We found and tested 47 old drugs that might treat the coronavirus
May 5, 2020 6:23 PM   Subscribe

Results show promising leads and a whole new way to fight COVID-19 The Conversation has a round-up of two months of coronavirus structure research and the pathways that different drugs might use to work against the virus.
posted by hippybear (26 comments total) 21 users marked this as a favorite
 
Every night I FaceTime my mother, who lives alone and is desperately lonely right now. I tell her that every day we can stave off this virus is a day closer to people figuring out what can treat it or prevent it.

Posts like this give me hope that I’m not just bullshitting her and myself. Thank you.
posted by kimberussell at 6:57 PM on May 5 [20 favorites]


I got tested for the virus, I had all the symptoms, but the test was negative. I had some infection, with a cough, with fever, with symptoms. I was prescribed an antibiotic and a cough syrup with dextromethorpan. I read the paperwork on both drugs, and both could cause covid 19 symptoms, expecially "the cough syrup of death," which I did not use at all. The antibiotic worked, however and I had no allergic reaction to it. It made me think that certainly some treatments used in trauma units to manage the airway, might be causing some of the symptoms as side effects. Again and again they say people with other medical conditions suffer more. Well, drug interactions can be terrible, and a lot of individuals have conflicting perscriptions already, before they become ill with a viral infection. So there are new treatments on the horizon for this virus, and the treatment of completely analyzing the prescriptions people already take, to make sure they don't react with one another, or react with airway management in an ICU.
posted by Oyéah at 7:30 PM on May 5 [2 favorites]


DMX is "the cough syrup of death"? Is that how it's referred to in the literature for COVID? How interesting. I used to do it in high quantities for recreation 30 years ago. It's a chemical related to PCP and it has interesting dissociative quantities.
posted by hippybear at 7:33 PM on May 5 [10 favorites]


I guess, thinking about it, what dextro does is distance your brain from the impulses coming in from the lungs that they need to cough, which is how it stops coughing. You just don't feel the need anymore. But in an illness that involves building up mucous in the lungs to the point of non-function, that could definitely be a problematic way to treat it.
posted by hippybear at 7:37 PM on May 5 [4 favorites]


Science News about DMX.
posted by Max Power at 7:39 PM on May 5


ahem... DXM. DMX is a rapper.
posted by logicpunk at 7:40 PM on May 5 [30 favorites]


Goodness! I had no idea. I consider myself having learned a thing (possibly an important thing!) today.

The chart in the linked article showing all the ways the virus can attack a person and the targets identified to focus drugs on is pretty great. I nearly feel like I want to print it out big and put it on my wall.
posted by hippybear at 7:41 PM on May 5 [1 favorite]


I find dextromathorphan just really unpleasant - I believe that people do it for fun, but people do all kinds of things I don't like for fun. I have more than once forgotten this or thought "it's not that bad" and taken some nyquil and gone to sleep and woken up feeling so awful and stupid and groggy that I think the cold has gotten way out of hand, but it's just the DXM.

Ugh.
posted by aubilenon at 7:50 PM on May 5 [1 favorite]


Now all we have to do is have people stay home and self-isolate until doctors figure out why the virus is attacking kidneys and causing blood clots and depleting oxygen levels apart from its lung-clogging primary mechanism, and figure out how best to treat it!

Which, here in America, we're...

Um...

...Never mind.
posted by delfin at 8:00 PM on May 5 [4 favorites]


I think I read someplace that the theory is the blood clots come from the attack on the lungs and its replete tangle of tiny capillaries, and that the kidney problems (and COVID toes) are due to these tiny clots being free in the blood stream. But I can't find that reference. It makes sense to me, someone who has no medical training, but that doesn't mean its true.
posted by hippybear at 8:04 PM on May 5 [1 favorite]


ahem... DXM. DMX is a rapper.

I'm glad someone said it. I was afraid this thread was going to make me lose my cool.
posted by Jpfed at 8:53 PM on May 5 [21 favorites]


Um, about the virus attacking the kidneys, the liver, the eyes, the intestines, and all . . .
posted by jamjam at 9:06 PM on May 5 [3 favorites]


Jpfed, yes, I was definitely on the verge of acting the fool myself
posted by potrzebie at 9:17 PM on May 5 [9 favorites]


I believe that people do it for fun, but people do all kinds of things I don't like for fun.
But have they tried putting it in their, you know, butts?
posted by aspersioncast at 9:36 PM on May 5 [3 favorites]


Oh lord DXM. That stuff makes me straight hallucinate. Not “heh heh far out man look at the floating doggies” hallucinate. More like “BEEEEES! BEEES IN MY EYES!!!! THEY WANT MY SPOONSSS!!!!”. I was told to buy Robitussin that contained it exactly once by my doctor when due to a flu shot scheduling mishap I got the full blown “kill me now” Influenza that was going around a few years ago. In retrospect... I think I wrote an osteology paper while bedridden with influenza and high as a bee-fearing kite on that terrible stuff. DXM would literally have to be the difference between life and death for me to take it again.
posted by Homo neanderthalensis at 9:50 PM on May 5 [3 favorites]


But have they tried putting it in their, you know, butts?

I feel like it's extremely likely some people have tried this, yes.
posted by aubilenon at 9:56 PM on May 5 [4 favorites]


tone of that article was a bit too excited as to the promise of its hopeful achievement for my taste/open credulity. but, penn center for research on coronavirus and other emerging pathogens co-director susan weiss gave this presentation on coronavirus and the many targets it presents for pharmaceutical intervention at a penn symposium on covid-19 april 3 (other presentations from the event are available at penn medicine channel). dr. weiss was also the featured guest on this week in virology episode 609, may 3.
posted by 20 year lurk at 10:04 PM on May 5 [5 favorites]


Ugh. I groaned when I read the original paper. This paper represents the stuff you would do in the first week of screening for a new drug target. That first week usually extends to at least 5 years of medicinal chemistry work before you have something being tested in people, and those fail more than 90% of the time. Many of these drugs do incredibly broad shit like "inhibit protein synthesis" and are worthless to test in cell culture - the question is not will such agents stop the virus, it's will they stop the virus before they kill the patient. The authors are reasonably cautious about interpretation of the results, but none of this is relevant to the current pandemic at least until something has been tested in infected primate models.

Host directed antiviral therapies are not a new idea despite every review article claiming they are the next big thing for the last 20(?) years. I only know of HIV's Maraviroc as an approved host factor drug that is widely used. This review covers some of the recent approaches without the fog of rushed coronavirus research.

I don't want to kill anyone's hope, but I would put the likelihood of having an antiviral safe enough to use prophylactically within two years at <5%? I think therapeutic antibodies and vaccines will beat novel small molecules in the race to be therapeutically relevant.
posted by benzenedream at 12:27 AM on May 6 [13 favorites]


For sure.

I think we will see / have seen in order of effectiveness and timeliness:
1) Better overall clinical management, use of proning, late intubation, use of CPAP
2) Better understanding of immune response and use of steroids and anti-IL6 drugs
3) Use of convalescent serum
4) A moderately effective but difficult to produce vaccine used for medical professionals and the very vulnerable
5) Antivirals and targeted monoclonals (only likely to be effective early in infection)
6) Mass vaccines
posted by atrazine at 12:51 AM on May 6 [4 favorites]



Oh lord DXM. That stuff makes me straight hallucinate. Not “heh heh far out man look at the floating doggies” hallucinate. More like “BEEEEES! BEEES IN MY EYES!!!! THEY WANT MY SPOONSSS!!!!”. I was told to buy Robitussin that contained it exactly once by my doctor when due to a flu shot scheduling mishap I got the full blown “kill me now” Influenza that was going around a few years ago. In retrospect... I think I wrote an osteology paper while bedridden with influenza and high as a bee-fearing kite on that terrible stuff. DXM would literally have to be the difference between life and death for me to take it again.



There's an specific enzyme deficiency in a certain percentage of the population (certain ethnicities are over represented but I forget which) that is responsible for this and it sounds like you might have it? Most people metabolize DXM well enough that the side effects you experienced don't happen until they drink a full bottle of the red stuff. I can imagine it would be very disturbing if one were suddenly tripping out unexpectedly. This is why it's a good idea to make sure to do some testing before going straight to drinking a full bottle if you're planning on doing DXM recreationally.

/the more you know
posted by some loser at 5:07 AM on May 6 [1 favorite]


If these are existing drugs that are in use, why wouldn't a statistical analysis of those populations reaction to the virus be an indicator of the efficacy of the particular medicine? Hard data to get I guess, and hard to interpret, the folks that are taking serious drugs are likely more at risk than a standard population.
posted by sammyo at 5:14 AM on May 6


But have they tried putting it in their, you know, butts?

I feel like it's extremely likely some people have tried this, yes.


I feel like every time the question involves butts, the answer is yes.
posted by sexyrobot at 6:07 AM on May 6 [5 favorites]


Back in the early days of search engines I was developing software using a thing called "DirectX Media" for like capturing video. Its abbreviation was "DXM"

I learned many many things about recreational cough syrup that summer but had to more or less write my own documentation for Microsoft's particular technology.
posted by abulafa at 9:06 PM on May 6 [2 favorites]


That first week usually extends to at least 5 years of medicinal chemistry work before you have something being tested in people

I believe all the drugs being talked about in this article have already been tested in people, and have proven safe for ingestion. The question at this point is efficacy against COVID.
posted by hippybear at 6:33 PM on May 8


If you win the medchem lottery and get a drug that can be repurposed as-is, great. The more usual case is that you find something with marginal effectiveness in cell culture which still need medchem tweaks to become useful in a new context, which saves you some time (an existing nontoxic scaffold is easier to derivative) but is essentially a new drug, e.g. hydroxychloroquine is the less toxic 2nd gen version of chloroquine.
posted by benzenedream at 10:50 PM on May 8


You know, I’ve been thinking for some time now that someone should try carbon-dating the hydroxychloroquine from trumps cronies. It would not surprise me in the least if that shit was left over stock from the Korean War or something.
posted by sexyrobot at 5:46 PM on May 11 [2 favorites]


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