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04-13-2020, 05:50 PM | #20491 | |
I love your mom
Join Date: Feb 2020
Location: Sturgeon Falls, Ontario
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My wife says it’s not something she would take unless she really had too , I understand for some it is s last ditch effort. |
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Posts: 6,635
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04-13-2020, 05:52 PM | #20492 |
I love your mom
Join Date: Feb 2020
Location: Sturgeon Falls, Ontario
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Their dosage doesn’t seem that extreme.
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Posts: 6,635
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04-13-2020, 05:53 PM | #20493 | |
Supporter
Join Date: Feb 2005
Location: Olathe, Ks
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Posts: 128,256
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04-13-2020, 05:53 PM | #20494 | |
Life is changing..
Join Date: Jul 2012
Location: NW Missouri
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Posts: 39,072
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04-13-2020, 05:59 PM | #20495 |
Supporter
Join Date: Feb 2005
Location: Olathe, Ks
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Barring some sort of surprise today looks to be a mirror image of yesterday on the totals.
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Posts: 128,256
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04-13-2020, 06:12 PM | #20496 |
Best Body On ChiefsPlanet
Join Date: Jan 2014
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Posts: 5,894
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04-13-2020, 06:14 PM | #20497 |
Now you've pissed me off!
Join Date: Jan 2006
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Okay, here's the deal with the Brazilian study:
1) They used chloroquine phosphate, not hydroxychloroquine (Plaquenil). Hydroxychloroquine dosages are normally smaller, but the chloroquine doses themselves are quite a bit above what a patient would normally receive for malaria. However, mechanistically, the drugs are the same. Hydroxychloroquine is given at a lower dose and is generally considered a safer drug, but if chloroquine is not efficacious, hydroxychloroquine is unlikely to demonstrate efficacy either. 2) The reason why the study was stopped was that 25% of the participants in the high dose arm (the low dose arm is still a high dose) developed a QTc interval of >500. This is not surprising given that the patients were also receiving azithromycin which also prolongs the QT interval. Clinicians get very nervous with a QTc above 500 because it greatly increases your risk of Torsades de Pointes, which is a fatal heart arrhythmia (imagine an inversion of your normal heart rhythm). 3) All patients in the trial were also being given ceftriaxone, which is a broad spectrum cephalosporin. It's a great drug and is often used for empiric therapy of a variety of infections patients may present with in the hospital; however, the results of that study would be muddied by its addition. There are other issues with trial design that I could point out, but it's not really necessary for the purpose of this discussion. More importantly, this is a teachable moment about anchoring. This is a common occurrence in medicine: someone will see a patient, begin reading their chart and latch on to a diagnosis or therapy without considering changes to the clinical picture as more information is unveiled. |
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04-13-2020, 06:21 PM | #20498 |
Forever Royal
Join Date: Mar 2012
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According to the article they were giving 600 mg and it was those high dose patients that had the heart problems and it was that part of the study that was stopped. The lower 450 mg dosage patients apparently did not have those issues.
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04-13-2020, 06:25 PM | #20499 |
Now you've pissed me off!
Join Date: Jan 2006
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Posts: 74,848
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04-13-2020, 06:26 PM | #20500 | |
I love your mom
Join Date: Feb 2020
Location: Sturgeon Falls, Ontario
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Posts: 6,635
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04-13-2020, 06:31 PM | #20501 |
Would an idiot do that?
Join Date: Nov 2000
Location: Arizona
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04-13-2020, 06:42 PM | #20502 | |
Life is changing..
Join Date: Jul 2012
Location: NW Missouri
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And a question.. Why are they set on using azithromycin? Couldn't you substitute another antibiotic that doesn't have the potential cardiac side effects? Why not just use doxycycline or something? |
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Posts: 39,072
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04-13-2020, 06:57 PM | #20503 |
Supporter
Join Date: Feb 2005
Location: Olathe, Ks
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final numbers a smidge better than Sunday but the same for the most part
+7 new deaths but -780 new cases |
Posts: 128,256
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04-13-2020, 07:02 PM | #20504 | |
Now you've pissed me off!
Join Date: Jan 2006
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Quote:
If you were concerned about the antibiogram and proper coverage, doxycycline would actually be a good choice as it is a broad spectrum antibiotic, like azithromycin, that also covers atypical pathogens. |
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Posts: 74,848
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04-13-2020, 07:27 PM | #20505 |
Inmem 2.0
Join Date: Aug 2007
Location: My house
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