Can oral antiviral drugs be used once confirmed? Should you worry about interactions? Doctors reveal the truth behind drug jams
Omicron The number of confirmed cases in the local area has increased sharply in recent days. The command center announced that people in three categories: “home isolation”, “self-prevention period” and “home quarantine” have tested positive using rapid screening reagents at home and can be classified as such after being confirmed by medical staff after video consultation. Confirmed. The number of confirmed cases in Taiwan is expected to continue to rise, and people from all walks of life are concerned about whether oral antiviral drugs can be prescribed in time, so that high-risk groups can have “life-saving drugs” available during the golden time.
Can oral antiviral drugs be used once confirmed? Must meet 5 indications
Dr. Sun Maosheng, chief strategy officer of Guangtian General Hospital, said in an interview that prescribing oral antiviral drugs must go through several hurdles. First, the signing of a consent form for drug use. Since oral antiviral drugs are not eligible for drug injury relief, doctors must obtain informed consent from the patient. The drug’s pros and cons can be prescribed before it can be prescribed. The original consent form format has been simplified and has been changed to a method where the patient only needs to express consent for use during the video conference, which greatly reduces the explanation time.
Second, the scope of drug indications. Oral antiviral drugs mainly have five major indications, including: confirmed positive cases, within 5 days of the onset of illness, not yet requiring the use of oxygen (not progressing to severe disease), aged over 12 years and weighing More than 40 kg, non-pregnant women (pregnant women are currently included in the list of patients who can use Pfizer’s oral medicine, Paxlovid, which is evaluated by clinicians as the benefits outweigh the risks and can be used after being fully informed and consented), but Merck’s oral medicine, Monapiravir, is still Not recommended for pregnant women), it can be prescribed if it meets the indications and has any of the following 14 risk factors.
After SARS-CoV-2 infection, risk factors for severe illness include: age older than 65, diabetes, chronic kidney disease, cardiovascular disease (excluding hypertension), chronic lung disease (interstitial lung disease, pulmonary embolism, pulmonary hypertension, Tracheectasis, chronic obstructive pulmonary disease), tuberculosis, chronic liver disease (cirrhosis, non-alcoholic steatohepatitis, alcoholic liver disease and immune hepatitis), disability (attention-deficit and hyperactivity disorder, cerebral palsy, congenital disability, developmental or learning disability, spinal cord injury), mental illness (mood disorder, schizophrenia), dementia, smoking, BMI greater than 30 (or BMI greater than the 95th percentile for children and adolescents aged 12–17 years), pregnancy , diseases that affect immune function (HIV infection, congenital immunodeficiency, solid organ or blood stem cell transplantation, use of steroids or other immunosuppressants).
Do antiviral drugs interact with chronic disease drugs? Be careful when taking these medicines
However, if the patient is taking medications for chronic diseases, the risk of drug interactions and serious side effects must also be considered. Dr. Sun Maosheng pointed out that there are many types of drugs that can interact with oral antiviral drugs, and they are divided into red, orange, yellow and green levels according to the level of risk. Red indicates that concurrent use is prohibited, and orange must be used with caution after evaluation by a physician.
Since many patients may be taking more than one drug at the same time, interactions are an important consideration before prescribing a drug. Dr. Sun Maosheng gave an example. For people taking antiarrhythmic drugs, some antihyperlipidemic drugs, and people with third-stage liver cirrhosis, the risk of drug interactions is relatively high. Doctors may adjust their medication or prescribe other prescriptions with the same but different effects. types of medications to ensure patient medication safety.
At this stage, the number of people infected with the epidemic continues to increase, and there is still a certain proportion of moderate to severe cases. Oral antiviral drugs can reduce the risk of hospitalization or death by 89%. Dr. Sun Maosheng believes that the indications for oral antiviral drugs are to be used within 5 days of the onset of illness, which exceeds It will no longer meet the indications after 5 days. Therefore, if the indications are met, the sooner the medicine is available to the diagnosed patients, the better.
Dr. Sun Maosheng reminded that the absorption rate of oral antiviral drugs is good, and there is no need to worry about the absorption effect before or after meals or being affected by food. Paired with the cloud medication record, doctors can know the patient’s medication information in real time and avoid drug interaction problems. Now the main hope is to improve the administrative process of diagnosis notification, as well as network system congestion and other problems, to further speed up the speed of drug prescribing, so that more patients can take drugs in a timely manner.
The number of severe cases and deaths is the key! Doctor: There is hope of liberation after passing the final stage
Omicron is highly contagious, and the number of local confirmed cases surges by more than 50,000 to 60,000 every day. Medical institutions must simultaneously respond to the needs of the public for consultation, admission, notification, prescribing medicine, and issuance of diagnosis certificates. How to simplify the process and maximize medical human resources? It will be a big test to use it where it is needed most.
Dr. Sun Maosheng pointed out that after the three categories of people who are quarantined at home are treated as confirmed by rapid screening and go on the road, the triage of mild, moderate and severe cases should continue to be implemented. Patients can also have relatives and friends bring relevant documents and information to the hospital to collect medicines on their behalf through video conferencing, or have them receive medicine on their behalf. Prescriptions issued by the hospital can be collected from core pharmacies in various locations. If the administrative process for notification of confirmed cases is delayed, it may cause people to exceed the indication time limit when they want to receive antiviral drugs, increasing the risk of severe illness.
“Now we are no longer concerned about the number of confirmed cases, but about whether there is a sudden increase in the number of severe cases and deaths!” Dr. Sun Maosheng said that Omicron has gradually evolved into influenza-like disease, and the number of infections is expected to continue to rise, and a greater proportion of the population will be protected by immunity. , medical institutions are doing their best to prevent serious illness and deaths from rising. The peak of the epidemic in the next 1 or 2 months will be the “final stage”. Once it is over, it is expected to be “liberated” and return to normal life.
Dr. Sun Maosheng pointed out that hospitals in various places have currently used methods such as opening epidemic prevention clinics and green channels in the hospital to retain medical manpower as much as possible and focus on caring for moderate and severe patients. The public is reminded that they should still conduct complete independent health management before the peak of the epidemic, and high-risk groups should also be fully vaccinated.
source:
Publicly Funded COVID-19 Treatment Oral Antiviral Drug Receipt Program
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