Fleet Surgeon Article June_July 2022

Fleet Surgeon Article June_July 2022

Hydroxychloroquine – Is it safe or not?

Quinine was isolated from the Chinchona Officialis tree bark in Peru. It has been used in the past for treatment of malaria. In 1825, a British Army officer in India discovered that the bitter medication was more palatable if mixed with gin and so, the gin and tonic was born. Now, this article has nothing to do with quinine but it seemed like a less dry lead–in to discuss the track record of hydroxychloroquine safety. We shan’t discuss whether or not to use it for COVID but just the fact that it is almost as old as Methusalah. So, let’s mix a G and T with a wedge of lime and read on…

Anchorlines, June/July 2022

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Spoiler alert

This article addresses a medical and political hot potato, namely studies on the safety of hydroxychloroquine (HCQ). It does not presume to comment on its efficacy as an antiviral. Reasons for topic selection are threefold: members have asked about the issue, it remains very germane, and it piqued my own interest after having come across some medical literature. Our club is blessed with a smart membership that can think independently and this is offered with respect for your consideration. As an aside, this is not my area of medicine but I have been fortunate to have written a number of medical articles and book chapters to the literature and know my way around PubMed and literature searches.

Your Fleet Sturgeon’s short answers based on available literature:

1. Is hydroxychloroquine safe? Short answer: yes, based upon years of experience and recommendations/reviews by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) 1,2 The WHO has it on its list of essential medicines as well. 3 2. Some COVID studies have shown toxicity of HCQ; were these studies well–done? It turns out that some of these appear to have been designed to show side effects of hydroxychloroquine. 4,5 3. Cardiac concerns (discussed below) are the main issue and patients should avoid higher doses used in some studies.

Anchorlines, June/July 2022

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Origins of chloroquine (CQ) and hydroxychloroquine (HCQ)

The bitter bark from a high altitude tree from S outh American was known to have curative qualities back in the 1600s. French chemists identified quinine and its use for periodic fever diseases. 6 Bayer Dye Works, Germany identified chloroquine (CQ) in 1934. The WHO was established to deal with malaria. It selected chloroquine and dichlorodiphenyltrichloroethane (DDT) as their program to eradicate the disease. 6 The latter had the disastrous wildlife effect of thinning bird eggshells and its use ceased. Hydroxychloroquine (HCQ) was identified in 1946 and found to have 40% less toxicity than chloroquine. 7

Past findings on safety of CQ and HCQ

Fortunately, these medications have a long history of use with much >Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12

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