. http://dx.doi.org/10.2165/00128415-201214110-00050.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1412 (July 2012): 13–14. http://dx.doi.org/10.2165/00128415-201214120-00046.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1415 (August 2012): 15. http://dx.doi.org/10.2165/00128415-201214150-00053.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 388 (February 1992): 6. http://dx.doi.org/10.2165/00128415-199203880-00015.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 402 (May 1992): 6. http://dx.doi.org/10.2165/00128415-199204020-00019.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 405 (June 1992): 6. http://dx.doi.org/10.2165/00128415-199204050-00017.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 406 (June 1992): 6. http://dx.doi.org/10.2165/00128415-199204060-00015.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 419 (September 1992): 6. http://dx.doi.org/10.2165/00128415-199204190-00019.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1199 (April 2008): 16. http://dx.doi.org/10.2165/00128415-200811990-00046.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1203 (May 2008): 16. http://dx.doi.org/10.2165/00128415-200812030-00050.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1214 (August 2008): 11–12. http://dx.doi.org/10.2165/00128415-200812140-00029.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1104 (June 2006): 8. http://dx.doi.org/10.2165/00128415-200611040-00022.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1111 (July 2006): 9. http://dx.doi.org/10.2165/00128415-200611110-00024.

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&NA;. "Chloroquine." Reactions Weekly &NA;, no. 1115 (August 2006): 10. http://dx.doi.org/10.2165/00128415-200611150-00031.

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