Hydroxychloroquine...........

291,913 Views | 1854 Replies | Last: 3 mo ago by Jabin
Rick Flex
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corkscrewduck said:

barnyard1996 said:

TXAggie2011 said:

While I'm not saying that's necessarily wildly inaccurate or that I even disagree with the majority, Liz Wheeler is an OANN personality and has a particular group of folks following her. I'm sure the results are skewed vs the general public, at least a little.

Yes, in today's politcal arena, conservatives would risk it in hopes that it works, and liberals would not in hopes it would extend the crisis and sink Donald Trump. That's the skew you are referring to.








yea im gonna deny something that could maybe help save my life to take down donald trump. Do you people hear yourselves?

Take the political non sense to Forum 16. Thanks
Player To Be Named Later
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AggieJosh2002 said:

Anybody have success getting some Zinc care to share where you might see it available?

Are the Calcium-Magnesium-Zinc combos ok? I hate to start adding to much new stuff


I ordered some through Google shopping. Google Zinc Picolionate and a few will pop up. I got the "NOW" brand, 50mg

Here's some 20mg
https://www.clinicalnutritioncenters.com/zinc-picolinate-by-douglas-laboratories-20mg-100-tablets/?gclid=CjwKCAjwvOHzBRBoEiwA48i6AnvtODskrzNjOWHiv7i9YZOoAaj1Rd6Je9z40v4yHGLgvlk9_sRogRoCbZsQAvD_BwE

BreNayPop
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Most adult multivitamins have 15mg zinc...
Sid Farkas
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BreNayPop said:

Most adult multivitamins have 15mg zinc...
My daily +50 year old men's multivitamin has 11mg...im being lazy here since it's probably already been posted: but how many mg could have an effect on suppressing virus growth?
74OA
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Doc Reveille yesterday: "We have some very positive news also! The combination of hydroxychloroquine and zithromax combination is starting to be used widely in many trials and reports are still very encouraging. Early reports are now saying that we have yet to see a patient on this combination require a ventilator. This is very early but still encouraging. If can slow down the amount of critical patients and deaths, this virus will just become a 2 wk netflix binge. And contrary to a doctor on CNN this is not a highly dangerous drug that has not been tested. He is right in that it has limited testing with COVID but it has been out for 65 years and we have tremendous experience with many other diseases. Yes, it has many side effects as I have pointed out previously. Some are considered serious but they are not common and if you are positive for COVID-19 in my opinion the benefits probably outweigh the risks. Certainly, if it is available I will definitely be using it in my patients, family or even myself. There is also a trial started in healthcare workers to see if it prevents the virus. So that should be interesting news, if it does and we can protect the healthcare workers this would be a huge breakthrough in getting things back to normal."
74Ag1
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74OA said:

Doc Reveille yesterday: "We have some very positive news also! The combination of hydroxychloroquine and zithromax combination is starting to be used widely in many trials and reports are still very encouraging. Early reports are now saying that we have yet to see a patient on this combination require a ventilator. This is very early but still encouraging. If can slow down the amount of critical patients and deaths, this virus will just become a 2 wk netflix binge. And contrary to a doctor on CNN this is not a highly dangerous drug that has not been tested. He is right in that it has limited testing with COVID but it has been out for 65 years and we have tremendous experience with many other diseases. Yes, it has many side effects as I have pointed out previously. Some are considered serious but they are not common and if you are positive for COVID-19 in my opinion the benefits probably outweigh the risks. Certainly, if it is available I will definitely be using it in my patients, family or even myself. There is also a trial started in healthcare workers to see if it prevents the virus. So that should be interesting news, if it does and we can protect the healthcare workers this would be a huge breakthrough in getting things back to normal."
Great post
Tabasco
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agreed!
AgDoc03
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Our hospital has several cases and I'll ask the critical care/pulmonary teams if they've been using this and if they've noticed any effects on outcomes.
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74OA
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Anything?
OldArmy71
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Depressing news from frontline ER Aggie doc in New Orleans:

Quote:


Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil's potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.

We are also using Azithromycin, but are intermittently running out of IV.


This is on the "Clinical Pearls" thread.

I have no idea what I'm talking about, but maybe it works early on to prevent the virus disease from getting worse. It may not be very useful once you're really sick.
Pelayo
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pre and post exposure recommendation for what they are worth





We'll follow the post-exposure, considering the pre


even if ineffective harm is all but nil

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Keegan99
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What do you think about adding Zinc with it?

Since the chloroquine is, theoretically, an ionophore to get the Zinc into the cell?
Pelayo
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Keegan99 said:

What do you think about adding Zinc with it?

Since the chloroquine is, theoretically, an ionophore to get the Zinc into the cell?
if you can find it don't think there is any harm.
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cone
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who issued those recommendations
KidDoc
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cone said:

who issued those recommendations
I received a very similar email from my employer (CHI) yesterday.
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cone
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curious because InfectionAg was questioning the efficacy
KlinkerAg11
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Maybe it's a better preventative than treatment
KidDoc
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cone said:

curious because InfectionAg was questioning the efficacy
Yes the limited and unproven current data seems to favor post exposure prophylaxis and/or early in the course of the illness.
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Philip J Fry
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OldArmy71 said:

Depressing news from frontline ER Aggie doc in New Orleans:

Quote:


Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil's potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.

We are also using Azithromycin, but are intermittently running out of IV.


This is on the "Clinical Pearls" thread.

I have no idea what I'm talking about, but maybe it works early on to prevent the virus disease from getting worse. It may not be very useful once you're really sick.


That makes sense to me consider the virus turns your lungs to mush. I hope thee are trials with giving people this medicine when they are first diagnosed.
Barnyard96
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The front line problem is assay time. It is taking 3-5 days to get results back before they can prescribe treatment.

Hope that 45 minute test is available soon...
yaterag
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While the recommendations seem like a good idea, the task force name is a little misleading. This isn't the United States Covid task force that recommended this. This recommendation comes from the National Task Force in India made up of members of the Indian Council of Medical Research. I'm not denouncing their recommendation, but it needs to be stated who the recommendation actually comes from.
Pelayo
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I am not endorsing anything, just letting people know what is out there and what I choose to do.
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eric76
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Keegan99 said:

What do you think about adding Zinc with it?

Since the chloroquine is, theoretically, an ionophore to get the Zinc into the cell?
What's the deal with zinc?

The use of zinc to deal with the cold came about because of a little girl with leukemia who went to her doctor in Austin while coming down with a cold. Shortly after arriving, the doctor gave her a zinc gluconate lozenge but instead of swallowing it, she let it melt in her mouth. By the end of the visit, her cold symptoms had largely disappeared.

After some testing, it was thought that the zinc was effective against the rhinovirus which it was known to seriously damage or destroy in a test tube. I haven't kept up with whether it might be effective against other viruses. It wouldn't surprise me, though, to find out that it is effective against more than just rhinoviruses.

That said, my understanding is that the zinc is effective only when it comes into direct contact with the virus. You want the zinc to wash against the cells in the throat infected by the rhinovirus so that it can come into direct contact with the virus, I've never read that zinc does much to the virus if you just swallow it.

I told my sister about the zinc gluconate a few months after the initial reports by the doctor in Austin. She tried it and said that she would prefer the cold. I've used it a number of times and don't like the taste (especially with Hawaiian Punch) but think it was generally effective. I always let the lozenge melt in my mouth and then didn't drink anything for at least half an hour to let the zinc stay in contact with the infected cells in the throat.

Is there any research that shows that zinc does much to the virus if swallowed? If the zinc has to come into direct contact with the virus to work and it works well against coronavirus, where would the zinc have to coat to be effective?
Keegan99
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The zinc needs to get into the cell. Hence the use of chloroquine as an ionophore.

eric76
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Keegan99 said:

The zinc needs to get into the cell. Hence the use of chloroquine as an ionophore.


Oh. So the zinc is not there to disrupt the virus itself, then. That makes more sense.
74Ag1
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Keegan99 said:

The zinc needs to get into the cell. Hence the use of chloroquine as an ionophore.



Thanks
cisgenderedAggie
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If that's really the mechanism, shouldn't it work on any RNA virus that uses RdRNAP?
Player To Be Named Later
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India banned the exports out of the country of hydroxychloroquine. They must be at least somewhat of a believer.
74Ag1
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Player To Be Named Later said:

India banned the exports out of the country of hydroxychloroquine. They must be at least somewhat of a believer.

Yes they think they may need it.
Dr. Not Yet Dr. Ag
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Just a heads up, there was a recently published Chinese pilot RCT for HCQ in CV19. Patients enrolled had mild disease. Only 30 patients total, although unlike the French trial, this was randomized, the same PCRs were used in both groups, and no one was excluded for getting sicker in the treatment arm. Of the 15 patients in the HCQ group, 1 developed severe disease vs 0 in the control group. 13 of 15 in the HCQ group tested negative on day 7 of treatment vs 14 of 15 in the control group.

Nevertheless, we cannot make any definitive statements regarding therapy given such low numbers in the trial.

http://www.zjujournals.com/med/EN/10.3785/j.issn.1008-9292.2020.03.03

I am still in the group that wants to see more evidence of efficacy prior to widespread utilization; however, I don't think this one study should necessarily change anyone's practice. Just thought it would be a good idea to share as a counterpoint to the awful French study.
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Palovic
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Dr. Not Yet Dr. Ag said:

Just a heads up, there was a recently published Chinese pilot RCT for HCQ in CV19. Patients enrolled had mild disease. Only 30 patients total, although unlike the French trial, this was randomized, the same PCRs were used in both groups, and no one was excluded for getting sicker in the treatment arm. Of the 15 patients in the HCQ group, 1 developed severe disease vs 0 in the control group. 13 of 15 in the HCQ group tested negative on day 7 of treatment vs 14 of 15 in the control group.

Nevertheless, we cannot make any definitive statements regarding therapy given such low numbers in the trial.

http://www.zjujournals.com/med/EN/10.3785/j.issn.1008-9292.2020.03.03

I am still in the group that wants to see more evidence of efficacy prior to widespread utilization; however, I don't think this one study should necessarily change anyone's practice. Just thought it would be a good idea to share as a counterpoint to the awful French study.
Thanks for sharing. The question many may have is the conventional treatment was given to both groups and that is not defined anywhere that I can find in the study nor are the ages, time of first symptoms, nor pre-existing conditions of the group. I downloaded the study and much of it is in Chinese and I did not take time to try and translate.

I can concur that this one study should not change anyone's practice by any means and if anything, the treatment of HCQ and conventional treatment yielded fairly decent results without knowing any of the group dynamics.

Just my thoughts
cone
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correct me if I'm wrong, but the control group didn't receive a placebo
Dr. Not Yet Dr. Ag
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You are correct, they received "conventional therapy" which the HCQ group received as well. I have not done a deep dive into this trial yet, so I'm not sure whether conventional therapy was clearly defined, either.
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cisgenderedAggie
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Using Google Translate.

Quote:

1.2. Grouping and treatment

The subjects were randomly assigned to the experimental group and the control group at a ratio of 1: 1. The test group received conventional treatment plus oral chlorochloroquine sulfate 400 mg once daily for 5 days. The control group received only conventional treatment, including bed rest, oxygen inhalation, and symptomatic supportive treatment. Viral drugs such as alpha interferon nebulization, oral lopinavir / ritonavir (clepivir), etc., and antibacterial drugs are given if necessary. All subjects were screened on the day of admission, completed randomization and started treatment (including antiviral therapy). There were no significant differences in general demographic data, clinical manifestations, laboratory results, and chest CT findings between the two groups at the time of enrollment (Table 1). All patients received alpha interferon nebulization, while 12 (80.0%) of the experimental group received abidol; 10 of the control group (66.7%) received abidol, and 2 (13.3%) Received lopinavir / ritonavir treatment.
Dad
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Is this stuff helping or not?

I was hoping by now we'd have more information. I thought if it was being widely used and working we might see the death relative to confirmed cases go down but it seems like it is going up if anything.
 
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