Safety of Hydroxychloroquine and Chloroquine

The COVID-19 pandemic has many people searching for remedies to prevent or treat the disease. In particular, recent media coverage of clinical trials of hydroxychloroquine (brand name Plaquenil, among others) and a similar medication called chloroquine (brand name Aralen) have led some people to take these without a doctor’s prescription, or to take a higher dose than what they have been prescribed. 

In the United States, hydroxychloroquine is approved for the treatment of malaria, systemic lupus erythematosus, and rheumatoid arthritis. Chloroquine is approved for the treatment of malaria. While they can be very effective in the treatment of certain conditions, side effects and toxicity can occur at even regularly prescribed doses.  

Hydroxychloroquine and chloroquine toxicity can involve almost every organ system. Effects may include headache, vision or hearing changes, low blood potassium, and changes in heartbeat. If used without a doctor’s supervision, in combination with other medications, or by someone with underlying medical problems, side effects can include irregular heartbeat (arrhythmia), seizures, and heart failure leading to death. 

The Food and Drug Administration (FDA) recommends no one take hydroxychloroquine or chloroquine to prevent or treat COVID-19 outside of a clinical trial because of the risk of heart failure.  This medication and substances related to it (including those found in fish tank additives) should never be taken without a physician’s approval. 

If you have taken hydroxychloroquine or chloroquine and are concerned about the possibility of side effects, call your doctor or the Poison Control hotline at 1-800-222-1222.  For more information, see the Blue Ridge Poison Center’s article on hydroxychloroquine.

Safe Use of Household Cleaners

Because of COVID-19, many people are wondering how they can clean surfaces in their household to reduce the risk of spreading the disease.  The Centers for Disease Control has guidance on how to clean and what products will kill the COVID-19 virus. While cleaning can help the spread of illnesses, even regular household cleaners can be dangerous if they aren’t used properly.

Follow these guidelines for safety:

  1.  Don’t mix different cleaners together.  Chemicals in different cleaners can react to produce irritating or even poisonous gases. Don’t reuse bottles.
  2. Follow the directions on the bottle.  Store the cleaner in its original bottle, and make sure the label can be read. Some cleaners can cause skin and eye burns, so be sure you are wearing gloves and eye protection if recommended.  Some cleaners are not intended to be used on food contact surfaces.
  3. Don’t get the cleaner on your skin or in your mouth.  Even relatively mild cleaners can cause skin irritation if allowed to stay on the skin and vomiting if swallowed.  Stronger cleaners can cause severe burns.  Follow the directions on the bottle if the cleaner gets in your mouth or on your skin. If the label says to get medical help, call 911.  If you aren’t sure what to do, call the Poison Control hotline at 1-800-222-1222.
  4. Store cleaners out of the reach of children and pets.  They should be stored in a locked cabinet or in a high place where children can’t reach and they can’t accidentally fall out. Teach children not to touch cleaners until they are old enough to clean safely.

Pool Chemical Injuries

Treating pools with chemicals is important to prevent the spread of disease.  However, improper storage or use of these chemicals can cause injury.  Most chemicals used to treat pools contain chlorine or bromine, which can irritate the skin, eyes, mucous membranes, and respiratory tract.  Treatment primarily consists of removal from the source and supportive care

Most of these injuries take place at private residences, so it is important to use pool chemicals properly and keep them safely stored away from children and pets.  For more information, visit the Blue Ridge Poison Control Center website: https://med.virginia.edu/toxicology/wp-content/uploads/sites/268/2019/06/Jun19-PoolChemicals.pdf

Kratom

What is kratom?

Kratom is an herbal extract made from the leaves of a tropical evergreen tree. It is sold as a herbal supplement in the United States. Kratom has some properties similar to opiates, but also can act as a mild stimulant. Some people take kratom to reduce opiate cravings or treat pain. Others take it recreationally, believing it helps improve mood.

Why am I hearing so much about kratom lately?

Kratom was first introduced into the US in the late 1990s and for years its use was very limited. In recent years kratom use has become much more common, possibly because of the opiate epidemic and people trying to use kratom to reduce their dependence on opiates. A new study on Poison Control Center calls related to kratom found they’ve become much more common in the past few years. In 2011 Poison Control Centers received 13 calls about kratom. This rose to 682 in 2017, and two-thirds of the 1807 kratom-related calls between 2011–2017 happened in 2016 and 2017.

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