Coronavirus Tidbits #25 3-31-20

Drugs:

No evidence for or against the use of non-steroidal anti-inflammatory drugs such as ibuprofen – Study, led by researchers at King’s College London, also found other types of drugs, such as TNF blockers and JAK inhibitors safe to use.

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Evidence suggests that ACE inhibitors and angiotensin receptor blockers may improve prognosis in COVID-19 hypertensive patients

Recent concerns that common antihypertensive drugs may have a negative effect in COVID-19 patients are not supported by the evidence, report scientists in a new review published in Mayo Clinic Proceedings

Patients with hypertension should continue taking anti-hypertensive medications.

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Shortages of medicines needed for placing patients on ventilators

The medicines include more than a dozen sedatives, anesthetics, painkillers, and muscle relaxants…There has been a 51% increase in demand so far this month for half a dozen different sedatives and anesthetics: propofol, dexmedetomidine, etomidate, ketamine, lorazepam, and midazolam. But the fill rate —  the rate that prescriptions were able to filled and shipped to hospitals —dropped from 100% at the beginning of the month to just 63% on March 24.

Similarly, the demand for three analgesics — hydromorphone, fentanyl, and morphine — rose 67% so far this month, while the fill rate fell from 82% to 73%. Meanwhile, the demand for four neuromuscular blockers — cisatracurium, rocuronium, succinylcholine chloride, and vecuronium — rose 39% while the fill rate plummeted to 70%.

‘The drug supply chain is one of just-in-time production and supplies…I am not sure that manufacturers are ramping up for the surge…nobody is talking about shortages due to a huge spike in demand.”

“Manufacturers also need time. An injection is going to need at least 21 days in quarantine after it’s manufactured — even if suppliers are ramping up ‘- Erin Fox, Director of drug-information service at University of Utah

This is also part of the fallout from the misguided War on Drugs.”