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A sudden epidemic affects the hearts of hundreds of millions of compatriots across the country, always pay attention to the epidemic, care about health, has become the strongest theme of this Spring Festival, with the release of the National Health Commission's "Diagnosis and Treatment Plan for Pneumonia Infected by The New Coronavirus (Trial Fifth Edition)", ribavirin This old drug has once again entered the public eye, so what is its uniqueness? Today, the pharmacist will tell you about ribavirin's "past life and this life"!
"My" lineage and family
I, ribavirin, commonly known as viral azole, must have heard about me already!
I was the first nucleoside drug to be used in broad-spectrum antivirals through chemical synthesis. It was synthesized in 1970, listed abroad in 1974, and successfully imitated in China in 1981. It has a strong inhibitory effect on nearly 20 kinds of clinically common DNA and RNA viruses.
Originally approved by the FDA for respiratory syncytial virus infection, it was widely used in domestic clinical applications of viral infectious diseases, such as influenza A and B, children's hand-foot-and-mouth disease, hepatitis C and other diseases, and was even abused as a common cold medicine in previous years. I also want to make a name for myself here, I can't treat the common cold!
Fighting the coronavirus,
Why "I" was pushed to the front
I am a guanine analogue that rapidly phosphorylates after entering virus-infected cells, and the product acts as a competitive inhibitor of viral synthase, inhibiting inosine monophosphate dehydrogenase, influenza virus RNA polylyase and mRNA guanosine transferase, thereby causing a decrease in intracellular guanosine triphosphate, impairing viral RNA and protein synthesis, and inhibiting the replication and spread of the virus.
The new crown virus is a single-stranded RNA positive chain enveloping β coronavirus, similar to SARS, there is no confirmed effective antiviral treatment method, so as an existing SARS inhibitor, try "veteran new use", let me once again stand on the front line of "anti-epidemic", to protect the health of patients unfortunately infected with the new crown virus.
Remarks: According to the "Diagnosis and Treatment Plan for Pneumonia Infected by Novel Coronavirus (Trial Fifth Revised Version)" issued by the National Health Commission, the dosage of ribavirin is: adults, 500 mg / time, 2-3 times a day intravenous infusion. )
Although it is curative,
But "I" is not suitable for everyone
*Pregnancy or pregnancy: I am classified as X in the fda-published pregnancy medication classification, which has a strong teratogenic effect, so it is contraindicated in pregnant women or women who may be pregnant. For female patients receiving ribavirin treatment and partners for male patients, avoid pregnancy during treatment and 6 months after the end of treatment; I can excrete a small amount from breast milk, so mothers should stop breastfeeding during breastfeeding!
* Renal dysfunction patients: I mainly excrete the body through the kidneys, and hemodialysis can not effectively remove me, so people with different degrees of renal dysfunction should be cautious!
*Patients with severe or unstable heart disease should also "stay away" from me!
Pay attention to "my" "natural enemies"
Non-co-wearing type (absolutely contraindicated): lamivudine, deserosin. (can cause mitochondrial toxicity)
Water-fire intolerable type (serious adverse reactions): abacavir, warfarin, azathioprine, zidovudine, sitavudine, tamatabine, etc.
Parting ways (potentially dangerous): interferon, aluminum hydroxide, ganciclovir, magnesium carbonate, etc.
There is no end to the medicine,
"I" also has deficiencies
As the saying goes, "No one is perfect." ”
As a broad-spectrum antiviral drug, although my field of action is extremely extensive, my shortcomings are also many, but fortunately, after more than 50 years of testing, the pros and cons for me are still very clear.
First of all, large doses of application can lead to heart damage, for patients with respiratory diseases can cause breathing difficulties, chest pain, etc., so we must obediently follow the doctor's advice, do not be greedy.
Secondly, my biggest disadvantage is hemolytic anemia, so it is not suitable for patients with severe anemia, severe heart disease, autoimmune hepatitis and bleeding disorders, and they accidentally touch the minefield, and the consequences are very serious.
Finally, I may also cause you to have adverse reactions such as headaches, abdominal cramps, nausea and vomiting, fatigue and weakness, do not panic, please suspend the medication and go to the doctor immediately.
Pharmacist Special Reminder:
Ribavirin is a prescription drug that must be used rationally under the guidance of a doctor, do not blindly rob, improper self-prevention or treatment may lead to the above serious adverse consequences, more than worth the loss.
For the treatment of the new crown virus, there is no so-called "special drug", so do not believe the Internet rumors and blindly follow the trend.
Washing hands frequently, disinfecting frequently, going out less, wearing masks, eating reasonably, resting regularly, and improving your own resistance are king!
bibliography
1. Li Yalan, Du Jianhong, Xi Gehong. Research progress of broad-spectrum antiviral nucleoside drug ribavirin[J].Tibetan Medical Journal, Vol. 33, No. 2, 2012
2. Diagnosis and Treatment Plan for Pneumonia Infected by Novel Coronavirus (Trial Fifth Revised Edition)
3. Medication assistant ribavirin - drug overview
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Author: Zhang Zehua, Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University