In the recent outbreak of the deadly COVID 19, scientists across the globe are working day and night to find a cure or develop a vaccine that can protect the entire mankind. In this aspect, the first drug or the drug of choice as stated that comes to our mind is hydroxychloroquine. With all the developed countries buying large quantities of this medicine, we have to know every aspect of this drug, will it be a blessing or a curse in the current scenario.
Hydroxychloroquine belongs to a class of antimalarial drugs, it is used to treat malaria and other autoimmune diseases like SLE, rheumatoid arthritis, chronic discoid lupus erythematosus, in case of malaria, it is given to patients sensitive to chloroquine.
MECHANISM OF ACTION OF HYDROXYCHLOROQUINE
The mechanism of action of hydroxychloroquine in the case of malaria is that it accumulates in the lysosome of the parasite, raising the pH of the vacuole, thereby inhibiting the normal growth and replication of the parasite. Its accumulation in the human organelles also raises the pH, inhibits antigen processing, and also antigen presentation of the cell and finally reducing the inflammatory response.
In the case of SARS-CoV and SARS-Cov-2, the raised pH in the endosomes prevents the virus particles from fusion and entry into the cell. It also inhibits the terminal glycosylation of ACE2 which is the receptor for SARS-CoV and SARS-CoV-2 for cell entry, this process makes the ACE2 less glycosylated, this, in turn, may interact with the SARS-CoV-2 spike protein less efficiently thereby inhibiting the viral entry.
ADVERSE EFFECTS OF HYDROXYCHLOROQUINE
The common side effects caused by this drug includes,
- Loss of appetite
- Dizziness etc…
The case in which we have to consult the doctor includes the following conditions,
- Difficulty in hearing
- Ringing in ears
- Blurred vision
- Sensitivity to light
- Irregular heartbeat
- Seeing flashes of light etc….
However its use in COVID -19 still need to be approved, there has been many opposing and supporting arguments on this, many places, around the globe the use of this drug in critically ill patients affected with Covid-19 was fatal, especially in case of cardiac patients, it can cause irregular heart rhythm, extremely low blood pressure and muscle and nerve damage. Some studies suggest that the use of the drug can be deleterious to both the patient and public health in their effort to contain the spread of the virus, by increasing the severity of the disease. However, the Indian Council of Medical Research has recommended the use of hydroxychloroquine in very specific cases, as prophylactic by asymptomatic health workers involved in the care of confirmed or suspected cases and by asymptomatic household contacts of laboratory-confirmed cases of COVID -19. But the use of the drug as the drug of choice for COVID -19 is yet to be proven.