Any of you prescribing ivermectin?

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Dred Pirate

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Curious as to if any of you are/have prescribed ivermectin for covid? We have one doc in our shop that is and he gets made fun of by others. He even tried to push our pharmacy into allowing him to use it in house - but obviously got push back. I have seen the other docs mocking it while sitting 5 feet from him, then him trying to justifyn its use. it is comical and a little sad all at once.

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Not on your life. There’s enough evidence to show its doing more harm than good. I’d be especially opposed to giving it someone who’s unvaccinated and wants it. Chances are, those are precisely the clowns that want it.
 
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Not since I sold the petting zoo
 
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We were threatened with termination if we were caught prescribing it.
wow - that is a little extreme but direct them to this wackjob - only $185 for visit and $350 for the medicine.

I wonder how much money she has made off this whole pandemic - maybe the conspiracy theroists should follow the money and see if she developed itin a lab - oh wait - I am guessing that would require her to have more clinical knowledge than she does unless the lizard people gave it to her.
 
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wow - that is a little extreme but direct them to this wackjob - only $185 for visit and $350 for the medicine.

I wonder how much money she has made off this whole pandemic - maybe the conspiracy theroists should follow the money and see if she developed itin a lab - oh wait - I am guessing that would require her to have more clinical knowledge than she does unless the lizard people gave it to her.

Not as much as big Pharma with some the marginally or not-effective IV infusions. I'm not a proponent of Ivermectin BTW.
 
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Ivermectin is experimental. The Pfizer vax is not. The most positive study on ivermectin, was retracted. People are refusing the proven and demanding the experimental. The happiest people about this are the Tide pod eaters; they look like geniuses now, in comparison.

Refusing seatbelts, riding motorcycles helmetless, taking street drugs with fentanyl, skydiving parachuteless, dewormer in lieu of vaccines. It's all different versions of the same stupid.

My patience and sympathy are running thin for these donghats.
 
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I wish I had less morals... so I could profit off of stupid for much less work.
 
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I wish I had less morals... so I could profit off of stupid for much less work.
"There's a sucker born every minute." - P.T. Barnum
 
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funny story my dad, who barely graduated high school, had a hog farm for 40 years. Called me and asked if this ivermectim is the same stuff he sprayed on pigs back in the day for scabies. When i said yes, his response - why the hell would people take that??
 
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It takes cajones to prescribe something the FDA specifically says not to. Indefensible if a negative outcome occurs.


Yes, I know there are off-label uses for every medication, but the FDA usually doesn't make a separate page to say that an off-label use isn't supported by research.
 
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funny story my dad, who barely graduated high school, had a hog farm for 40 years. Called me and asked if this ivermectim is the same stuff he sprayed on pigs back in the day for scabies. When i said yes, his response - why the hell would people take that??
Your dad have common sense that a lot of people lack, obviously.
 
It takes cajones to prescribe something the FDA specifically says not to. Indefensible if a negative outcome occurs.


Yes, I know there are off-label uses for every medication, but the FDA usually doesn't make a separate page to say that an off-label use isn't supported by research.
Very, very true.
 
Let's all sing along. Ready?

"And like a good neighbor....Your feed store is t h e r e . . . "
 
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Unfortunately, some patients are finding quacks to prescribe them ivermectin and getting courts to force hospital to administer them

Judge orders Ohio hospital to treat Covid patient with ivermectin (might be paywalled)
 
Unfortunately, some patients are finding quacks to prescribe them ivermectin and getting courts to force hospital to administer them

Judge orders Ohio hospital to treat Covid patient with ivermectin (might be paywalled)
On the other hand, if you’re near dead, with no hope and have already tried everything, I guess some experimentation ?might? make sense?

Much of ACLS is exactly that, or started that way, at least.
 
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On the other hand, if you’re near dead, with no hope and have already tried everything, I guess some experimentation ?might? make sense?

Much of ACLS is exactly that, or started that way, at least.
Agree. When you’re basically dead, why not try something. Ivermectin though, meh.

I still don’t understand why anyone would think a drug that kills parasites would have any effect on a viral disease.
 
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Agree. When you’re basically dead, why not try something. Ivermectin though, meh.

I still don’t understand why anyone would think a drug that kills parasites would have any effect on a viral disease.
Like any other poison, if you put a high enough concentration of it in a test tube with live stuff, it'll kill it. They you can tell someone gullible to "extrapolate that to all 8 billion people" and "calculate the lives could've been saved" if the conspirators hadn't suppressed this drug. Make a catchy meme about it and boom, that "truth" is viral and seen by millions.

Little do they know that lots of toxic stuff that kills viruses in test tubes, also kills people when given to them in real life. And millions that read the catchy meme never had the patients or knowledge to read about all the stages and types of trials these drugs have to go through to pan out. Nor are they aware that only a tiny percent ever do.

"I saw a dank meme, therefore I'm an expert!"
 
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I've always been mysti
Agree. When you’re basically dead, why not try something. Ivermectin though, meh.

I still don’t understand why anyone would think a drug that kills parasites would have any effect on a viral disease.
I've been mystified by that too. Same with hydroxycholorquine. Not sure how someone picked these medications randomly to test out on COVID. Seems to me I'd try standard antivirals first.....
 
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Unfortunately, some patients are finding quacks to prescribe them ivermectin and getting courts to force hospital to administer them

Judge orders Ohio hospital to treat Covid patient with ivermectin (might be paywalled)
I think my hospital and every respectable medical organization would support a physician who refuses to administer court-ordered ivermectin. I don't tell a judge how to do his job, so perhaps he shouldn't tell us how to do ours. What's next? Court order for Dilaudid for fibro patients? I simply will refuse. I'm not an agent of the court and as such cannot be ordered to do something that will cause harm to an individual.
 
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I've always been mysti

I've been mystified by that too. Same with hydroxycholorquine. Not sure how someone picked these medications randomly to test out on COVID. Seems to me I'd try standard antivirals first.....

Generally, I'm in your boat - but the concept has been applied elsewhere with some success. Metformin for PCOS, NASH, some carcinomas.
 
One time I had a patient tell me he used “horse lineament” for pain. I though he was just crazy. Then I had three or four more say the same thing. They all said it worked. I looked it up. It’s actually a topical nsaid, DMSO.
 
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Curious as to if any of you are/have prescribed ivermectin for covid? We have one doc in our shop that is and he gets made fun of by others. He even tried to push our pharmacy into allowing him to use it in house - but obviously got push back. I have seen the other docs mocking it while sitting 5 feet from him, then him trying to justifyn its use. it is comical and a little sad all at once.
No.
 
Ivermectin is experimental. The Pfizer vax is not. The most positive study on ivermectin, was retracted. People are refusing the proven and demanding the experimental. The happiest people about this are the Tide pod eaters; they look like geniuses now, in comparison.

Refusing seatbelts, riding motorcycles helmetless, taking street drugs with fentanyl, skydiving parachuteless, dewormer in lieu of vaccines. It's all different versions of the same stupid.

My patience and sympathy are running thin for these donghats.
The doc I had was referencing that retracted study last week. I asked if he knew the article had been retracted. I could tell he hadn’t. Again. I am all for using meds off label if there is some sort of evidence to support, especially in a last ditch effort. But I just don’t see it here at all.
 
Agree. When you’re basically dead, why not try something. Ivermectin though, meh.

I still don’t understand why anyone would think a drug that kills parasites would have any effect on a viral disease.
I mean... Clarithromycin and Naproxen have anti-influenza A properties... and at least there's an in-vivo study out there (N=200, which seems small, but look at the size of most of the studies medicine is practiced off of... the N=1000+ are a relatively new concept) showing benefit.

Boner medications also work for some pulm hypertension.

ACEi are bad for renal function... except for nephrotic syndrome.

 
Boner medications also work for some pulm hypertension.
That one is a little deceptive. I thought it was the other way around. I do recall being in the PICU as a resident, and there was some kid with PDA or something, and the Peds Cards fellow (in a thick Indian accent) making a quite funny joke about Cialis (using the name brand).
 
That one is a little deceptive. I thought it was the other way around. I do recall being in the PICU as a resident, and there was some kid with PDA or something, and the Peds Cards fellow (in a thick Indian accent) making a quite funny joke about Cialis (using the name brand).
I'm too lazy to look up which use came first... but the reverse works as well...

Pulm HTN medication for boners? LULZ!
 
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I'm too lazy to look up which use came first... but the revere works as well...

Pulm HTN medication for boners? LULZ!

It was for pulm htn but they found out that it causes boners and then they proceeded to make billions
 
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ACEi are bad for renal function... except for nephrotic syndrome.
err what? ACEi causes a rise in Cr that isn't terribly clinically relevant except in ~1% of patients while adding years of dialysis free time to basically every type of nephropathy.
 
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Cytokine storm reduced with hydroxychloroquine makes sense, but using decadron will allow you to keep your job.
 
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Curious as to if any of you are/have prescribed ivermectin for covid? We have one doc in our shop that is and he gets made fun of by others. He even tried to push our pharmacy into allowing him to use it in house - but obviously got push back. I have seen the other docs mocking it while sitting 5 feet from him, then him trying to justifyn its use. it is comical and a little sad all at once.

No.
 
We have an NP in the ICU ordering it like crazy.
Also he's a flat earther who's also a Qanon follower so 🤷‍♂️.
 
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At this point, anyone who admits to ordering ivermectin is in danger of being sanctioned by ABEM – so I'd imagine we won't see a lot of folks publicly posting their practice.
 
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Let me get this straight. Most will agree that BiG I has very little affect on a Virus. If you prescribe it you will be mocked, possibly lose your license, and removed from a medical staff realizing that is has very little side affects.

Yet,
,
1. We can call everyone with a fever, tachycardia septic thus pumping them with broad spectrum abx before being seen by an MD OK?
2. We can ask pts their pain scale which is always 10, thus prompting Dilaudid that is much more dangerous
3. We can call someone falling 10 feet onto grass walking with a limp a trauma activation and a 10K charge
4. We can prescribe decadron for Covid pts which also has not shown improved outcome but has more adverse effects
5. We prescribe zpaks for URIs b/c pts demands it.

Alot of hypocrisy in medicine.


Disclaimer - I do not prescribe Imvermectine, HCQ
 
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err what? ACEi causes a rise in Cr that isn't terribly clinically relevant except in ~1% of patients while adding years of dialysis free time to basically every type of nephropathy.
In the vast majority of cases, I agree, it isn't terribly clinically relevant. Yet people will hold for worsening renal function or not start because of an elevated creatinine.
 
Let me get this straight. Most will agree that BiG I has very little affect on a Virus. If you prescribe it you will be mocked, possibly lose your license, and removed from a medical staff realizing that is has very little side affects.

Yet,
,
1. We can call everyone with a fever, tachycardia septic thus pumping them with broad spectrum abx before being seen by an MD OK?
2. We can ask pts their pain scale which is always 10, thus prompting Dilaudid that is much more dangerous
3. We can call someone falling 10 feet onto grass walking with a limp a trauma activation and a 10K charge
4. We can prescribe decadron for Covid pts which also has not shown improved outcome but has more adverse effects
5. We prescribe zpaks for URIs b/c pts demands it.

Alot of hypocrisy in medicine.


Disclaimer - I do not prescribe Imvermectine, HCQ
I agree with the essence of what you are saying that there is a lot of hypocrisy in medicine, but I'm not sure these are the best areas or ways to highlight this point.

1) Sepsis has very high mortality, more so than COVID-19. Patients in our ED (and I’d bet most) don’t get antibiotics prior to an EP seeing the patient. Sepsis is driven by an underlying infection and antibiotics are the best focused treatment we have for bacterial infection. I think being a little over-aggressive with a single dose of antibiotic(s) is the right answer versus the alternative of delayed care for septic patients. Certainly there is a balance. Some institutions have focused too highly on metrics trying to just game the system, but many places still allow some reason in the process.

2) I don't think most of us just throw Dilaudid at anyone that says it's a 10 (Everyone knows to 'say 8' anyways!) We measure the degree of pain and treat in a corresponding manner. The pendulum is quickly moving away from pain scales and opioids. Almost too far at times. I can’t remember the last time I gave Dilaudid. I also only average about 1 opioid script a month, usually only for 1-3 days and a handful of pills. This seems fairly in line with the average based upon our statewide prescription opioid monitoring reports.

3) I think overly aggressive trauma activation criteria are isolated to a few for profit entities. There is a fairly high threshold for our activation criteria. I'm not heavily involved with our trauma committee, but believe there is a decent amount of regulation. I don't think compensation for activation plays a huge role, but I do always say follow the money so I could be proven wrong.

4) I thought the RECOVERY trial showed benefit. Is there better, or newer, data out there showing differently?

5) It can sometimes be tough to tell if patients solely have a viral infection or are developing a superimposed bacterial infection (granted many are often just viral). They aren't though developing tapeworm. I don’t think Azithromycin resistance has proven a major problem. If they clearly have viral symptoms, I almost never prescribe a Z-pack. If they get one though because they are going to doctor shop until they do, then I don’t think that’s the end of the world.
 
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Antibiotics are otc in the 3rd world. Even Mexico.
 
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