Posted on 04/10/2020 10:54:51 AM PDT by SeekAndFind
The drug doesn't come without a certain set of risks, and no one knows if it can effectively treat COVID-19.
The president and some of his close advisors — desperate for a COVID-19 cure — are asking “What do you have to lose?” by taking hydroxychloroquine (HCQ), a strong medication never adequately tested for efficacy or safety in COVID-19 patients. The correct answer to the president’s question, which he doesn’t seem to want to hear, is that we have our lives to lose.
The president acknowledges “I’m not a doctor” but this raises the question “What do doctors know about the drug recommended by the president?" Most doctors are aware that HCQ can be effective for patients with malaria, arthritis or lupus. If they were to follow the president’s suggestion and prescribe it for COVID-19 patients, they would also like to know that it will benefit some of those patients, at least.
This drug hasn't proven to be successful in treating viral illnesses
What is known? HCQ has been tested previously in several viral illnesses but never found effective. Importantly, there is no evidence whatsoever that HCQ can prevent COVID-19, and there is only anecdotal evidence that it improves the course of the disease. The reports that it can reduce the measurable levels of the virus in patients are seriously flawed, lack a valid control group and were released to the public with little, if any, scientific review. Proper clinical trials with HCQ are underway, but these will take months. In summary, doctors do not know if HCQ or any other drug now being tested is effective or will have any medical benefit.
Without any assurance of benefit, what do you have to lose? Most doctors rely on the FDA-approved label to evaluate the “risk” side of the benefit/risk equation for each presciption. The drug label for HCQ, and its close relative Chloroquine, are very clear about their risks and both contain a page and a half of stark warnings that include the possibility of blindness due to retinal injury, loss of consciousness due to low blood sugar, suicidal behavior, heart failure, potentially lethal interactions with other drugs, lethal heart rhythm disturbances and yes, death. When doctors prescribe HCQ, they expect that the risk of these potentially tragic side effects will be outweighed by some benefit.
Doctors are also trained to use their medical skills to evaluate the patient’s overall condition as part of the risk/benefit equation for a drug and to take appropriate measures to mitigate any risks. They know that some patients are at greater risk of developing side effects than others. Unfortunately, the patients at greatest risk for most of HCQ’s serious side effects are the same as the very sickest COVID-19 patients, e.g. those on respirators with low blood oxygen levels and with disturbances in body chemistry.
Continuous ECG monitoring is one of the methods used to prevent potentially lethal cardiac effects of HCQ and chloroquine. In many ICUs, computerized decision support systems monitor the patient’s electronic chart and send advisories to physicians when a drug’s risk exceeds safe thresholds. However, these surveillance tools are not generally available outside of the hospital and could not protect those who might try to prevent COVID-19 by taking HCQ.
Special exceptions are made for emergencies
Pandemics and other public health tragedies alter the usual norms and requirements of medical practice. When a life is in danger, physicians may decide to prescribe an unproven drug and monitor the patient for any potentially serious side effects. To enable such use, the FDA has “approved” the careful use of HCQ under an Emergency Use Authorization (EUA). It should be emphasized that the FDA did not approve HCQ as either safe or effective to treat or prevent COVID-19. Recognizing the unique situation doctors are facing, the FDA’s emergency authorization is for the “unapproved use of hydroxychloroquine” supplied from the nation’s stockpile but only for hospitalized adults and adolescents “for whom a clinical trial is not available, or participation is not feasible”.
The FDA’s EUA Fact Sheet should be carefully read by anyone contemplating prescribing or taking HCQ. Also, the public should know that the FDA is working hard to correct a problem at some public websites that post drug labels. Labels for 15 of the 49 products containing HCQ are out of date and do not contain the warnings found in the currently approved HCQ label or in the FDA’s Fact sheet.
In this crisis, our political leaders are grasping at straws and encouraging hope. When faced with a national medical crisis such as a pandemic, I encourage our leaders to defer to the medical and scientific experts who have the knowledge, skills and training to save lives and to not encourage unnecessary or unfounded risks with our lives and our safety.
Dr. Raymond L. Woosley is a professor of medicine at The University of Arizona, College of Medicine-Phoenix. He is the president of the Arizona Center for Education and Research on Therapeutics.
Whotta lib gasbag.
In my town, for decades, we have had front-end loaders to clean the streets daily of the piles of dead bodies of Lupus and rheumatoid arthritis sufferers who took hydroxychloroquine and died.
If only Doc Gasbag here had been around to warn them...
Aspirin Misuse May Have Made 1918 Flu Pandemic Worse
October 3, 2009
https://www.sciencedaily.com/releases/2009/10/091002132346.htm
In February 1919…Edward's fever kept getting higher and higher…aspirin…was given to him by the 1/2-handful over and over…Edward sweated through his mattress…Dr.…could not save his patient.
Doxycycline is one of the replacements in that instance?
Exactly.
One year ago this month, I underwent Oral Surgery.
My surgeon prescribed Hydrocodone and an extremely high dose of Ibuprofen. I think they were 600 MGs. I was instructed to take the Ibuprofen three times daily.
Of course, I’d taken Ibuprofen before, but not at that high amount. A few days later, I started feeling very anxious and then started suffering panic attacks.
I do suffer from anxiety and panic attacks and am prescribed benzos for panic attacks, but I couldn’t figure out why, all of a sudden, I was a panicky mess.
On a whim, I googled Ibuprofen and what can happen if one takes large amounts. I was shocked to discover that, in a few select people, large amounts of Ibuprofen can cause panic attacks. Those were rare side effects but, for people like myself, the pills could cause panic attacks.
After that, I cut down on the Ibuprofen and took more of the Hydrocodone. That helped immensely.
Your post was spot on. There are many innocuous drugs that most people take with no problems but, for some reason, cause serious problems for some people. Everyone’s systems are different.
You won’t find anything current- any COVID + patient who dies while under treatment will be deemed COVID related.
Medication related deaths are far harder to prove
In fact the severe side effects that can occur in an acute setting- erythema multiforme, toxic epidermal necrolysis, prolonged QT syndrome, cardiomyopathy should be picked up by a provider (especially if the patient is hospitalized) with the patient immediately being taken off the hydroxycholorquine. All of the above conditions have been associated with death and you should look them up individually as opposed to the medication itself.
The bigger issue is if people to get a hold of this and use it without a physician monitoring (difficult though not impossible) and especially if they think they can use it without a concern as a preventative for months at a time as some here seem to be suggesting. Then other potentially issues arise, equally nasty, including aplastic anemia, hepatic necrosis and retinopathy, Not good.
The biggest danger I see is the various states using it as a POST-preventative.
As in - you have to test positive for Covid or go into the hospital for Covid, meaning you'll have to wait, meaning you may become physically damaged while waiting.
Kind of your auto mechanic making you wait till there's engine damage before he'll let you have that $2 quart of oil.
Leave it to the state governments to set up a DMV-style approach to a problem that is time-sensitive. "Take a number and have a seat. We'll get to you right after lunch."
BTW - did you know that the Democrat Michigan state representative who was able to mitigate her Covid infection couldn't get the HCQ in Michigan?
Her husband (who was also infected, but hadn't got his test results back) had to drive to a neighboring state to get her The Good Stuff...
They need to give you the treatment regime when you present with symptoms.
There is a huge difference in the side effects between Hydroxychloroquine and Chloroquine. Most of the bad side effects have been tied to HQ alone. HCQ is much safer, with fewer side effects. Almost trivial side effects with HCQ.
The potential side effects listed are taken from the history of CQ, because it was out first, and they didn’t know yet what they would be for HCQ. Very difficult to remove side effects from a label later, and pretty much no reason to. Litigation reasons.
As a preventative, you can pretty much give it to anyone who could use it to prevent malaria. Which is darn near everyone. The body doesn’t know which disease you will be exposed to. Millions of doses given each year for !alaria prevention, all over the world.
The Chemotherapy Drugs given to me to treat my CLL (Chronic Lymphocytic Leukemia) MAY HAVE given me MDS (Myelodysplastic Syndrome) otherwise known as Pre Leukemia.
There is also a chance that I already had MDS but it was not Diagnosed along with my CLL.
Without the Chemotherapy Drugs first given to me fourteen Years ago to battle my CLL, I probably wouldn’t even be around to worry about the side effects.
The different Opinions of all these Doctors makes you realize that picking one Doctor over a another is like buying a Lotto Ticket. Could be a Winner, but probably isn’t.
Doxy is a replacement for azithromycin, which may cause EKG problems in patients with heart disease.
They had you on quinine. Tastes like crap, as you know (Thank you for your service, MUCH )
Not sure why they didn’t have you guys on chloroquine. Quinine cheaper?
It’s used now in the US for leg cramps.
Actually azithromycin is a great treatment for gonorrhea!
Get the word out!!
What do you have to lose by taking hydroxychloroquine?
Let’s see, the bracing experience of having a tube inserted down your trachea is the first thing that comes to mind.
Been reading Medscape for about 15 years, mainly for med education.
They do tend to be practical.
https://www.medscape.com/viewarticle/927033#vp_2
Before I would believe this doctor, I would like to know about his sources of income, does he sit on a Pharm board and how hid patients have fared in the pandemic.
Remember, Doctors bury their mistakes!
Thanks, I just tweeted this to my Bishop. He is being hounded by a Twitter troll who thinks HCQ is a poison pushed by anti-science Trumpkins to make money and kill Americans.
That is why doctors treating a coronavirus patient with cardiac issues and certain other counter-indications can use Doxycycline instead of Azithromycin. Doxycycline works well with the HCQ and Zinc.
No medication is totally benign. Even aspirin with more than a century of common use has side effects and can be dangerous. However this is a biased hit piece. There is ample evidence that HCQ is an effective treatment in many cases of COVID-19. The drug has a 50 year history and is cheap and generic. Ideally years of double blind studies would be needed to get FDA approval for use with COVID-19, but given the long history of this drug and its apparent effectiveness in treating this pandemic why not use it.
Yeah, this seems to have shut some rabid anti-HCQers up — for now.
Well i meant the drug has been used for 65 yuears now- for lupus and arthritis, and also for malaria- milliosn and millions of peopel have been on it, soem short erm, soem long term- certainly they must have soem stats abotu how many have died as a direct result of using it
[[All of the above conditions have been associated with death and you should look them up individually as opposed to the medication itself.]]
I know they can occur along with the use of the drug- (now that you’ve pointed that out to me) but it’s the facts I’m after- how many of those cases were caused by the drug? How many occurred totally separate from the drug while they were on the drug? These are important things- to know if we’re to judge whether the drug is safe or not- with so many years- decades of use- there must be stats on this now if the drug is so unsafe- it should be common knowledge, and plastered all over then et by now-
but my point is that these are ‘possible side effects’ not ‘likely side effects’- many drugs list possible side effects- but rarely ever see those side effects happen except in very specific unique situation -
[[The bigger issue is if people to get a hold of this and use it without a physician monitoring]]
I somewhat agree- but many many people take much more dangerous drugs and are sent home and told ‘if you experience any of these symptoms, call right away’
[[aplastic anemia, hepatic necrosis and retinopathy, Not good.]]
These things won’t occur as if these are such a concern with the drug- the physician will order blood tests, eye tests, and other tests periodically, as needed, to prevent those htigns- I was on a drug that could destroy the liver and kidneys- i took those drugs for a long time, at home- years- and had to get periodic tests to determine if the drugs were hurting those organs
I just don’t see, with the long history and safety record of this drug, which by the way was far safer than the ones i was on, why it should be denied, even as a prophylactic use drug- sure, there are some —possible— symptoms, however, they are very very rare from what I’m finding- far more rare than the drugs’ side effects that i was on (I did suffer from other pretty nasty side effects, one, bronchitis, which landed me in hospital twice- but didn’t suffer the kidney and liver issues- tests were all good-)
I’m sure soem won’t bother getting tested, ad might- might end up with serous side effects, but we can’t prevent a population from using it during a pandemic simply because of irresponsible people who don’t follow doctor’s advice-
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