Saturday, March 21, 2020

Trump's Wonder Cure Drugs for Covid-19


I received the following letter today from a PAASE member, detailing the dangers of Chloroquine and hydroxychloroquine approved by FDA for malaria but not for corona virus as Trump falsely proclaimed in TV the other day.  Dr Fauci clarified that Trump announcement was not true. Here's the letter for your information.
  
"Trump is wrong! It is not meant for prophylaxis or prevention. It should be reserved for high-risk COVID + cases admitted in hospital, and is part of many protocols (together with Azithromycin). 

People circulating this, including their recommended prophylactic dose for adults and children, are dangerous and must be stopped:

The Vibermongerers and Viberquackdocs are even posting the dose: “Start Chloroquine 500 mg one tablet per week as a prophylaxis for covid for adults. For kids take in syrup form and equivalent to 8.3 mg per week dose. Prophylaxis can be continued for 6 to 8 weeks.” NO baseline screening (retina, heart, liver, G6PD)! Dangerous!

Chloroquine and hydroxychloroquine belong to the quinolone family. Although their therapeutic and toxic doses differ, they are related drugs with similar clinical indications for use and similar manifestations of retinal toxicity.

Shown to cause severe hypoglycemia including loss of consciousness that could be life-threatening in patients treated with or without antidiabetic medications; patients should be warned about risk of hypoglycemia and associated clinical signs and symptoms; patients presenting with clinical symptoms suggestive of hypoglycemia during treatment with chloroquine should have blood glucose level checked and treatment reviewed as necessary.

Cases of cardiomyopathy resulting in cardiac failure, in some cases with fatal outcome, QT interval prolongation, torsades de pointes, and ventricular arrhythmias reported; Caution with hepatic disease, alcoholism, and coadministration with other hepatotoxic drugs; Caution with history of auditory damage; May provoke seizures in patients with history of epilepsy. 

May cause hemolysis in glucose-6 phosphate dehydrogenase (G-6-PD) deficiency; blood monitoring may be needed as hemolytic anemia may occur, in particular in association with other drugs that cause hemolysis. 

  • Chloroquine
  • Antimalarial w/ antiviral activity
  • interferes w/ viral entry by changing acidification inside of cell
  • inhibits SARS-CoV2 co-receptor
  • immune modulating activity (we don’t know yet if that’s good or bad for COVID-19)
  • Inexpensive, long track record
  • In vitro has similar effectiveness against SARS-CoV2 as Remdesivir
  • Reported to improve pneumonia, viral clearance, and disease course from China cases (but we don’t have RCT trial data or robust cases of this)
  • Requires higher dose than for malaria: 500mg BID
  • Limited supply in the US

  • Hydroxychloroquine: related to chloroquine
  • Preferred as alternative: can increase PO dose, has decreased drug interactions, and is more widely tolerated
  • May be more potent against SARS-CoV2 than chloroquine (in vitro studies)

Personal Note: As a retired FDA Chemistry Team Leader in the Division Of Anti-Infective Drug Products, I am familiar of the side effects and dangers of Chloroquine if a proper dosage is not given to the patients. What works in the Lab(in vitro studies) do not necessary translate as safe and effective to humans!

No comments:

Post a Comment

Related Posts Plugin for WordPress, Blogger...