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      Pharmacotherapy of COVID-19: confine to existential drugs or search for new ones?

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          Abstract

          Background

          The recent COVID-19 outbreak (pandemic) has inflicted great human lives and economic losses. Aside from being abated, new surges in cases are being recorded. The sudden emergence and fulmination of the disease and its rapid spread caught the health authorities worldwide, including the developed ones, off guard, with no novel drugs available. Therefore there was no choice other than using the old drugs.

          Objectives

          This study aims to reveal the possible mechanism of action, adverse drug reactions and beneficial combination of drugs used in COVID-19 treatment

          Methods

          We undertook a comprehensive living structural review of COVID-19, searching databases, and other sources to identify literature on drugs used in the treatment of COVID-19. We analyzed the sources, publication date, type, and the topic of the retrieved articles/studies in the available search machines.

          Results

          Although a large number of literature on COVID-19 deals with pathology, clinic, and epidemiological issues, few studies that tackle pharmacology and toxicology of the drugs used could be found in the literature. At least twenty six (26) drugs, alone or in various combinations, are found in the literature to be used in various countries in the world. These drugs had been used previously for other purposes but they also possess activities that could target various steps involved in the virus invasion-replication-multiplication and leaving the cell. Pharmacokinetic fundamentals had also been applied in some combination (decrease Lopnavirs metabolism by ritonavir), but some drugs that were initially extensively used at high doses without benefiting from some of their properties are recently being abandoned (hydroxychloroquine, ionophore for Zn2+).

          Conclusion

          The literature concerning drugs used in the treatment of COVID-19 lag far behind the great number of literature that discusses diseases pathogenicity, clinical picture, and epidemiology. The World indeed had been caught unprepared for COVID-19, hence obliged to use old drugs.

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          Author and article information

          Journal
          ScienceOpen Preprints
          ScienceOpen
          23 July 2020
          Affiliations
          [1 ] Pamukkale University, Medical Pharmacology
          Article
          10.14293/S2199-1006.1.SOR-.PP0J7NG.v1

          This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

          The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

          Medicine

          COVID-19, Fusion/budding inhibitor, Folding inhibitor, Protease inhibitor, ACE2 modulator, RdRp inhibitor, Cytokine inhibitor, Antivirals

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