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Chloroquine has been mentioned widely as a treatment for COVID-19 and President Trump recently mentioned it favorably. There is some in vitro science and mechanistic support for this use (it exhibits antiviral properties against both SARS and COVID-19 coronaviruses), demonstrated clinical utility in SARS, and shows promise in use against COVID-19.
Like many human drugs, it also has veterinary use, and one example of this has hit the headlines. Not only have the usual MSM sources done their usual sterling job of reportorial misfeasance and malfeasance, (combined with Blame Trump, of course) the conservative snarkitariate has been spreading the fake news, demonstrating the wisdom of the old advice to engage brain before putting mouth in gear.
An Arizona man has died after ingesting chloroquine phosphate — believing it would protect him from becoming infected with the coronavirus. The man’s wife also ingested the substance and is under critical care.
The toxic ingredient they consumed was not the medication form of chloroquine, used to treat malaria in humans. Instead, it was an ingredient listed on a parasite treatment for fish.
The couple unfortunately equated the chloroquine phosphate in their fish treatment with the medication —known as hydroxychloroquine — that has recently been touted as a possible treatment for COVID-19, which has infected more than 42,000 people in the U.S. and killed at least 462.
Ace of Spades does a great job of addressing the media malfeasance/blame Trump aspect but displays just as much ignorance as did NBC. And, sadly as the Arizona couple.
Ben Shapiro likewise, and reportedly President Trump retweeted this:
Blaming Trump for someone ingesting fish tank cleaner is a new level of Trump Derangement Syndrome.
— Ben Shapiro (@benshapiro) March 24, 2020
During a press conference, Trump spoke about studies that showed chloroquine (generic name hydroxychloroquine) treated coronavirus.
So this elderly couple in Arizona thought the additive chloroquine phosphate in fish tank cleaner was the same thing.
They proceeded to drink the fish tank cleaner.
The man died. The woman is in ICU.
One of the last things my stepfather A”H said was “just don’t add to the confusion.” Ben, Mary, Ace… you’re confusing things. You ought to know better.
First the disclaimer: I’m not an MD, DO, NP or PA. Or DVM. I can’t write prescriptions for drugs. That said, I majored in biochemistry and minored in chemistry, have practical experience as a lab tech (meaning weighing out precise amounts of powders, measuring precise amounts of liquids, and mixing them up.) Also meaning having survived a few hazardous situations along the way (sulfuric acid geyser, anyone?) some of which definitely did not make me stronger though they obviously didn’t kill me. and have been reading medical and then biomedical primary and secondary literature for more than 50 years now.
Now the attempt at correction:
There are two forms of chloroquine used in medicine; Hydroxychloroquine which is available as a generic or as the brand name drug Plaquenil. There is also chloroquine itself, which is most commonly dispensed as, yes, Ben, yes, Mary, yes Ace’s moronic commentators, chloroquine phosphate. The sulfate and dihydrochloride are also used.
Chloroquine phosphate/(etc.) and hydroxychloroquine are used similarly in medicine and both have in vitro activity against the SARS and COVID-19 viruses and some reports of efficacy in COVID-19 patients, including gravely ill ones; hydroxychloroquine may be more effective against COVID-19 but both chloroquine and hydroxychloroquine have been and are being used right now.
So what’s with this “fish tank cleaner?”
Chloroquine phosphate isn’t an aquarium cleaner per se, but it kills some organisms that cause some fish diseases and I think mung in the tank.
If you’re a fish fancier, you already probably know more about this than I do, if it’s just your satiable curiosity, Professor Google will tell you more than you want to know.
So what were these people doing with it on their shelf?
Ag and veterinary suppliers used to be sort of loosey-goosey and sold antibiotics for animal use some of which were identical to human meds, and preppers often took advantage of this in stocking up for TEOTWAWKI. This has pretty much been shut down and you need a prescription from a veterinarian, at least to get pharmaceutical grade stuff, though you can still take your chances on eBay, or could until the last couple of days; they’ve shut down chloroquine sales as have pretty much everybody else any semi-sane person will buy from.
They took it driven by fear:
The couple — both in their 60s and potentially at higher risk for complications of the virus — decided to mix a small amount of the substance with a liquid and drink it as a way to prevent the coronavirus.
“We were afraid of getting sick,” she said.
The veterinary chloroquine products come as tablets and powder; assuming the NBC reporter got at least one thing right, “decided to mix” makes it sound as though they had the powder on hand.
The therapeutic, toxic and lethal ranges are usually considered to be 0.03 to 15 mg/l, 3.0 to 26 mg/l and 20 to 104 mg/l, respectively. However, nontoxic cases have been reported up to 39 mg/l, suggesting individual tolerance to this agent may be more variable than previously recognized
The drug is very well absorbed and distributes pretty evenly in our body’s water, which (depending on size and body fat) is in 40 liters give or take (sometimes a lot.) So what goes in your mouth winds up in your body fluids.
Notice that there is substantial overlap between therapeutic and toxic blood levels: assuming that you have 40 liters of body water, the respective drug doses to get the above body fluid levels would be
therapeutic: 1.2 – 400 mg
toxic: 120 mg – 1040 mg (~ 1 g)
lethal: 800 mg – 4160 mg (~ 4.1 g)
These are actual measured postmortem levels in people being treated with the drug (“non-toxic” in the study meant that the dead patient was not exhibiting signs of chloroquine toxicity.) “Individual tolerance to this agent may be more variable than previously recognized” is probably understated.
It’s possible that there were some highly toxic additives in the chloroquine phosphate preparation the Arizona couple took, but fish fanciers tend not to like to put poisons in with their fish. We may learn otherwise later, but my guess is that in addition to taking a drug on inadequate indications, they took the wrong dose. It’s very, very easy to miscalculate a dose of almost anything. Lose your koi, that’s a shame. But taking it yourself?
Or maybe Arizona Man (or Woman) did do the dosing calculations right in theory and got killed by the variable tolerance.
If it had been a prepper after TEOTWAWKI, probably nobody would have known. Meanwhile, the upshot of this is that potentially useful disaster supplies are going to be harder to get.
There are a lot of things that can make you stupid. Fear is one of them.Published in