Cant Think of a Name said:

---

Hey, the guy above me copied me!

The Texas Medical Board (or whomever makes these decisions) wont authorize this drug treatment without a confirmed test. The tests are taking 5-7 days to get results, and are highly inaccurate. This treatment works best if administered in the first 7 days.

Anyone else see a problem here?

---

Cant Think of a Name said:

---

Hey, the guy above me copied me!

The Texas Medical Board (or whomever makes these decisions) wont authorize this drug treatment without a confirmed test. The tests are taking 5-7 days to get results, and are highly inaccurate. This treatment works best if administered in the first 7 days.

Anyone else see a problem here?

---

DTP02 said:

---

. We clearly don't have anywhere close to enough right now which is why many states are limiting prescriptions.

---

Player To Be Named Later said:

---

DTP02 said:

---

. We clearly don't have anywhere close to enough right now which is why many states are limiting prescriptions.

---

They aren't limiting it, they're wasting it by forcing Docs to give it to patients that won't see the best benefit from it.

---

Player To Be Named Later said:

---

DTP02 said:

---

. We clearly don't have anywhere close to enough right now which is why many states are limiting prescriptions.

---

They aren't limiting it, they're wasting it by forcing Docs to give it to patients that won't see the best benefit from it.

---

BadMoonRisin said:

---

Reveille said:

---

DTP02 said:

---

74Ag1 said:

---

https://www.independentsentinel.com/hydroxychloroquine-keeps-people-alive-at-the-smith-center/

---

[NOTE: they have now changed the link. My summary below linked and summarized the original video. You may just have to take my word for it because I'm not going to try to hunt down the original link]

I was just coming to post this. Here's a direct link to the show, with the interview starting a little after the 12 min mark:



It's an interesting interview on several fronts, although it's a bit disjointed.

A quick and dirty recap:

- ID Clinic in NY has 70+ COVID patients. The majority are diabetic, pre-diabetic, and/or obese, so lots of high risk folks. Mentions some study from Seattle that zeroes in on the high incidence of diabetes and obesity among serious COVID patients and that this probably isn't getting enough attention

- He's giving hydroxychloroquine and Zithromax to all of his patients and has not lost any yet.

- here's the big point: none if the patients that had been on the protocol for even 3 days needed to be intubated

- of the ~20 patients who needed to be intubated they all came to the clinic fairly late in the infection and had been on the protocol for 2 days or less. He agrees that the protocol is a game-changer.

- he is concerned about side-effects of the protocol, especially given most of his patients have other risk factors, so they've been monitoring EKGs. Only two EKGs showed any concerning readings after starting the protocol.

---

I watched this night also! Was very interesting and looks very promising. He stated being an infectious disease doctor he hasn't read EKG's in over 20 years so had them read by an electrophysiologist and they found two with slightly widening QT Intervals. He did say that they were also on other medications that prolong QT Interval.

I think it also reiterated what we have been thinking and that diseases that cause weakening of the immune system like diabetes put you at high risk is serious disease!

---

Does the potential prolonged QT interval that is a side effect of this medication last only while the patient is on the medication, or is there a risk that it would prolong it permanently?

---

P.U.T.U said:

---

The Texas board of Pharmacy is limiting it since doctors were writing prescriptions to themselves for hundreds at a time to give to their families and friends.

---

aginlakeway said:

---

P.U.T.U said:

---

The Texas board of Pharmacy is limiting it since doctors were writing prescriptions to themselves for hundreds at a time to give to their families and friends.

---

This is a fact. First-hand knowledge. (from pharmacy side)

---

AG 2000' said:

---

To the docs, are you guys modifying approach at all with this?

Sister is a medical consultant up in Colorado and shared that one of her facilities is having great success with the HCQ / Zpac combo.

She said they're starting anti-virals and antibiotics as soon as someone's got symptoms, and also admitting those in 'risk' groups who have initially mild presentations.

Said getting them started early is key, but they haven't lost a patient yet.

---

AG 2000' said:

---

Sister is a medical consultant up in Colorado and shared that one of her facilities is having great success with the HCQ / Zpac combo.


Said getting them started early is key, but they haven't lost a patient yet.

---

AG 2000' said:

---

To the docs, are you guys modifying approach at all with this?

Sister is a medical consultant up in Colorado and shared that one of her facilities is having great success with the HCQ / Zpac combo.

She said they're starting anti-virals and antibiotics as soon as someone's got symptoms, and also admitting those in 'risk' groups who have initially mild presentations.

Said getting them started early is key, but they haven't lost a patient yet.

---

Player To Be Named Later said:

---

That's not how our country works though.

---

DTP02 said:

---

AG 2000' said:

---

To the docs, are you guys modifying approach at all with this?

Sister is a medical consultant up in Colorado and shared that one of her facilities is having great success with the HCQ / Zpac combo.

She said they're starting anti-virals and antibiotics as soon as someone's got symptoms, and also admitting those in 'risk' groups who have initially mild presentations.

Said getting them started early is key, but they haven't lost a patient yet.

---

To be clear, they aren't waiting for a positive test first, right, just symptom onset?

---

dermdoc said:

---

Player To Be Named Later said:

---

That's not how our country works though.

---

And people want government run health care. Oy vey.

---

P.U.T.U said:

---

The Texas board of Pharmacy is limiting it since doctors were writing prescriptions to themselves for hundreds at a time to give to their families and friends.

---

AG 2000' said:

---

DTP02 said:

---

AG 2000' said:

---

To the docs, are you guys modifying approach at all with this?

Sister is a medical consultant up in Colorado and shared that one of her facilities is having great success with the HCQ / Zpac combo.

She said they're starting anti-virals and antibiotics as soon as someone's got symptoms, and also admitting those in 'risk' groups who have initially mild presentations.

Said getting them started early is key, but they haven't lost a patient yet.

---

To be clear, they aren't waiting for a positive test first, right, just symptom onset?

---

Correct. They're on the outskirts of Denver. Were getting told 5-7 day turnaround time on test results. The docs there agreed that the patients could very well be dead before they got results back.

So they're treating on symptoms. Said they even stopped asking the dumb questions like "have you been to China or Italy recently". They've got confirmed community spread in their county and city, set that aside as a screening question.

---

McInnis 03 said:

---

Derm, sounds like you need to call Abbott (gov, not labs) and give him an earful. If TX Bureaucracy is costing lives, I'm sure a good Aggie can get the message across to him.

---

JJMt said:

---

Reveille said:

---

Pelayo said:

---

dermdoc said:

---

Yes you will get crucified if some one has an adverse reaction and maybe sued.

I agree completely! I believe you do what's right!

I have been sued once and won. And it still haunts me sometimes. But I know it is better to do what is right. And trust God to protect you.

---

Yep

---

I agree completely!

---

I agree completely, also, and I'm a lawyer!

I've often thought that one way to reform our tort system, including malpractice claims, is to make the losing plaintiff lawyer(s) have to pay the winning defendant's fees and costs. That would still keep the courthouse doors open for legitimate claims, but would ensure that the plaintiff lawyers made damn sure that the claim was legitimate before filing it.

Sorry for the derail. Back to the thread now.

---

dermdoc said:

---

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.

---

FriscoKid said:

---

McInnis 03 said:

---

Derm, sounds like you need to call Abbott (gov, not labs) and give him an earful. If TX Bureaucracy is costing lives, I'm sure a good Aggie can get the message across to him.

---

Yeah, just imagine he is an umpire.

---

BiochemAg97 said:

---

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.

---

cisgenderedAggie said:

---

Marcus Aurelius said:

---

Hydrochloroquine has essentially no side effects. Remdesivir - not alot of data. Anectodally - nothing . Contraindicated with increased LFTS.

---

Hydroxychloroquine can cause irreversible retinal damage and sudden cardiac death.

---

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.

---

Just to piggyback on what Dermdoc has said. Below are the risk factor for retinal toxicity. The thing to focus on is the total cumulative dose of 1,000 grams. None of these patients will get close to this. As an optometrist I have very little concern for retinopathy from patients taking this medication for COVID. Retinal toxicity is very rare in patients that take hydroxychloroquine long term for underlying autoimmune diseases.

• daily dose greater than 400 mg (or, in people of short stature, a daily dosage over 6.5 mg/kg ideal body weight) or total cumulative dose of more than 1,000 g
• medication use longer than five years
• concomitant renal or liver disease (because the drug is cleared by both routes)
• underlying retinal disease or maculopathy
• age greater than 60 years.