800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 [table=0] [td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only [td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only [td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis [td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out [td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details [td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 [table=0] [td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 [table=0] [td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 [table=0] [td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only [td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only [td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis [td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out [td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details [td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 [table=0] [td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
markmark 800床的tertiary referral hospital, 用的就是马云版的中国治疗手册 No Fever or Respiratory Compromise - DO NOT treat with empiric antiviral therapy - Supportive care only WITH Fever and NO Respiratory compromise - DO NOT treat with empiric antiviral therapy - Supportive care only Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
[table=0]
[td=270] No Fever or Respiratory Compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] WITH Fever and NO Respiratory compromise [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care only
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age <60 y.o. WITH or WITHOUT Fever. [td=462] - DO NOT treat with empiric antiviral therapy - Supportive care AND consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out - If patient continue to worsen can consider therapy listed below on patient by patient basis
[td=270] Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. WITHOUT or WITHOUT Fever [td=462] - Initiation of therapy should be considered in patients with comorbidities, symptomatic disease, and abnormal chest x-ray without other cause - Consider: Hydroxychloroquine 400 mg daily X5 days* (Preferred) or Lopinivir/ritonavir 400/100 mg q12h X7 day - Consider antimicrobial coverage for community acquired pneumonia and oseltamivir for influenza based on clinical presentation until bacterial pneumonia and influenza can be ruled out
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND Age ≥ 60 y.o. AND ICU admission [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
[td=270] WITH Fever AND Respiratory Compromise (O2 Saturation < 90%) AND ONE of the following: - Mechanical Ventilation - Septic Shock - Symptomatic Progression on antiviral therapy [td=462] - Consider: Hydroxychloroquine 400 mg daily X5 days* PLUS PO ribavirin 400 mg q12h (Preferred) or Lopinivir/ritonavir 400/100 mg q12h PLUS PO ribavirin until remdesivir is acquired. - In confirmed cases can additionally consider Remdesivir via compassionate use program, contact pharmacy for more details
mark
应该是吧
谢谢提醒，明天去提一下。
毕竟，这些努力是为了每一个人民的生命。
能跟外行展开来讲讲其中的具体机制吗？
mark...
具体机制其实大家并不是很清楚，这也是应用氯喹类药物的一个缺点，不过有用就行。简单的你可以看下知乎杀生丸的一篇文章：
https://zhuanlan.zhihu.com/p/106621213
对症治疗，发烧退烧，低氧吸氧
所有给病人减轻症状或者续命的，但无法治好这个病的医疗措施，都算supportive cares.
谢谢！法国成功用硫酸羟氯喹治疗的报道今天出来了，他们用的剂量是每天600毫克（而不是800毫克），感觉调剂量（在具体机制不清楚的情况下）是个art不是science
这个杀生丸也写了一篇https://www.zhihu.com/people/sha-sheng-wan-94-99
另外一篇英文报道在这
最后再提一下，杀生丸的留言里有人讲，这个病一定要轻症用药。你可以从武汉这个用硫酸羟氯喹自救的实例里看到，患者始终血氧都没下过90%https://zhuanlan.zhihu.com/p/105910852
我看楼主医院的这个治疗方案，血氧在90以上的都不符合条件用这个药，非得拖到血氧下来了才符合用药资格。。。我是外行，只能说，如果我是轻症，血氧90以上，我会对这样的治疗方案感到担心，会对自己的病情感到担心
氯喹果然用上了？看来轻症，年龄小就是什么不给治啊，吃吃感冒药拉倒。。。。
硫酸羟氯喹
只要能维持体内足够浓度就行，氯喹代谢很慢的。400mg对重症过少了，预防是可以的。这个治疗方案当然是有问题的，氯喹要尽早使用，美国的医生过于自大，或不愿意惹麻烦。
前面有讨论了，美国现在基本就没有这个药的库存，开药也拿不到药
我是纯粹外行，但是我真心希望美国的医院可以接纳吸收中国和法国的治疗经验，少走可以避免的弯路。
就算医院的治疗方案不能该，船太大不方便掉头，每一个医生在面对病人的时候，有没有一些空间，一些自由度可以调整方案？
真心希望我们不要再一次learn it the hard way，这个代价太沉重了
能指一个讨论的link吗？我一定是错过了.
另外，为什么没有库存了？
宁愿等死也不愿意造这个药么？磷酸氯喹没必要，早被淘汰的东西，硫酸羟氯喹很多国家都有现货吧？还有瑞德西韦。尽快加紧制造这些药才是头等重要的事。
抱歉有点串贴了，好几个贴在讨论用药，是这个链接
https://forums.huaren.us/showtopic.aspx?topicid=2521136&postid=83207025#83207025
谢谢，贴在下面了。太匪夷所思了，美国这次应对能如此全面的掉链子，简直让人瞠目结舌。
楼主，请看到我，请教你：如果我一旦确诊，但属于轻症，按方案不该给我开羟氯喹， 实际上库存可能也不允许给我开羟氯喹，这种情况下，如果我自带羟氯喹，医生可以指导我用药吗？
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储存不够。今天的新闻才报道法国试验的氯喹管用，但美国储存太低，听说拜耳正加班加点赶制氯喹。一个月后情况会好很多。
中国医生喊了两个月氯喹管用，没人听，法国实验一结束，NBC新闻，CNN昨晚都报道了。
但库存量太低，中国大批订购时候，都在袖手旁观看着，都没想到要多存一些。
Jetholy 发表于 3/19/2020 1:47:09 AM
我也听说这个药效果好副作用低。美国有这个药吗？
有瑞德西韦这个药可以扔进垃圾桶。
mark
谢谢更正
用了这药可以把新冠当流感了吗？这么管用， 中国为啥还不全面复工开学呢？
Meaning: Watch closely, no treatment.
我听说mgh和yale都用那个手册呢。