“The precise mechanism of action in chloroquine is poorly understood”, Pharmacist Iniobong Usen

1188 views | Anne Molokwu | April 3, 2020

In this interview, Pharmacist Iniobong Usen, who is also a chemist and the owner of a reputable pharmacy in Uyo, shares her understanding of the viral disease. Her answers to certain questions about COVID-19 will not only clarify the misinformation surrounding the treatment of the virus but also help in protecting you and your loved ones against the pandemic.

Q: What is COVID-19? 

A: According to WHO, it is an infectious disease caused by a newly discovered Coronavirus. Most people infected by it would experience mild to moderate respiratory illness and recover without special treatment. Older people and those with underlying medical conditions such as chronic respiratory disease, cardiovascular disease, diabetes, and cancer are more likely to develop serious illness.

Q: How is it transmitted?

A: The virus is transmitted when the fluid from an infected person comes in contact with a person who is not infected. This could be by touch. When this happens, the unsuspecting victim goes on to wipe his/her face with unwashed hands, and also eat with the same hands. The activities carried out by the victim encourages the contraction and spread of the virus.

Q: What are the symptoms, are they similar to that of any other viral, bacterial or fungal infections?

A: The symptoms are fever, cough, tiredness, shortness of breath etc. Yes, its symptoms are similar to that of common cold and flu which is a self-limiting viral infection and can be mistaken for pneumonia.

Q. What are the preventive measures?

A: Frequent washing of hands with soap and water, use of alcohol-based hand sanitizers, coughing/sneezing into a Kleenex or paper towels and dispose of properly, avoiding touching the eyes, nose and mouth, avoiding contact with sick people especially if you are not a health care professional, practising social distancing by restricting yourself to the use of telecommunication, subscribing to online meetings/seminars/customer care and work from home.    

Q. What information about COVID-19 can you share from WHO, CDC, UNICEF, UN or the Ministry of Health? 

A: WHO launched a global trial of the four most promising COVID-19 treatment options. The first is an experimental antiviral compound called remdesivir. The second is the malaria medications called chloroquine and hydroxychloroquine. The third is a combination of two HIV drugs called lopinavir and ritonavir. The fourth is a combination of lopinavir, rotinavir, and an immune system messenger that can cripple viruses called interferon-beta. The study trial is still on-going and a conclusive result is yet to be released.

Q: Tell us about Chloroquine?

A: Chloroquine belongs to the 4-aminoquinoline compound. It has antimalarial and anti-inflammatory properties. It also has the potential for chemosensitization and radiosensitization activities.

Q. Do the chemical properties of chloroquine suggest it kills viruses?

A: It has been used as an antimalarial, ameobicide and immunomodulatory agent, but its precise mechanism of action is poorly understood.

Q. Are there other drugs with similar chemical properties that can be used as its substitute while treating a medical condition?

A: Yes. There are similar drugs like hydroxychloroquine and amodiaquine.

Q. What is the usual dosage of chloroquine in treating some medical conditions?

A: For malaria, the prescription is usually 1000mg to be taken on day 1 and day 2, then 500mg on day 3. For amoebiasis, the prescription is usually 500mg which is taken daily for 7 to 14 days.

Q. Does it have adverse effects on overdose?

A: Yes! It has adverse effects. When the right dosage is administered, it has mild to moderate side effects on some patients talk more of an overdose. The most common adverse effects are general body itching and hives. The recent high demand for chloroquine is due to the news all over the internet that it can be used in the treatment of COVID-19. I advise you not to self medicate on any drug. Report to any trained medical professional if you notice any symptoms of COVID-19.

Q. Do you think chloroquine can be used in the treatment of COVID-19 as many are suggesting?

A: COVID-19 is an emergent disease and the treatment protocols are still being investigated. Only those scientists, medical professionals and countries who have had experience in managing patients with the virus can answer that question correctly.

Q. Dettol antiseptic disinfectant mentioned coronavirus as one of the viruses it kills, how true is that?

A: Yes, it can kill it when used at the right concentration, and also following the manufacturer’s instructions.

Q. What is an alcohol?  

A: In chemistry, an alcohol is an organic compound with a hydroxyl functional group bound to a saturated aliphatic carbon atom. It is an flammable, colourless liquid with a boiling point of 78.5 degree Celsius and a melting point of -14.5 degree Celsius. Alcohol is used to manufacture alcoholic drinks, industrial methylated spirits, used as fuel, used as a solvent especially in the manufacture of perfumes and cosmetic products, and also in the manufacture of industrial feedstock.

Q: Does alcohol have any effects on viruses, and have the potential to be used as a preventive measure against COVID-19?

A: Yes. Alcohol could be used at proper concentrations to prevent the spread of COVID-19. The use of alcohol-based hand sanitizers could be employed and not indulging in drinking of alcoholic beverages like beer.

Q:  Why are social distancing and working from home a necessity?

A: The best way to curb the spread of the virus is isolation. Everyone should not go to work unless it is absolutely necessary and that in my opinion. However, this does not apply to health care workers and those that provide essential necessities. China had to do a total lockdown of all activities except in the health sector, in order to do get rid of it. 

Q: Do you think food hoarding is a necessity at this time, considering the rate at which people are stocking up on food items?

A: No! It is not only unnecessary but it will also create inflation in the prices of food items, as well as food scarcity. Moreover, some people may not have the immediate resources needed to buy in bulk and may go hungry if every available food item in the market is bought up by those who could at the time. The same thing happened when chloroquine was purported as one of the preventive measures, if not the cure, for COVID-19. It is very simple, people should buy what they need and not for hoarding purposes.

Q: Compared to Ebola and Lassa fever, do you think COVID-19 is deadlier?

A:   No, I do not think so. I could say it is more contagious and therefore proper preventive measures and controls must be put in place at all levels in the community to mitigate its wildfire spread.

Conclusion: 

Clinical research during an outbreak of any kind of infectious disease is a challenging one. A lot is usually expected of the scientists who rigorously carry out the research and study trials. The pressure to hit the jackpot is always felt by the scientists as well as the public. In the meantime, everyone is advised to observe proper oral and respiratory hygiene. The recommended social distancing, working from home, and telecommunicating with friends and colleagues should be done by all to curb the spread of the virus.

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