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

325,237 Views | 1854 Replies | Last: 9 mo ago by Jabin
Ag_of_08
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You talk about prayer and giving people false hope in the same sentence.... I'll leave that though there.

Hope is not a bad thing in anyway. If they're wrong, it doesn't work, but people get a little bit of hope and some faith that the medical field is willing to try. They succeed and a pandemic becomes survivable...
Fitch
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No. If my family were to fall victim to it I would ask for HCQ, Azithoromycin and Zinc treatment out of the starting gates. I would demand it. But I would only do it with the same confidence as I roll the dice in Vegas, not because it's a doctors recommendation alongside other alternatives.

I think about that a lot these days.
BiochemAg97
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JB99 said:

Fitch said:

74Ag1 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?

He is trying to defend his "wrong" position. He is a typical overly cautious Dr that wants to see all the clinical trials and tests that take a long time. Typical bureaucrat... slow.

All the use is saving lives but he want accept it. FDA has approved it.
Sir, this is not correct.

The drug is unproven for COVID-19 in a clinical setting, with or without azithromycin and zinc. There are a myriad of small-patient-count reports and anecdotes that encourage optimism, but nothing defendable right now. The trials and studies in New York and elsewhere are trying to answer whether it's a valid prophylactic, treatment, or otherwise. Timing, age, gender, hyer(hypo)tension, pre-existing conditions, blood type, all have a weight in decision-making for any drug. Doctors on these forums have acknowledged doubts about it working. Everyone involved is still trying to figure it out.

Think about the weight of making this drug an endorsed medical recommendation from the federal government of the United States without substantial evidence it works.

Literally billions of people would hang their hopes on it, on trials of 30 or 40 people at a time right now. Best case - it works and we have massive runs on supply. Worst case - it has minimal to no effect outside of the small study populations circulated to date, or worse, gives false hope.

Can we just pray for and support the people trying to figure out how to help?


Your worst case is literally nothing. You realize there is no treatment, none that is defendable. There's absolutely no good reason not to try and use this treatment. So we are going from having nothing and hoping we win the genetic lotterry and don't need a ventilator to having the possibility of some hope. Just consider one of your children or parents or yourself getting this disease. Are you going to discourage a doctor from prescribing this because iy's not definitive? Of course not.


The worst case is a bunch of morons decide there is a cure, break quarantine, and we stop flattening the curve.

Given the drinking aquarium cleaner, the covid19 parties, etc, there are a lot of morons in this country.
BiochemAg97
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Ag_of_08 said:

You talk about prayer and giving people false hope in the same sentence.... I'll leave that though there.

Hope is not a bad thing in anyway. If they're wrong, it doesn't work, but people get a little bit of hope and some faith that the medical field is willing to try. They succeed and a pandemic becomes survivable...


You do realize that the medical field is trying it, and that, judging by the comments on this forum, there are a whole lot of people sold on the idea that we already have a cure. Hope is good, but too much false hope can lead to actions that make this worse.
KidDoc
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74Ag1 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?

He is trying to defend his "wrong" position. He is a typical overly cautious Dr that wants to see all the clinical trials and tests that take a long time. Typical bureaucrat... slow.

All the use is saving lives but he want accept it. FDA has approved it.
This is 100% wrong.

Modern western medicine is based on scientific theory. We strive to do things that are PROVEN to work in large double blinded studies. We do not always have that luxury so we try stuff "off the cuff" now and then but any MD that says he knows his combo works is lying or selling your something.

The data is building and we should have good data in the next 4-6 weeks. Dr Fauci is just stating what any MD/DO should state about this-- it is unproven but does show some promise.
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Barnyard96
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Is the bigger problem, the slow results of the tests? Once they fix that, wont many other things start to fall into place?

Player To Be Named Later
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Seems like people's best bet is to do all they can to avoid contracting this virus for the next 4 to 6 weeks until testing catches up and we've waded through all the bureaucracy and red tape.

Can't say I'm super optimistic about what a diagnosis means for people currently.
Tx-Ag2010
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If I have to get it I'd much rather be one of several patients who are getting the doctors full attention and benefit of 4-6weeks of learning what works and what doesn't rather than ride it out in a tent with massive amounts of triage going on...
CardiffGiant
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Seems like we've been hearing about this for a month and yet we still have mass casualties going on. Why is that? Is there not enough supply of the drugs?
Barnyard96
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CardiffGiant said:

Seems like we've been hearing about this for a month and yet we still have mass casualties going on. Why is that? Is there not enough supply of the drugs?
Its largely due to testing. Many docs stating its taking 3 to 5 to 10 days to get a test results back. Big problem.
CardiffGiant
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So does a patient have to be confirmed through testing before a DR can administer these drugs to someone who has all the symptoms of COVID-19?
Pelayo
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CardiffGiant said:

So does a patient have to be confirmed through testing before a DR can administer these drugs to someone who has all the symptoms of COVID-19?
No. If clinical suspicion is high enough some including me are treating the at risk.
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Barnyard96
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Pelayo said:

CardiffGiant said:

So does a patient have to be confirmed through testing before a DR can administer these drugs to someone who has all the symptoms of COVID-19?
No. If clinical suspicion is high enough some including me are treating the at risk.
Are all hospitals now doing this for at risk?
Pelayo
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barnyard1996 said:

Pelayo said:

CardiffGiant said:

So does a patient have to be confirmed through testing before a DR can administer these drugs to someone who has all the symptoms of COVID-19?
No. If clinical suspicion is high enough some including me are treating the at risk.
Are all hospitals now doing this for at risk?
All? Doubtful. Most? Doubtful as well.
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Keegan99
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What is your sense of outcomes for those where you've done an earlyish (shortly after symptom onset) intervention with HCQ?
JD Shellnut
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So can doctors in Texas now prescribe it even with no test results in yet? I was under the impression that the state of Texas required a positive test first. Pardon my confusion.
Pelayo
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Keegan99 said:

What is your sense of outcomes for those where you've done an earlyish (shortly after symptom onset) intervention with HCQ?
Unfortunately the few I have treated were 7-10 days in. Four did great, one admitted icu a couple of days after. He was/is older.
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74OA
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Any feedback from the drug combo observational test throughout New York hospitals yet?
dermdoc
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First of all, I would be happy for Pelayo to be my doc. He and I think alike.

The problem with the use of hydroxychloroquine/azithromycin/zinc(from now on referred to as haz)is that it is being used on folks who already are severe or have ARDS. You want to treat them BEFORE the cytokine storm, not after.

That is why supply of haz is much more important than tests. Anybody with symptoms should be treated with haz. And as early as possible.

I personally would not even wait on a baseline EKG or "test" which can change day to day if I was treating a family member.
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dermdoc
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Fitch said:

No. If my family were to fall victim to it I would ask for HCQ, Azithoromycin and Zinc treatment out of the starting gates. I would demand it. But I would only do it with the same confidence as I roll the dice in Vegas, not because it's a doctors recommendation alongside other alternatives.

I think about that a lot these days.
Why am I not surprised that you and I think exactly the same on this? Stay safe my friend.
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Infection_Ag11
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JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?


The point is many (including some physicians and, sadly, our president) are pronouncing it as a panacea with definitive curative ability and that generates a false sense of security. Many, including many on our site here, are using this as an argument for discontinuing our current social distancing policies.

Nobody is saying it doesn't work or that it shouldn't be tried in certain patients. It might work, but the data currently is flimsy and we should not make policies on the basis that it has a strong efficacy in this disease. We also shouldn't blindly prescribe it to all suspected or even all confirmed COVID patients because even IF it works, the benefit doesn't outweigh the risk in every case.
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FriscoKid
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Pretty excited about this case too.

https://texags.com/forums/16/topics/3103692

Hearing what you docs are saying and seeing some of the stories I'm a firm believer.
Barnyard96
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Infection_Ag11 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?


The point is many (including some physicians and, sadly, our president) are pronouncing it as a panacea with definitive curative ability and that generates a false sense of security. Many, including many on our site here, are using this as an arguments for discontinuing our current social distancing policies.

Nobody is saying it doesn't work or that it shouldn't be tried in certain patients. It might work, but the data currently is flimsy and we should not make policies on the basis that it has a strong efficacy in this disease.
Bull**** The president never said it was a panacea or anything close to that.

But dont worry, plenty of doctors have pissed on our cheerios enough so we're not sure what to hope for anymore.

It all evens out in the end.
Infection_Ag11
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dermdoc said:

Anybody with symptoms should be treated with haz. And as early as possible.


While I respect your opinion I strongly disagree.

As an example, I have a friend in GI at a different institution currently managing a fulminant drug induced hepatitis from plaquenil in a resolved COVID case. Young guy who would have almost certainly been fine regardless but got an outpatient script for it. Now his COVID symptoms have completely resolved but he may end up needing a liver transplant.

Just be careful is all I'm saying.
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Boo Weekley
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KidDoc said:

74Ag1 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?

He is trying to defend his "wrong" position. He is a typical overly cautious Dr that wants to see all the clinical trials and tests that take a long time. Typical bureaucrat... slow.

All the use is saving lives but he want accept it. FDA has approved it.
This is 100% wrong.

Modern western medicine is based on scientific theory. We strive to do things that are PROVEN to work in large double blinded studies. We do not always have that luxury so we try stuff "off the cuff" now and then but any MD that says he knows his combo works is lying or selling your something.

The data is building and we should have good data in the next 4-6 weeks. Dr Fauci is just stating what any MD/DO should state about this-- it is unproven but does show some promise.
Sorry, some of that needs to go out the window when we know it's not a dangerous drug taken as prescribed and we are ripping up the constitution and demanding that society shut the F down and could be on the verge of entering Great Depression 2.0 with tens of millions of unemployment claims and lives ruined if this drags on much longer.

This is unprecedented and we are all having to adapt. The FDA and doctors who are only concerned with the virus itself, and not the complete collapse of society, need to adapt as well.
Infection_Ag11
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barnyard1996 said:

Infection_Ag11 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?


The point is many (including some physicians and, sadly, our president) are pronouncing it as a panacea with definitive curative ability and that generates a false sense of security. Many, including many on our site here, are using this as an arguments for discontinuing our current social distancing policies.

Nobody is saying it doesn't work or that it shouldn't be tried in certain patients. It might work, but the data currently is flimsy and we should not make policies on the basis that it has a strong efficacy in this disease.
Bull**** The president never said it was a panacea or anything close to that.

But dont worry, plenty of doctors have pissed on our cheerios enough so we're not sure what to hope for anymore.

It all evens out in the end.







I voted for the guy and love a lot of the things he's done, but he called it "one of the biggest game changers in the history of medicine".

He put the drug on a pedestal which, IMO, is irresponsible for someone in his position at this stage of the game.

I'll vote for him again in November, but he really does need to learn when to sit down and let others do all the talking.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Boo Weekley
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Infection_Ag11 said:

dermdoc said:

Anybody with symptoms should be treated with haz. And as early as possible.


While I respect your opinion I strongly disagree.

As an example, I have a friend in GI at a different institution currently managing a fulminant drug induced hepatitis from plaquenil in a resolved COVID case. Young guy who would have almost certainly been fine regardless but got an outpatient script for it. Now his COVID symptoms have completely resolved but he may end up needing a liver transplant.

Just be careful is all I'm saying.
What condition did he have? Perfectly healthy guy with no pre-existing liver conditions or anything of note in his medical records?
Proc92
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Infection_Ag11 said:

barnyard1996 said:

Infection_Ag11 said:

JB99 said:

SUag said:




What's the point of this? Is he saying not to use it until it's definitive? What does this accomplish?


The point is many (including some physicians and, sadly, our president) are pronouncing it as a panacea with definitive curative ability and that generates a false sense of security. Many, including many on our site here, are using this as an arguments for discontinuing our current social distancing policies.

Nobody is saying it doesn't work or that it shouldn't be tried in certain patients. It might work, but the data currently is flimsy and we should not make policies on the basis that it has a strong efficacy in this disease.
Bull**** The president never said it was a panacea or anything close to that.

But dont worry, plenty of doctors have pissed on our cheerios enough so we're not sure what to hope for anymore.

It all evens out in the end.







I voted for the guy and love a lot of the things he's done, but he called it "one of the biggest game changers in the history of medicine".

He put the drug on a pedestal which, IMO, is irresponsible for someone in his position at this stage of the game.

I'll vote for him again in November, but he really does need to learn when to sit down and let others do all the talking.
I thought he said it could turn out to be a game changer. He said maybe so, maybe not.
DTP02
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Didn't see this on here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

Study from NIH testing primate cells in lab setting showed chloroquine as "potent inhibitor of SARS coronavirus infection and spread." It worked as a pre-infection prophylactic and in inhibiting spread in early stages of post-infection.
Barnyard96
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Thank you Mr President for putting it on a pedestal so the average american will know about the drug and push the conversation. I know it will make many doctors and scientists uncomfortable that you broke their protocols, but they will get over it. Or, maybe they won't.

Infection_Ag11
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Boo Weekley said:

Infection_Ag11 said:

dermdoc said:

Anybody with symptoms should be treated with haz. And as early as possible.


While I respect your opinion I strongly disagree.

As an example, I have a friend in GI at a different institution currently managing a fulminant drug induced hepatitis from plaquenil in a resolved COVID case. Young guy who would have almost certainly been fine regardless but got an outpatient script for it. Now his COVID symptoms have completely resolved but he may end up needing a liver transplant.

Just be careful is all I'm saying.
What condition did he have? Perfectly healthy guy with no pre-existing liver conditions or anything of note in his medical records?


My understanding is he was a completely healthy individual in his late-30s with no prior liver disease. Hepatotoxicity is an uncommon but known complication of Plaquenil.
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Infection_Ag11
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barnyard1996 said:

Thank you Mr President for putting it on a pedestal so the average american will know about the drug and push the conversation. I know it will make many doctors and scientists uncomfortable that you broke their protocols, but they will get over it. Or, maybe they won't.




But rest assured, we'll still get blamed when that patient has an adverse reaction to the drug. Especially in a patient who had a very low probability of developing severe disease from COVID.
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SMM48
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Wow that's crazy
Infection_Ag11
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SteveMedina said:

Wow that's crazy


The thing is stuff like that stops being crazy after a while, which is why we're accused of being over cautious all the time. I hear "they're just antibiotics" all the time, but you see enough C. Diff, drug induced liver injury, bone marrow suppression, etc. and you learn to respect them.

Every rheumatologist alive is pulling their hair out right now hearing everyone say "it's just Plaquenil".
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dermdoc
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With all due respect, the same thing can happen with Tylenol. I have used plaquenil for decades as have rheums I know with out ever hearing of this side effect. And it is interesting we used to have to check a G6pd. Weird.

With all due respect, I kind of throw caution out the door when I am dealing with a pandemic. And I would be pissed if a doc did not start me or my family on the cocktail if the meds were available.

And sir, I am in the cheap seats and you are in the front row. I am definitely not qualified.
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