Chloroquine, past and present • Hacker News Board

Re: Chloroquine, past and present

#241

Post by webmobdev » Sat, Mar 21, 2020, 1:40 AM UTC

gumby wrote: post #91

cameldrv wrote: post #62

We definitely want more studies, but IMO we're reaching a tipping point. We have anecdotal evidence from China and South Korea, and this quite flawed, but at least data-containing study from France. Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. COVID isn't quite as bad as c…

> Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. The FDA's Office of new drugs is split into divisions (dermatology, oncology etc) and the different divisions have different approval criteria as you mention. From my Onco friends' PoV, cancer patients are pretty much assumed…

> Don't self-medicate with chloroquine. It's very hepatotoxic.

Also, for those considering to use the Cinchona bark itself as a prophylactic measure, as a natural / herbal / ayurvedic remedy, note that it also has potentially risky side-effects like slowing the heart, constipation and impact on the nervous system. In large quantity cinchona is UNSAFE and can be deadly. Symptoms of overdose include ringing of the ears, headache, nausea, diarrhea, and vision disturbances. Cinchona can also cause bleeding and allergic reactions, including hives and fever. It also interacts with a lot of other medicines like anti-coagulants, heart medicines, antacids etc. Be sure to check your medication list first.

Source: https://www.rxlist.com/cinchona/supplements.htm

Re: Chloroquine, past and present

#242

Post by roenxi » Sat, Mar 21, 2020, 1:48 AM UTC

m0zg wrote: post #118

gnulinux wrote: post #108

Earlier quoted context omitted.

Youth also doesn't want to deal with this disease. I'm 23 y.o., healthy as far as I know, but I still don't want to catch this disease. Why spend 2 weeks on the bed dealing with the worst flu, risk getting hospitalized? After all, even young patients can be hospitalized, even though fatality rate is lower. I vote everyone stay home for the time being.

>> Why spend 2 weeks To acquire immunity while there are still hospital beds available in some places, in the unlikely event that you need one. That won't be the case a month from now.

I'm a big fan of selfishness so I'll represent the 'that is just a bad idea' argument:

1) Such an individual would be contracting an unknown virus in an environment where hospital staff are the least prepared and practiced at dealing with it.

2) Such an individual is still exposing themselves to high risk of mistiming the outbreak and hitting it at the peak.

3) They might accidentally catch a different disease thinking it is COVID. Then if they got COVID they'd have 2 diseases; which is probably going to be quite bad.

If we all avoid getting COVID-19 for, say, another 2 months it is likely we'll have an available and effective drug for treating it. There are something like 5 different candidates I've heard of, so even if the odds of any individual one working out are <30% there is still a good chance there will be effective treatment by mid year. The contain, delay and avoid strategy really is a better bet.

Re: Chloroquine, past and present

#243

Post by smt1 » Sat, Mar 21, 2020, 1:49 AM UTC

teddyvangogh wrote: post #224

pkaye wrote: post #222

Earlier quoted context omitted.

Might need to check for G6PD genetic deficiency before taking it though. https://en.wikipedia.org/wiki/Glucose-6-phosphate_dehydrogen...

right. we need to wait for FDA approval. and since it's prescription only, you need to check with your doctor.

Depending on the country, chloroquine (or hydroxychloroquine) are over the counter. At least it is in both the UK and India. The UK has banned export of it, and in India it's less prevalent than it used to be because of the spread of chloroquine-resistant malaria. It used to be used /extremely/ widely in places where malaria is a common occurrence.

Re: Chloroquine, past and present

#244

Post by spion » Sat, Mar 21, 2020, 2:05 AM UTC

easytiger wrote: post #206

hpkuarg wrote: post #192

Earlier quoted context omitted.

Not the GP, but "mild" probably actually means mild. Given that only (highly) symptomatic people are tested, we don't know how many people contracted the virus and only had mild cold symptoms. Developing pneumonia would already put you outside of that "mild" designation.

We have a pretty good idea in Italy how many cases are asymptomatic or very mild and it is enormous. Traveling right now but if you are interested I'll update tomorrow

Yes, please.

Re: Chloroquine, past and present

#245

Post by cgio » Sat, Mar 21, 2020, 2:17 AM UTC

Given the relationship with Malaria, does anyone know if correlation with G6PD has been subject of research? G6PD is a common genetic Deficiency that provides immunity from malaria. G6PD people have to avoid consuming e.g. blue colour, sulphites and other anti malarial drugs, aspirin, fava beans etc. at risk of haemolysis.

Re: Chloroquine, past and present

#246

Post by treeman79 » Sat, Mar 21, 2020, 2:18 AM UTC

cameldrv wrote: post #189

teddyvangogh wrote: post #171

Earlier quoted context omitted.

1. it's prescription only. 2. it's already available for compassionate use. The FDA is allowing chloroquine and remdesivir to be used for 'compassionate use' to treat the coronavirus. https://www.businessinsider.com/chloroquine-remdesivir-compa...

You don't need compassionate use for Chloroquine. It's FDA approved, so it's just off-label, which doesn't require any hoops, just a prescription from a doctor.

I take it for Sjogrens.

I have to watch does as it has a strong stimulant effect at times.

It is Life changing for me, but i was having a lot of severe anxiety attacks from it.

Dr doubled the doSe. Yea a week long freak out occluded before I figure out what was going on.

Still worth it. Just have to be careful

Re: Chloroquine, past and present

#247

Post by treeman79 » Sat, Mar 21, 2020, 2:21 AM UTC

jennyyang wrote: post #197

cameldrv wrote: post #141

Earlier quoted context omitted.

I appreciate an expert opinion here. What do you think is the actual rate of adverse events from Chloloroquine, and of what severity?

One of the comments in the article: I prescribe Plaquenil extensively in patients with autoimmune conditions.The safety profile of this drug is excellent. It is also still used for malaria prophylaxis in healthy individuals .it is not a new drug. I don’t see the reason of labeling it as dangerous. The question is : does it work for Covid19 prevention and treatment? The answer is “the current limited evidence suggests…

Had a week long freak out from it. Apparently mild stimulant can magnify if your on other stimulants.

Amazing drug otherwise. My autoimmune symptoms have greatly reduced on it. Wish I could take the full dose.

Re: Chloroquine, past and present

#248

Post by m0zg » Sat, Mar 21, 2020, 2:27 AM UTC

SketchySeaBeast wrote: post #168

m0zg wrote: post #167

Earlier quoted context omitted.

Studies show it wouldn't work if _everyone_ thought like that at the same time. But studies also show that you need to "pulse" the infection rate among low-risk populations in order to get past this in a controllable fashion by temporarily and partially lifting the restrictions on those people and letting them acquire immunity, while carefully isolating and supporting the high risk populations. The fundamental truth…

And if that wants to get organized I can see how that would work. "Get sick to beat the rush", however, is not that - it's an action where the only good outcome would be if only you do it, which I think is a definition of selfishness.

Thats fine, but as things are right now, we're short on beds in a few places, and are wasting beds everywhere else. Seems like a waste of the precious resources to me.

Re: Chloroquine, past and present

#249

Post by paulmd » Sat, Mar 21, 2020, 2:47 AM UTC

teddyvangogh wrote: post #224

pkaye wrote: post #222

Earlier quoted context omitted.

Might need to check for G6PD genetic deficiency before taking it though. https://en.wikipedia.org/wiki/Glucose-6-phosphate_dehydrogen...

right. we need to wait for FDA approval. and since it's prescription only, you need to check with your doctor.

Doctors: "you need to wait for FDA approval!"

also doctors:

https://twitter.com/ml_barnett/status/1241172371404357633

https://twitter.com/JeffreyLowMD/status/1241172812762468353

https://twitter.com/amberwvzz/status/1241196003425992704

Re: Chloroquine, past and present

#250

Post by roenxi » Sat, Mar 21, 2020, 3:08 AM UTC

duchenne wrote: post #231

Since this 13th of February, the Koreans recommend the use of hydrochloroquine for patients infected by the covid-19 [1]. The Covid-19 fatality ratio in Korea is one of the lowest in the world, around 1%. The study in France showing a spectacular drop in covid-19 viral load after only 6 days of hydrochloroquine treatment has been directed by Pr Didier Raoult who is the most cited researcher on infectious disease in t…

I'm reminded of the old armour-where-the-bullets-aren't story [0]. The most important things to watch out for are places where symptoms don't show up at all.

One interesting challenge that the people doing studies must be facing is that by the time symptoms get bad the virus is probably to some degree irrelevant. If someone's lungs have given out then whether or not there are virus particles in their body probably doesn't matter so much; the damage is done. Raw viral load isn't putting people in hospital as much as that important parts of their body have been dissolved.

For a drug to be effective against the virus maybe it needs to be cheap & administered very early before symptoms become too obvious. That'd be hard to study.

[0] https://medium.com/@penguinpress/an-excerpt-from-how-not-to-...