Home DiseasesCovid-19 Corona drugs: application, effect

Corona drugs: application, effect

by Josephine Andrews
Published: Last Updated on 260 views

Some of the risk patients become seriously ill with Covid-19, so that medical treatment has to be given in the hospital. In these cases, medication helps to reduce the severity of the disease. Other medications, on the other hand, can relieve the symptoms in mild and moderate courses. Here you can find out which medications are available to doctors in intensive care acute treatment and what you can do yourself if the symptoms are mild.

Which drugs help with Corona?

For Covid-19 patients who have to be treated in hospital, doctors use two treatment strategies in acute drug therapy:

  • Immunomodulatory drugs: They slow down an excessive (self-damaging) reaction of the immune system.
  • Antiviral drugs: They slow down the multiplication of the corona virus in the body.

In addition, doctors use other concomitant medications in individual cases after individual consideration .

Immunomodulatory drugs

Anti-inflammatory drugs (immunosuppressants) help with severe Covid 19 courses. In such cases, they prevent the immune system of the affected patient from being misdirected in its defense against the virus and even attacking its own body.

Dexamethasone : Corticosteroids are currently the standard treatment for hospitalized patients who may have increased oxygen needs or require mechanical ventilation. The active ingredient dexamethasone plays a key role here. It reduces the risk of dying from a serious infection.

Janus kinase inhibitors (JAK inhibitors): In addition, anti-inflammatory treatment alternatives based on antibodies are also gaining ground: the so-called Janus kinase inhibitors. Typical representatives of this substance class are, for example, baricitinib, tofacitinib or ruxolitinib. They are used in medicine, among other things, to treat autoimmune diseases such as rheumatoid arthritis or severe neurodermatitis .

Interleukin-6 antagonists (IL-6 antagonists): Another group of anti-inflammatory drugs are the so-called interleukin-6 antagonists – here in particular the active ingredient tocilizumab. However, it is only considered in patients with rapidly deteriorating health after an individual risk-benefit assessment.

Fluvoxamine : A few years ago, doctors discovered that certain medications for depression—called selective serotonin reuptake inhibitors (SSRIs)—also have anti-inflammatory effects. Doctors can therefore use fluvoxamine in high-risk patients – i.e. older or previously ill people – with a confirmed Sars-CoV-2 infection in individual cases.

Detailed information on the active substance dexamethasone can be found here .

Antiviral drugs

Various new antiviral drugs have been developed to treat Covid-19 since the beginning of the pandemic. However, physicians also rededicated known antivirals for the treatment of Covid-19.

The term antiviral drugs covers a wide range of drug groups. They range from classic small molecules (with individually different mechanisms of action) to biotechnologically produced antibody preparations.

Monoclonal Antibodies

Antibody drugs: They work in a similar way to antibodies that the body produces itself: once these drugs are given (usually intravenously), they catch the virus circulating freely in the body. To do this, they attach themselves to certain structures on the outer shell of the pathogen and block them.

Typically, these monoclonal antibody drugs bind to the spike protein. Since the virus particles are then no longer able to penetrate the human cell, this is also known as “neutralization” in specialist circles. The result: the multiplication of the virus is slowed down or ideally stopped completely.

A well-known antibody preparation approved by the European Medicines Agency (EMA) is Ronapreve. It is a combination of casirivimab plus imdevimab. The two antibodies are usually only effective in the early phase of the disease and should therefore ideally be administered within a maximum period of seven days after the onset of symptoms.

However, it has been shown that the effectiveness of these drugs has decreased significantly compared to the omicron variant. Since the spike protein of the virus has changed due to mutations, the antibodies are now less able to recognize it. The antibody drug Sotrovimab , which is now available on the European market, is intended to close this supply gap and offer protection against omicrons.

Detailed information on the active ingredient sotrovimab can be found here .

Another combination drug with the trade name Evusheld™ (with the two active ingredients tixagevimab and cilgavimab ) recently received approval from the European Medicines Agency (EMA). It is specifically intended for the preventive treatment of at-risk patients with immunodeficiency, in whom the effectiveness of a vaccination is reduced.

Detailed information on the active ingredients tixagevimab and cilgavimab can be found here .

In addition, other drugs with the same active principle are currently being clinically tested and examined by the authorities.

Plasma therapy : Therapeutic antibodies against the coronavirus can also be obtained from blood plasma donations from patients who have already recovered. However, this treatment option is only available to a very limited extent. The effectiveness and tolerability is also very individual and therefore varies greatly.

The use of plasma therapy outside of clinical studies is therefore currently not recommended.

antivirals

Antivirals directly or indirectly interfere with the replication mechanism of viruses within the human cell:

Paxlovid : This preparation from Pfizer can be taken as a tablet and combines two substances: the “actual active ingredient” nirmatrelvir, which as a so-called protease inhibitor inhibits the multiplication of the virus, and its active ingredient ritonavir. The latter prevents nirmatrelvir from being broken down by the liver too quickly. Paxlovid has held provisional approval for the European market since January 2021.

Detailed information on the active ingredient Paxlovid can be found here .

Molnupiravir : The active ingredient, also known as MK-4482 or EIDD-2801 in the development phase, intervenes directly in the Sars-CoV-2 replication process and thus prevents it from multiplying in the body. Molnupiravir’s mechanism of action is based on the targeted promotion of viral mutation processes that occur during the replication of the viral genome. This often results in errors that render the virus inoperable.

Molnupiravir is still in the assessment phase of European authorities. Therefore, it is not yet available in practice. Also, no conclusive statements on the effectiveness, tolerability and safety are currently possible.

Detailed information on the active substance molnupiravir can be found here .

Remdesivir : The antiviral agent remdesivir was the first drug that the European Medicines Agency (EMA) redesignated and thus also approved for the treatment of Covid-19. Depending on the study, the assessments of the effectiveness against Sars-CoV-2 vary widely – the benefit of such a Covid-19 treatment is considered controversial. Therefore, there is currently no clear recommendation for the routine use of remdesivir as a Covid-19 drug.

concomitant medications

Antibiotics are not effective against the corona virus. However, the administration of antibiotics can be useful if there is a suspicion of a bacterial concomitant infection or a septic course (bacterial blood poisoning ).

Detailed information on the use of antibiotics can be found here .

In some cases, doctors initiate thromboembolism prophylaxis . This is especially true if you have severe pneumonia caused by Covid-19 . In such cases, the formation of blood clots in the tissues of the lungs was often observed .

Patients treated in hospital are therefore often given a strong anticoagulant (e.g. low molecular weight heparin ) as a preventive measure. If the patient does not tolerate heparin, doctors use the alternative drug fondaparinux.

Detailed information on the active ingredient heparin can be found here .

What medications relieve the symptoms?

In the majority of cases, coronavirus vaccinations in healthy (immunocompetent) people reliably protect against severe courses. Nevertheless: Even a supposedly “mild” course can be accompanied by symptoms.

A well-stocked medicine chest is then helpful . To relieve possible symptoms, it should contain the following:

  • Fever-reducing drugs – such as acetylsalicylic acid , paracetamol or ibuprofen
  • decongestant nose drops or nose drops based on salt water
  • soothing lozenges or gargles for a sore throat
  • Bronchodilator and soothing ointments (e.g. with eucalyptus)
  • Chamomile, eucalyptus or sage for inhalation
  • Nasal douche with salt water solutions
  • Vitamin C , vitamin D and zinc as a supplement – after medical consultation

Pulse oximeter : In addition to the clinical thermometer, a so-called pulse oximeter can help to monitor your state of health. Such a pulse oximeter is a device that you clip onto your fingertip, where it measures the oxygen saturation of your blood.

If oxygen saturation falls, this indicates a deteriorating state of health and an increased need for oxygen.

However, opinions on the necessity of such a purchase differ widely: proponents see a home pulse oximeter as a good way of detecting a possible deterioration in health in good time.

In this way, necessary care can be arranged in the hospital at an early stage. Others, however, point to the inaccuracy of the measurement method itself and the high acquisition costs. They therefore see no general need.

Treatment with over-the-counter (pharmacy-only) medication can at best supplement the Covid-19 recovery. If the symptoms persist over a longer period of time, do not improve or even worsen, you should always seek medical advice immediately.

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