Just wondering ... we know that both hydroxychloroquine and ivermectin have had significant success as treatments for covid. Yesterday, I saw a South African doctor, doctor Chetty, speaking about the great success he'd had with promethazine. (A drug I've not previously heard of) Also, a few days or a week ago someone posted a link about Niacin and Melatonin being used by a doctor with promising results.
So my question for you pharmalogical types is, do you see a connection between those drugs? I am just curious if they have something in common that would explain why they have all been successful, OR, if it just happens that they are all completely different, yet effective in their own ways. Would love to hear your expertise on the matter. Thanks!
Not a pharmacist but have related training.
The mechanisms of action for these medications are all significantly different from one another.
HCQ: The antimalarial agents chloroquine and hydroxychloroquine have been used widely for the treatment of rheumatoid arthritis and systemic lupus erythematosus. These compounds lead to improvement of clinical and laboratory parameters, but their slow onset of action distinguishes them from glucocorticoids and nonsteroidal antiinflammatory agents. Chloroquine and hydroxychloroquine increase pH within intracellular vacuoles and alter processes such as protein degradation by acidic hydrolases in the lysosome, assembly of macromolecules in the endosomes, and posttranslation modification of proteins in the Golgi apparatus. It is proposed that the antirheumatic properties of these compounds results from their interference with "antigen processing" in macrophages and other antigen-presenting cells. Acidic cytoplasmic compartments are required for the antigenic protein to be digested and for the peptides to assemble with the alpha and beta chains of MHC class II proteins. As a result, antimalarials diminish the formation of peptide-MHC protein complexes required to stimulate CD4+ T cells and result in down-regulation of the immune response against autoantigenic peptides. Because this mechanism differs from other antirheumatic drugs, antimalarials are well suited to complement these other compounds in combination drug therapy.
Ivermectin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203399/ This article provides a wonderful summary, particularly in Table 2. Too much for me to summarize here.
Promethazine: Promethazine is a phenothiazine derivative with antiemetic and antihistaminic properties. Promethazine antagonizes the central and peripheral effects of histamine mediated by histamine H1 receptors. The effects include bronchoconstriction, vasodilation and spasmodic contractions of gastrointestinal smooth muscle. In addition, this agent binds to muscarinic receptors, resulting in anticholinergic and antiemetic activities.
In summary, these medications have wildly different mechanisms of action, but they all appear to be effective at reducing the morbidity and mortality of Covid. Remember, Covid is a viral disease (for the first 7-10 days) followed by a huge immune response. This immune response is what kills people. Due to the complicated pathophysiology of the disease, there are many different potential targets for medical interventions.
Very interesting, thank you for the info. It's fascinating that they can all be different, yet they are all apparently effective for covid.
Incidentally, I saw a video on line of someone 'making hydroxychloroquine.' Basically, she simmered grapefruit and lemon peels. What was distilled down was bottled. Now, do you have any idea if this could actually be what we think of as hydroxychloroquine? Because if so, it would certainly be an easy thing for most everybody to make and have at hand, even for things like arthritis.
No problem. Yea, it's incredible to me how different they are, and yet how much each can help. And it's wonderful that, since they target different pathways, they can be used in combination with an additive effect to reduce morbidity and mortality.
I can't speak to making it that way and I am certainly not a chemist, I'm afraid. I know that it is, or is very similar to, quinine. I'm sure there are good instruction manuals out there for producing it safely.
Thanks. I was just reading through that ivermectin link, which I've actually seen before. It's very interesting. I am also fascinated that some doctor, don't remember his name, said Kory et all were hurting people with the ivermectin protocol and called on doctors to use the niacin / melatonin version. Hey, as long as there is a doctor who cares enough and is brave enough to prescribe any of the useful drugs, I'm thankful.