Tuesday, May 19, 2020

Hydroxychloroquine: A Cardiologist's View /200516

[Note: Due to the politicization of medical treatment decisions regarding COVID 19 and the obvious push for more expensive remedies that will benefit big Pharma, I asked Dr Grenzer to give the public a cardiologist's perspective on the medication, Hydroxychloroquine with Azithromycin as a treatment for COVID 19. Some have raised concerns that Hydroxychloroquine might be "unsafe" as a treatment.

Although every medication may have adverse effects, and a physician must consider these when prescribing any of them, it is very strange that there is suddenly such a concern about Hydroxychloroquine since it has been used safely for many decades and the World Health Organization has listed it as a safe medication and one of the "essential" medications to be on hand around the world. Yes, there can be adverse effects, but according to the physicians who use it regularly, these are quite rare.

Here is Dr Grenzer's perspective on the controversy. - Ron Panzer, Pres., Hospice Patients Alliance]

Hydroxychloroquine: A Cardiologist's View

by Louis E Grenzer, MD
Board Certified Cardiologist

May 16, 2020

Hydroxychloroquine has been around for 90 years and as is true with all drugs has some potential side effects.
Hydroxychloroquine's possible effects on the QT interval is not a major issue.
Azithromycin is one of the most frequently prescribed antibiotics. That drug is known to potentially prolong the QT interval which can be related to heart arrhythmias. So one should probably check an EKG to make sure the QT interval is not a problem. That said, I do not recall ever having to stop or avoid either drug for that reason.
There is good suggestive evidence that hydroxychloroquine will prove to be useful for Covid 19, especially when used early in the disease.
Doctors who treat a lot of Covid 19 patients note that patients very commonly quickly recover, with cure of the fever in just a few days, and I believe when the results of larger studies are available, the studies will be favorable -- particularly when the drugs are given earlier in the course of the disease.
As the side effects are not a big problem and the drug has been used for 90 years, i think the main issue is, "Does it work?"
We always like to see a controlled double-blinded study in a large number of patients, to prove the safety and efficacy of a drug. Doctors — who treat large numbers of patients — treat many diseases without that type of scientific evidence and do so before getting studies that "absolutely" prove how effective a drug is and do so without being challenged by politicians.
These are the type of decisions that we physicians make all the time.
Some Doctors, who are relied upon as so called "experts," often have not actually treated any patients in years. They may be afraid to suggest using a drug prior to having multiple large studies, and are sometimes less reliable in making such decisions.
It is apparent to me that the fake news and politicians are preventing physicians from using their professional judgment in relationship to this issue.
Doctors have been threatened with sanctions and even with the loss of their license by politicians, and the news media is promoting such threats.
So, I think that the media and politicians should keep their opinions on such issues to themselves.
I attended a lecture today by a very knowlegeable cardiac arrhythmia specialist on the topic of long QT interval where neither of the above two medications was mentioned. He did not have them on his list of drugs to worry about. The development of a prolonged QT interval needs to be looked for and it then becomes an issue for the physician to determine what to do. Doctors who treat patients make such judgments every day, and they consider the risk vs the benefit of their treatment plans.
My comments about news media, politicians, and so called experts applies to multiple other issues related to the covid 19 virus situation.
Yes, I am stating that we are being lied to for political reasons that should play NO role in such decisions!
In addition,conflicts of interest frequently explain such inappropriate advice.
If someone has a financial interest in a different medication, that person should not be relied upon to give advice, and certainly he should reveal that conflict.
As a physician, I find it upsetting that politicians and the media try to influence physicians in how to treat our patients.

THIS IS WRONG.

                                      — Louis E. Grenzer, M.D.

1.   See HydroxyChloroquine listed as safe and essential medicine:
World Health Organization Model List of Essential Medicines 2019
www.hospicepatients.org/world-health-org-model-list-of-essential-medicines-2019.pdf

2.    "What is the QT interval on electrocardiography (ECG)?"
www.medscape.com/answers/1894014-178295/what-is-the-qt-interval-on-electrocardiography-ecg

3.   Expert Lupus Doctor Says No COVID-19 in His Patients [who all take hydroxychloroquine for lupus]
www.educationviews.org/expert-lupus-doctor-says-no-covid-19-in-his-patients/
by Donna Garner April 8, 2020 EducationViews.org