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RE RISKS OF USING ANTI-MALARIALS FOR COVID-19: (Thread) TL/DR: It's not a black/white issue.
Many drugs are used off-label every day. Doctors and patients have the right to discuss the risks and benefits and decide. That's not shocking or new; it's an average Tuesday...
Many drugs are used off-label every day. Doctors and patients have the right to discuss the risks and benefits and decide. That's not shocking or new; it's an average Tuesday...
2/ As for media coverage of the French study and other considerations of using generic anti-malarials (chloroquite and hydrochloroquine) against COVID-19, again it's not a black/white issue.
It's shown promise, so the FDA has granted emergency-use authorization. That too...
It's shown promise, so the FDA has granted emergency-use authorization. That too...
3/...is something that happens all the time.
It's also got risks, & to state that drugs are often taken despite risks is veering into Captain Obvious territory.
But let's look at the risks in detail (w/ references) so ppl can have intelligent conversations w/ their doctors:
It's also got risks, & to state that drugs are often taken despite risks is veering into Captain Obvious territory.
But let's look at the risks in detail (w/ references) so ppl can have intelligent conversations w/ their doctors:
4/ The main risks are cardiac. These drugs can rarely cause cardiac arrhythmias in some people. The risk is generally (but not 100% of the time) reversible, meaning it can be monitored & the drug stopped if problems arise....
5/ The following reference was given to me by a pharmacist who's written thoughtfully on the current debate. It talks in detail about the many, many drugs associated with this risk, which isn't unique to anti-malarials:
https://crediblemeds.org/healthcare-providers/practical-approach/
https://crediblemeds.org/healthcare-providers/practical-approach/
6/ As it points out: "Drugs with the ability to prolong QT have been found in almost every other class of therapeutic agent, including antihistamines, antibiotics, anticancer drugs, gastrointestinal prokinetics, antipsychotics, etc."
7/ Here's what the pharmacist told me about what happens in the rare instance when a patient has such a reaction to any one of these many drugs that can cause this problem:
"I think the best course of action would be to adjust what can be adjusted in order...
"I think the best course of action would be to adjust what can be adjusted in order...
8/ "...to prevent the occurrence. One of those would be to discontinue or minimize treatment with QTc prolonging agents. The thought process is that if the patient is monitored (baseline and repeat ECG) then we should see resolution once we adjust for what can be adjusted...
9/ ...If a patient goes into TdP then we can administer magnesium until we can reverse the reversible cause for TdP."
(The abbreviations refer to the cardiac arrhythmias.)
(The abbreviations refer to the cardiac arrhythmias.)
10/ (If the pharmacist is reading this and would like to be publicly credited, please PM me--I'd be happy to credit you!)
11/ In summary, all drugs have risks and benefits that must be weighed. That's why there are doctors--they have experience with these outcomes and can give patients the information they need to decide what's right for them.
12/ If you're sick and need to make such a decision, please feel free to use the above information to help facilitate a discussion with your doctor.
Meanwhile, let's all stop making/sharing sensationalistic black/white headlines that don't help anyone.
*end thread*
Meanwhile, let's all stop making/sharing sensationalistic black/white headlines that don't help anyone.
*end thread*
