Wednesday, July 29, 2020

ADVISORY BOARD MEMBER ARTICLES - Novel Coronavirus Medicine Update: Newer and Existing Treatment- BY Dr. Hadia Rajesh,


Chief Editor’s Note: 

We the Pharmacists are the frequently contacted by the public among all the health care professionals and also a frontline warrior in COVID – 19 management.Though the most of the shops closed during the lockdown periods, pharmacies opened daily and served the mankind in the perilous period. Hence, pharmacy is considered as a noble profession. 

There are two strategic management i.e., “Red Ocean and Blue Ocean.” Pharmacists should adopt blue ocean strategies to bring some innovation in their profession. Slowly, our role shifting from dispenser to health care provider and we can also minimize the adverse impacts of COVID-19. Many research studies conducted shown that positive effect in COVID – 19 management by pharmacist. 

The role of pharmacists during COVID – 19 are, providing information and communication about COVID-19, availability of chronic diseases medicines, support to achieve rational medicines use, medication adherence promotion, medication review and follow up, clarify misunderstanding about COVID-19, minor illnesses consultations and conducting research on COVID -19 etc. 

This issue of our newsletter is focussed on COVID-19 related articles. Hope, these articles improve your knowledge about COVID-19 and its management. 


Novel Coronavirus Medicine Update: Newer and Existing Treatment



Continuous research and clinical trials are underway to handle the current Covid-19 crisis and find an effective therapy against the novel Coronavirus. The good news is that some of them have even started yielding positive results. Evidence based update about the recent advancements in Covid-19 treatment.


Favipiravir: Class of Drug: Antiviral: Favipiravir is a chain terminator in Coronavirus and also inhibiting an enzyme called RNA dependent RNA polymerase. This enzyme helps coronavirus to make more copies of itself. Restricting it means less viral copies leading to reduced number of viruses, less damage in the body, and quicker recovery.
Current Status Worldwide: Granted approved in Japan for novel influenza strains, Unlicensed USA and UK.Current Status in India: Drug Controller General of India (DCGI) granted approval for manufacturing & marketing to a pharmaceutical Company (Glenmark, Brand name: Fabiflu).People who is having mild-to moderate Coronavirus disease will get benefit from it.Cautions: Hypersensitivity to Favipiravir, Pregnancy, breastfeeding, Elderly and children. 

Remdesivir: Class of Drug: Antiviral: Mechanism of action is same as Favipiravir.
Current Status Worldwide: Granted approval for Emergency Use Authorization (EUA) by Food and Drug Administration (FDA) to treat adults and children hospitalized with severe COVID-19.
Current Status in India: Drug Controller General of India (DCGI) granted approval for manufacturing & marketing to a pharmaceutical Companies (Hetero Health Care, Brand name: Covifor) and (Cipla, Brand Name: Cipremi).Emergency use for the treatment of people hospitalized with COVID-19 will get benefit from it.Cautions: Hypersensitivity to Remdesivir, Severe impairment in kidney functions, High level of liver enzymes, Pregnant and lactating women, Children below 12 years of age. 

Dexamethasone: Class of Drug: Steroid: Works by suppressing the massive immune response evoked by the coronavirus, which may cause damage to lungs and other organs.
Current Status Worldwide: Granted Approval in UK to treat all people hospitalized with COVID-19, who require oxygen, including those on ventilators. Unlicensed in USA, exclusive recommendations for use of dexamethasone in people with COVID-19 have been released by the National Institutes of Health.Current Status in India: The Ministry of Health and Family Welfare has included dexamethasone in the updated clinical management protocol for COVID-19, after considering the latest available evidence and expert’s consultations. ICMR has taken a cautious approach towards the use of dexamethasone and is conducting its own trials since:-As per the experts, in India, the number of patients on ventilators is lower than the number of patients who require oxygen. Safety profile of corticosteroids in people with COVID-19 and having any preexisting conditions remains unclear.People who are hospitalized with severe respiratory complications of COVID-19, put on ventilator or oxygen support will get benefit from it.Cautions: Systemic fungal infections, Hypersensitivity to dexamethasone, cerebral malaria, cirrhosis, myasthenia gravis, renal insufficiency, peptic ulcer disease, ulcerative colitis, and people at higher risk for osteoporosis, pregnancy and lactation. 

Hydroxychloroquine: Class of Drug: Antimalarial: Works by interfering with the process of viral entry into the body’s cells.
Current Status Worldwide: WHO has stopped clinical trial on Hydroxychloroquine (HCQ) on 17th June 2020.Current Status in India: Phase 3 trial is being conducted to check role of Hydroxychloroquine for prevention of new infection and adverse outcomes following COVID-19 infection. Only approved for prophylaxis in high risk exposures and contacts.People will get benefit for Prevention of infection in asymptomatic healthcare workers, frontline workers and high-risk household contacts of confirmed positive cases.Cautions: Hypersensitivity to HCQ, retinopathy, G6PD deficiency, preexisting cardiomyopathy and cardiac rhythm disorders, Prophylaxis in children under 15 years of age, Pregnancy and breastfeeding.

References:

  • 1.      Hydroxychloroquine & COVID-19. WHO.
  • 2.      Clinical Trials Registry, India.
  • 3.      RECOVERY Trial, Oxford University News Release.
  • 4.      COVID-19 Clinical Management Protocol. MoHFW.

Dr. Hadia Rajesh, Pharm. D, Rph, Ph. D* (Pharmacy Practice)                      
Assistant professor,
Department of pharmacy Practice,
Sumandeep Vidyapeeth deemed to be University,                                     
Vadodara-391760
Mobile No: +919590677280




ROLE OF PHARMACIST IN COVID-19



The news nowadays is full of reports on corona virus. Everyone is panicking and scared. In this scenario, being aware and creating awareness will definitely help.
Coronaviruses or (CoV) are the viruses belonging to a large family, causing illness ranging from the common cold to more severe diseases. These diseases include Middle East Respiratory Syndrome or (MERS-CoV) and Severe Acute Respiratory Syndrome or (SARS-CoV). A novel coronavirus or (nCoV) has been identified as a new strain that has not been previously identified in humans. However, an outbreak of unusual respiratory condition was first reported in Wuhan, China, due to the infection caused by novel Coronavirus, now known as COVID-19.
This infection manifests as pneumonia, multi-organ failure, severe acute respiratory syndrome, and may even lead to death. It has become a pandemic and preventive measures are being employed for decreasing the prevalence of the disease. As the world is experiencing the outbreak of this infectious disease at present, it is important to know the role of Pharmacist in prevention of COVID-19

Pharmacists and Covid-19 pandemic:

Through public preventative measures advocated by WHO, the public are working together in their respective countries to ‘flatten the curve’. With a near enough global lockdown there seems to be an even greater dependence on pharmacists as the first point of contact to fulfill the public’s healthcare needs. Pharmacies around the world are one of the few places that are kept open for public service even during the strict lockdowns.
Pharmacists can give valuable information regarding about Do’s and Don’ts.

                                                                                   
ü         Wash your hands
ü         Practice respiratory etiquette
ü         Wear a mask
ü           Practice social distancing
    Inform over phone
ü           Follow the instructions given by Govt
ü           Stay updated with latest information
ü          Disclose your travel history over phone
¨     Don’t touch your face, eyes, nose, or mouth without washing your hands.
¨     Don’t hug, kiss or shake hands with anyone who is ill or has a cough, cold or fever.
¨     Don’t come in close contact with anyone, if you are unwell or have a cough, cold or fever.
¨     Don’t spit in public
 









References:

  1. International Pharmaceutical Federation. Coronavirus/COVID-19 preparedness.
  2. Corona.mygov.in
  3. Medvarsity.com
  4. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

              Dr.Raghavendra S.Hegde
             Pharm.D (PB), MBA., PGDHM., R.Ph (KSPC)
             Lecturer
             Dept of Clinical Pharmacy
             H.S.K College of Pharmacy, Bagalkot