The Challenges of COVID-19 Treatment in Older Patients and Potential Drug Interactions

Öz

COVID-19 is a new Coronavirus disease that researchers have reported older age, male gender, and comorbidity are associated with a higher risk of severe disease and mortality. Unfortunately, there is no sufficient supporting evidence that any potential therapy improves outcomes in patients diagnosed with COVID-19. Currently, one of the most popular potential treatment options is hydroxychloroquine. However, it also has serious adverse effects (<10%), including QTc prolongation with a possible risk of torsades de pointes, hypoglycemia, neuropsychiatric effects, and retinopathy. Therefore, careful monitoring is required during hydroxychloroquine treatment, and there is an urgent need to develop safe and effective drugs to treat COVID-19 potentially.

Anahtar Kelimeler

• COVID-19
• drug interactions
• hydroxychloroquine
• older adults
• polypharmacy

Proje Numarası

yok

Yaşlı COVID-19 Hastalarında Tedavinin Güçlükleri ve Potansiyel İlaç Etkileşimleri

Öz

COVID-19, araştırmaların ileri yaş, erkek cinsiyet ve komorbiditenin daha şiddetli hastalık ve ölüm riski ile ilişkili olduğunu bildirdiği yeni bir koronavirüs hastalığıdır. Ne yazık ki, herhangi bir potansiyel tedavinin COVID-19 teşhisi konan hastalarda sonuçları iyileştirdiğine dair yeterli destekleyici kanıt yoktur. Şu anda en popüler potansiyel tedavi seçeneklerinden biri hidroksiklorokindir. Ancak hidroksiklorokin, QTc uzaması ile birlikte olası torsades de pointes riski, hipoglisemi, nöropsikiyatrik etkiler, retinopati gibi ciddi yan etkilere (<% 10) neden olabilmektedir. Bu nedenle, hidroksiklorokin tedavisi sırasında dikkatli izlem gereklidir ve COVID-19'u tedavi etme potansiyeline sahip güvenli ve etkili ilaçların geliştirilmesine acil ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• yaşlı
• COVID-19
• İlaç etkileşimleri
• hidroksiklorokin
• polifarmasi

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Kaynakça

1. 1. Chan KW, Wong VT, Tang SCW. COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. The American journal of Chinese medicine. 2020 Mar; 13:1-26.
2. 2. Ates Bulut E, Soysal P, Isik AT. Frequency and coincidence of geriatric syndromes according to age groups: a single-center experience in Turkey between 2013 and 2017. Clinical interventions in aging. 2018; 13:1899-1905.
3. 3. Sanders JM, Monogue ML, Jodlowski TZ, et al. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020 May; 323(18):1824-1836.
4. 4. Taccone FS, Gorham J, Vincent JL. Hydroxychloroquine in the management of critically ill patients with COVID-19: the need for an evidence base. Lancet Respir Med. 2020 Jun ;8(6):539-541.
5. 5. Geleris J, Sun Y, Platt J, et al. Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. N Engl J Med. 2020 Jun; 382(25):2411-2418.
6. 6. Dixon DL, Van Tassell BW, Vecchie A, et al. Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19). Journal of cardiovascular pharmacology. 2020 May;75(5):359-367.
7. 7. https://www.covid19-druginteractions.org/. Accessed in 6th July 2020.
8. 8. Lexicomp® Drug Interactions. https://www.uptodate.com/drug-interactions/#di-druglist. Accessed in 7th July 2020.

9. 9. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed in 6th July 2020.
10. 10. U.S. Food & Drug Administration News Release: Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-and. Accessed in 18th June 2020.