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Chloroquine and Hydroxychloroquine for Coronavirus (COVID-19)?

Chloroquine and Hydroxychloroquine for Coronavirus (COVID-19)?

Chloroquine and Hydroxychloroquine for Coronavirus (COVID-19)?YouTube Link: When it comes to COVID-19, President Trump has called chloroquine and hydroxychloroquine “game changers,” while Dr. Fauci at the same time has said “there is no magic drug.” The reason why there is potential promise in these drugs is that because in labs, meaning in a test tube, they’ve been shown to be effective against the old SARS virus, and possibly against the new SARS virus, meaning SARS-CoV-2, the virus that causes Covid-19. And for this reason, there is now a high demand for these drugs. And as a result of this high demand, some people who take these drugs for other medical conditions, like lupus or rheumatoid arthritis, are having a hard time getting new prescriptions. So in this video, I’m going to dissect these drugs in further detail, and then explain their potential for preventing and/or treating COVID-19. What is Chloroquine and Hydroxychloroquine? Chloroquine, which is available in 250 mg and 500 mg tablets, is an old drug that has been used to prevent and treat malaria. HCQ, which is structurally very similar to chloroquine, is used to treat rheumatologic conditions such as lupus and rheumatoid arthritis, and is available in 200 mg tablets. For patients who require HCQ for the chronic treatment of rheumatologic disease, the maximum recommended daily dose is 5 mg/kg/day of actual body weight. So for example, if someone weighs 80 kg, that would be 400 mg per day. Both Chloroquine and hydroxychloroquine affect the innate immune system, and alter inflammation, although exactly how they do so remains unknown. What are the side effects of Chloroquine and Hydroxychloroquine? Overall, these drugs are considered very safe, as serious side effects are extremely rare. An itchy, maculopapular skin rash (reaction) occurs in about 10% of patients treated with chloroquine or HCQ. One known side effect of these medications with long term use is eye damage, specifically damage to the retina of the eye. That is why we always monitor patients with routine eye exams whenever starting these medications for long term use. With that said, Serious eye damage is relatively rare. Chloroquine can prolong the QTc interval on the EKG, and when there is prolonged QTc interval, there is a relatively higher risk of having a fatal arrhythmia, but overall, the risk of having a fatal arrhythmia from chloroquine by itself is very low. However, the risk is increased if someone is taking other medications that prolong the QTc interval. And HCQ does not prolong the QTc interval, so it by itself does not cause fatal arrhythmias. Can Chloroquine and Hydroxychloroquine be Used For COVID-19? Hydroxychloroquine is being studied to determine if it can be used to prevent and/or treat COVID-19. Trump claims that because the drug has been in use for years, it potentially poses fewer risks than a newly developed drug. And I can tell you that overall, they are both generally safe drugs, with HCQ being considered the safer of the two. But we don’t know if it's necessarily safe for patients with COVID-19 patients, because it has been studied in a clinical trial. Besides answering the question, is it safe in patients with COVID-19, we have to know if it's effective in patients with COVID-19. Why are these drugs thought to help fight COVID-19? There was a study in China that was published in the Journal of Bioscience Trends this month, which demonstrated that chloroquine seems to improve COVID-19-associated pneumonia, and it appeared to be safe in these patients as well. Chloroquine appears to have broad-spectrum antiviral properties, and this is why it is considered a Covid-19 treatment in China. But this was a small study and while it looks like there might be some promise, it's far from certain that it is effective against COVID-19. Regarding hydroxychloroquine in combination with the antibiotic azithromycin, there was a single "small study" that showed that the combination of these two medications seemed to help against Covid-19.Even if this combination does work, extra precaution has to be taken because when these meds are given together, they can alter the heart's electrical activity. Specifically, they can prolong the QT interval, which can lead to a fatal arrhythmia.

Posted by Doctor Mike Hansen on Friday, April 3, 2020

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