Wasn't left out at all. People just need to read the paper rather than the tweets.
Hydroxychloroquine...........
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Last: 4 mo ago by Jabin
Depends on location and what is available. There is no possibility of following the normal supply of PPE ideal now of discarding everything as you leave the patient room.Blackstreet said:
"According to the CDC, a health care worker taking care of COVID-19 suspected or confirmed patients should wear gloves, gowns surgical masks and face shield, which provides adequate protection against droplet transmission.
N95s should be used for critical patients during intermittent or continuous aerosol-generating procedures."
Then why is this the current recommendation from the hospital I am affiliated with. I must say I do not do inpatient medicine....
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Question for the doctors on the forum.
Due to HCQ's ability to act as a Zinc Ionophore; what are you thoughts about another zinc ionophore quercetin? I know that HCQ has other attributes that possibly make it much more effective against COViD-19 other than it being a Zinc Ionophore.
The general public that is looking at ways to boost immunity and quercetin looks to have been studied previously and could serve as a great option for those that are waiting for confirmation of testing and have very mild symptoms.
Due to HCQ's ability to act as a Zinc Ionophore; what are you thoughts about another zinc ionophore quercetin? I know that HCQ has other attributes that possibly make it much more effective against COViD-19 other than it being a Zinc Ionophore.
The general public that is looking at ways to boost immunity and quercetin looks to have been studied previously and could serve as a great option for those that are waiting for confirmation of testing and have very mild symptoms.
My question is "is a surgical mask sufficient" other than specific situations because thats what the CDC is saying?
When you are fighting for your life, don't see why this should even be an issue.
Gig'em, Ole Army Class of '70
That's very intriguing. I'm sure smart people are looking into it. Good find. I love that guy's videos. Very bright doc and great stuff.
As far as the current data shows yet. Outside of intubation, bronchoscopy , nebulized treatments, high flow O2 it seems to be all droplets which a normal mask is fine for.Blackstreet said:
My question is "is a surgical mask sufficient" other than specific situations because thats what the CDC is saying?
I have one N95 mask in clinic that is meant to be used with 1 patient only. I have been using a normal surgical mask for my cough/fever patients in clinic.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Thanks KidDoc. So why a panic or shortage of N95? Misuse?
Correct. CDC recommends in real COVID pt room, if not doing a procedure or viral aerosolization increasing maneuver, that a surgical mask suffices. But. Here to tell you. My N-95 is securely fastened in a COVID pt room regardless of what I am doing.
I can't comment on the availability of HCQ API specifically, but the supply chain for the API's from China that my company is buying has not been interrupted. There were about 10 generics approved for HCQ. Earlier in this thread, there were post about Teva and Mylan firing up their production. I would expect the other approved manufacturers have API and would initiate production as well. The production lead time of the API is hard to pinpoint and most likely depends on the API manufactures inventory of their raw materials and/or intermediates. BTW, most API for our nations drug supply are sourced from China and India.Sq 17 said:pbrancazio said:
Two generic manufacturers have started production of HCQ.
Any reports on limitations based on sourcing the active ingredients
I have seen many reports that a big chunk of pharma supply chain comes out of China. Somewhat mindboggling the # of doses that might be needed
Blackstreet said:
My question is "is a surgical mask sufficient" other than specific situations because thats what the CDC is saying?
Outside of specific scenarios yes, a surgical mask is usually sufficient. This is the case for the vast majority of respiratory viruses.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
I believe it is a 200mg dosage, so it will come down to the availability of the API and the capacity to produce the API. There is plenty of capacity to produce the doses.....the manufacturing site that I ran had 3 high speed presses and we were producing over 600 million tablets per year. Many of the major generic manufactures have sites with 20 or more high speed presses.Sq 17 said:
I have seen many reports that a big chunk of pharma supply chain comes out of China. Somewhat mindboggling the # of doses that might be needed
pbrancazio said:I believe it is a 200mg dosage, so it will come down to the availability of the API and the capacity to produce the API. There is plenty of capacity to produce the doses.....the manufacturing site that I ran had 3 high speed presses and we were producing over 600 million tablets per year. Many of the major generic manufactures have sites with 20 or more high speed presses.Sq 17 said:
I have seen many reports that a big chunk of pharma supply chain comes out of China. Somewhat mindboggling the # of doses that might be needed
https://www.google.com/amp/s/www.bloomberg.com/amp/news/articles/2020-03-20/teva-rushes-to-bring-malaria-drug-to-u-s-coronavirus-patients
Good paper on use and dosage in Europe
See page 9
https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf
See page 9
https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf
great find.
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
Exsurge Domine said:
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
And your source is?
Thanks 74....interesting paper. Although the study was small n=26 and n=16 the results were favorable, p-value<0.001 for HCQ.
Spoke with local pharmacist. Plaquenil orders surge has stressed system. Plaquenil is now limited to 21 pills. Documentation of Diagnosis, Covid status, RA, or Lupus is required. Apparently a fair number of doctor's, residents etc.. have ordered for family. Out of state doc's etc. Disappointing but not surprising and frankly unethical! One doc actually wrote a prescription for a 19 year old. WTF! That doc should be disciplined!
581 Covid + cases in Texas as of this moment. I have no idea of percentage with respiratory symptoms but they should be only people getting prescriptions.
581 Covid + cases in Texas as of this moment. I have no idea of percentage with respiratory symptoms but they should be only people getting prescriptions.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
74Ag1 said:Exsurge Domine said:
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
And your source is?
The paper that you posted on page 9 unless I read it wrong
Exsurge Domine said:74Ag1 said:Exsurge Domine said:
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
And your source is?
The paper that you posted on page 9 unless I read it wrong
They are prescribing it now but their system is overwhelmed. They may have just started.
This is not like you take a pill and your instantly cured. Maybe they don't have enough of it?
74Ag1 said:Exsurge Domine said:74Ag1 said:Exsurge Domine said:
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
And your source is?
The paper that you posted on page 9 unless I read it wrong
They are prescribing it now but their system is overwhelmed. They may have just started.
This is not like you take a pill and your instantly cured. Maybe they don't have enough of it?
I hope that's the case. I've got a lot of hope in hydroxychloroquine and remdesivir
PikesPeakAg said:
Spoke with local pharmacist. Plaquenil orders surge has stressed system. Plaquenil is now limited to 21 pills. Documentation of Diagnosis, Covid status, RA, or Lupus is required. Apparently a fair number of doctor's, residents etc.. have ordered for family. Out of state doc's etc. Disappointing but not surprising and frankly unethical! One doc actually wrote a prescription for a 19 year old. WTF! That doc should be disciplined!
581 Covid + cases in Texas as of this moment. I have no idea of percentage with respiratory symptoms but they should be only people getting prescriptions.
I would love to see those doctors have their medical licenses suspended.
Exsurge Domine said:74Ag1 said:Exsurge Domine said:74Ag1 said:Exsurge Domine said:
Bothersome that Italy is proscribing hydroxychloroquine and it doesn't seem to be doing much
And your source is?
The paper that you posted on page 9 unless I read it wrong
They are prescribing it now but their system is overwhelmed. They may have just started.
This is not like you take a pill and your instantly cured. Maybe they don't have enough of it?
I hope that's the case. I've got a lot of hope in hydroxychloroquine and remdesivir
Me too
I would be careful of reading too much into the hcq hype. There seems to be a reinventing of hcq each time there is a new viral outbreak based on in vitro data alone, and human data does not pan out. I hope that is not the case this time.
https://www.sciencedirect.com/science/article/pii/S0166354220301145
https://www.sciencedirect.com/science/article/pii/S0166354220301145
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
DrAg93 said:
I would be careful of reading too much into the hcq hype. There seems to be a reinventing of hcq each time there is a new viral outbreak based on in vitro data alone, and human data does not pan out. I hope that is not the case this time.
https://www.sciencedirect.com/science/article/pii/S0166354220301145
Howdy Doc, isn't the difference between HCQ and CQ is that since HCQ is milder you can take more of it which makes it more effective?
Ol_Ag_02 said:PikesPeakAg said:
Spoke with local pharmacist. Plaquenil orders surge has stressed system. Plaquenil is now limited to 21 pills. Documentation of Diagnosis, Covid status, RA, or Lupus is required. Apparently a fair number of doctor's, residents etc.. have ordered for family. Out of state doc's etc. Disappointing but not surprising and frankly unethical! One doc actually wrote a prescription for a 19 year old. WTF! That doc should be disciplined!
581 Covid + cases in Texas as of this moment. I have no idea of percentage with respiratory symptoms but they should be only people getting prescriptions.
I would love to see those doctors have their medical licenses suspended.
Seriously, for all the *****ing about Karens it's the doctors writing unnecessary prescriptions who are the bad guys here. They know better!
Politicians make this stuff sound a whole lot more promising than actual scientists do
Not a doc, but a PhD pharmaceutical scientist. I specialize in getting drugs into the body and know just enough about pharmacokinetics to make me dangerous.Palovic said:
Question for the doctors on the forum.
Due to HCQ's ability to act as a Zinc Ionophore; what are you thoughts about another zinc ionophore quercetin? I know that HCQ has other attributes that possibly make it much more effective against COViD-19 other than it being a Zinc Ionophore.
The general public that is looking at ways to boost immunity and quercetin looks to have been studied previously and could serve as a great option for those that are waiting for confirmation of testing and have very mild symptoms.
Just from reading a bit about quercetin, I think one of the issues could be it's low and highly variable bioavailability (0-50%) and the short half-life of the drug in the body (1-2 hours). It also undergoes rapid and significant metabolism once ingested which, while in vitro studies may show an effect, these effects aren't necessarily expected to occur in vivo.
HCQ, on the other hand, has a much higher bioavailability (75%) and the elimination half life, according to Wikipedia, is about a month.
Great information. The bioavailability is definately an issue.
I was doing some research and it looks like there is a study that shows Quercetin Phytosome provides more bioavailability of the product.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418071/
I was doing some research and it looks like there is a study that shows Quercetin Phytosome provides more bioavailability of the product.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418071/
Palovic said:
Great information. The bioavailability is definately an issue.
I was doing some research and it looks like there is a study that shows Quercetin Phytosome provides more bioavailability of the product.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418071/
Just ordered a couple of bottles
I have a few bottles coming in as well. There are a few other studies I am following for anti-virals that are being testing on COVID-19. They have shown effectiveness in vivo for other Corona viruses and influenza but have not had any trials against this strain.
If there were options for the mass population to take for early onset symptoms (washing hands, social distancing, face masks can only do so much right now and going forward), I believe you would see a much better effect on not only shallowing the curve but potentially effective control going forward.
If there were options for the mass population to take for early onset symptoms (washing hands, social distancing, face masks can only do so much right now and going forward), I believe you would see a much better effect on not only shallowing the curve but potentially effective control going forward.
Palovic said:
Great information. The bioavailability is definately an issue.
I was doing some research and it looks like there is a study that shows Quercetin Phytosome provides more bioavailability of the product.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418071/
Thanks for the article. This is the type of stuff that is right up my alley.
A very interesting paper. I don't know the researchers, but I do know some of the scientists that developed the biorelevant media they were using in the in vitro solubility tests.
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