4- Thursday Pharmacotherapy News – 2nd September

1 – Kidney injury in COVID-19 patients, drug development and their renal complications: Review study

• Since December 2019, the world was encountered a new disease called coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
• SARS-CoV-2 may directly and/or indirectly affect the kidneys.
• The direct pathway is by binding to ACE2 in the kidney and damage to cells.
• An indirect pathway is created by cytokine storm and using nephrotoxic drugs.
• ATI degree in COVID-19 victim’s autopsies is milder than the degree of AKI.
• Likely several factors play a role in developing AKI following COVID-19
• This study review the mechanism of AKI induction and the renal side effects of the most common drugs used to treat COVID-19 after the overview of the latest findings on SARS-CoV-2 pathogenicity.

Source: ScienceDirect

2 – A secondary approach with conventional medicines and supplements to recuperate current COVID-19 status

• Novel coronavirus 2019 (COVID-19) is a zoonosis that revised the global economic and societal progress since early 2020. The SARS-CoV-2 has been recognized as the responsible pathogen for COVID-19 with high infection and mortality rate potential.
• Besides the symptomatic mainstay clinical therapeutic approach, only Remdesivir has been approved by the FDA.
• In this review, they have precisely compiled the efforts to curb the disease and discussed the clinical findings of Ivermectin, Doxycycline, Vitamin-D, Vitamin-C, Zinc, and cannabidiol and their combinations.
• Additionally, the correlation of these molecules on the prophylactic and diseased ministration against COVID-19 has been explored.

Source: ScienceDirect

3 – A preliminary study on the association of tamoxifen, endoxifen, and 4-hydroxytamoxifen with blood lipids in patients with breast cancer

• The long-term treatment with tamoxifen can alter the lipid profile of patients with breast cancer.
• Only a few studies associated the plasma concentrations of tamoxifen, endoxifen, and 4-hydroxytamoxifen with blood lipids, which is relevant as the distribution of these compounds for the tissues can be changed, negatively affecting the treatment.
• The aim of this preliminary study was to associate the plasma levels of tamoxifen and the active metabolites with the lipid levels.

Source: ScienceDirect

4- Prolonged Viral Shedding in Patients with Mild to Moderate COVID-19 Disease: A Regional Perspective

• The risk of transmission of Coronavirus Disease 2019 (COVID-19) is increasingly understood to be greatest early after symptom onset, however, factors associated with prolonged and increased risk of transmission remain unclear.
• In settings where COVID-19 prevalence is low, there may be a benefit of extending the period that patients are isolated to decrease the risk of transmission.
• This study explored the duration of viral shedding in such a location.
• This study demonstrates prolonged shedding of COVID-19 in patients with mild-moderate disease.
• It suggests that some patients with mild disease may have recrudescence of symptoms a week or more after their initial symptoms resolved.

Source: SAGE Journals

5 – COVID-19 and Antimicrobial Resistance: A Review

• As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind.
• AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19.
• This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship.

Source: SAGE Journals

6 – Insulin NPH for steroid-induced hyperglycemia: predictors for success

• Hyperglycemia is a common and difficult to manage adverse effect of steroid therapy.
• Management of steroid-induced hyperglycemia is not clearly defined, however treatment with neutral protamine Hagedorn insulin (NPH) may be beneficial owing to pharmacokinetic similarities to intermediate-acting steroids.
• This study aimed to evaluate the efficacy of NPH for steroid-induced hyperglycemia and identify factors associated with achievement of euglycemia.
• NPH is a safe and efficacious option for acute care hospitalized patients experiencing steroid-induced hyperglycemia.
• More aggressive dosing initiation of NPH based on steroid dose may allow for earlier achievement of euglycemia without a difference in hypoglycemia.

Source: ACCP

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