Arkansas doctor under investigation for prescribing parasite pill thousands of times for Covid-19

[brooklynite]

Source: CNN

The Arkansas Medical Board is investigating after a doctor said he prescribed an anti-parasitic drug "thousands" of times for treatment of Covid-19, including to inmates in an Arkansas jail.

The FDA has been warning against the use of ivermectin for treatment of Covid-19 since March. The drug is used to treat parasitic infections, primarily in livestock, and the CDC recently cautioned about an increase in reports to poison centers of severe illness caused by the drug.

Justice of the Peace Eva Madison raised the issue during a county budget hearing in Fayetteville on Tuesday, saying a county employee had told her the jail's medical provider was prescribing ivermectin to treat and prevent Covid-19.


Read more: https://www.cnn.com/2021/08/26/us/covid-ivermectin-arkansas-doctor/index.html

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In al fairness, none of his “patients” reported having worms…

[captain queeg]

1. Ivermectin is a legitimate treatment against parasites in humans

And doctors are allowed to prescribe meds for off label uses. That being said it doesn’t have proven benefit for Covid. At least this is not as bad as someone taking a veterinary version of the drug they bought at the feed store which might include other drugs and an inappropriate dose. In the current insane US maelstrom it’s probably one of the lesser evils. At least a lot of people ought to be parasite free.

[RockRaven]

3. Off label usages, while allowed, still demand justification. There is no extant body of evidence

which justifies writing scrips for ivermectin. The supposed evidence cited by covidiots is absolute shite.

[hlthe2b]

5. Yes. "Off-label" use carries inherent risk to the prescriber for liability. And without

substantial evidence of effectiveness --typically in the absence of ANY alternatives (clearly not the case here given readily available vaccines)--the prescriber may well lose their license at least temporarily. In this case, he's left both the company for which he is contracted to provide medical services and the county that contracts him wide open to class action litigation. This amounts to nothing less than medical experimentation, given the incarcerated nature of the "patients" whose implied consent would be highly questionable. It is truly abhorrent. It would be a great case for ACLU to take on.

[FarPoint]

10. It definitely does not treat covid-19...

So, prescribing a drug one heard about on the internet as a cure, being a practicing physician....that is the bigger problem....If the inmates had symptoms of covid-19....acceptable treatment modalities were to be prescribed. The recipients being inmates....they can't research a drug while in a cell...they get meds in a " pill call" system, a nurse gives them a paper cup of meds or they just pour meds into inmates hand...there ya go...

[cadoman]

2. I doubt this will go anywhere, worse they could do is raise a ruckus and get him fired w/out cause

It's perfectly legal to prescribe meds off label. It's done all the time and we're in a pandemic so it's going to be even more common as doctors "practice" medicine based on what they're seeing in their patients. Ivermectin has a multi-decade safety profile.

If you go into a hospital right now for COVID, you'll be prescribed piles of off-label meds as they try to treat you, even if you're vaccinated and wearing a mask.

As legislators they're free to compare this doctor's professional judgement against other authorities like CDC or FDA, but as long as he's giving them human grade there's no harm done, and he still has the zero death record so that is something definitely in his favor.

[RockRaven]

4. They're not legislators, and the issue is not whether or not the behavior is legal...

They are a licensing board and the question is whether or not this is so unprofessional as to jeopardize the license.

I suspect no action will be taken, but for different reasons than yours.

[hlthe2b]

6. There is a lot of liability risk here. If they are not offering vaccines then his and THEIR

liability has increased dramatically. Off-label STILL requires some valid evidence of effectiveness in the absence of alternatives. Vaccination is THE approved prevention, even under the original FDA emergency approval. There is a good case for a class-action lawsuit which the county will be at risk for in addition to the company that hired him. And, that is why these county commissioners would be wise to act to remove this physician and if possible the company that provides services in the jail. And, yes, I do believe the medical board will at least suspend his license.

Off-label is NOT a free ticket to experiment--especially among the incarcerated. And the liability inherent in doing so has cost a colleague or two of mine at least a year's worth of headaches in defense of such actions--in uses far more defensible (ultimately) than this. They prevailed because there was sufficient evidence of effectiveness, even while not an FDA-approved indication. There is no such evidence here. In fact, the one weak study was withdrawn after evidence of "data manipulation" was at least alleged.

If you are a provider and take such a lackadaisical attitude towards off-label prescribing, the odds are it WILL catch up with you. Even in states that are laxer about such matters, there ARE those with expertise that serve on medical boards and they DO care. They also are called to testify in medical liability civil litigation.

[bucolic_frolic]

7. It is still standard care

if you're a horse.

[LiberalArkie]

8. Ivermectin Proposed Mechanism of Action and Rationale for Use in Patients With COVID-19

Snip

Proposed Mechanism of Action and Rationale for Use in Patients With COVID-19
Reports from in vitro studies suggest that ivermectin acts by inhibiting the host importin alpha/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host’s antiviral response.4,5 In addition, ivermectin docking may interfere with the attachment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to the human cell membrane.6 Ivermectin is thought to be a host-directed agent, which may be the basis for its broad-spectrum activity in vitro against the viruses that cause dengue, Zika, HIV, and yellow fever.4,7-9 Despite this in vitro activity, no clinical trials have reported a clinical benefit for ivermectin in patients with these viruses. Some studies of ivermectin have also reported potential anti-inflammatory properties, which have been postulated to be beneficial in people with COVID-19.10-12

Some observational cohorts and clinical trials have evaluated the use of ivermectin for the prevention and treatment of COVID-19. Data from some of these studies can be found in Table 2c.

Snip

Rationale
Ivermectin has been shown to inhibit the replication of SARS-CoV-2 in cell cultures.13 However, pharmacokinetic and pharmacodynamic studies suggest that achieving the plasma concentrations necessary for the antiviral efficacy detected in vitro would require administration of doses up to 100-fold higher than those approved for use in humans.14,15 Even though ivermectin appears to accumulate in the lung tissue, predicted systemic plasma and lung tissue concentrations are much lower than 2 µM, the half-maximal inhibitory concentration (IC50) against SARS-CoV-2 in vitro.16-19 Subcutaneous administration of ivermectin 400 µg/kg had no effect on SARS-CoV-2 viral loads in hamsters. However, there was a reduction in olfactory deficit (measured using a food-finding test) and a reduction in the interleukin (IL)-6:IL-10 ratio in lung tissues.20

Since the last revision of this section of the Guidelines, the results of several randomized trials and retrospective cohort studies of ivermectin use in patients with COVID-19 have been published in peer-reviewed journals or have been made available as manuscripts ahead of peer review. Some clinical studies showed no benefits or worsening of disease after ivermectin use,21-24 whereas others reported shorter time to resolution of disease manifestations that were attributed to COVID-19,25-27 greater reduction in inflammatory marker levels,26 shorter time to viral clearance,21 or lower mortality rates in patients who received ivermectin than in patients who received comparator drugs or placebo.21,27

Snip

https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/

Comment : Not enough evidence yet to support the use. But to use a animal drug formulated for an animal weighing around 1000 pounds does not make any sense at all. Except that the person can get it without a prescription. Drugs for animals are sometimes a lot cheaper than the exact drug sold for humans.

[Vinca]

9. Unless he's a veterinarian and we're talking cows, he needs to lose his license today.

[ck4829]

11. K&R

[marshall]

12. I am currently taking Ivermectin for COVID

I am fully vaccinated--I got the vaccine last February. Last Tuesday I was tested for COVID and on Thursday I got the positive test result. My doctor prescribed Ivermectin and Doxycycline. He is in the National Guard and has been deployed twice around my state in the last 18 months to help with front line crisis Covid care. Tomorrow a paramedic and nurse are coming to my home to administer monoclonal antibodies through an IV infusion. I didn't know what I had been prescribed until after I picked it up at the drive through pharmacy. It is most definitely human grade medication. After I saw what it was I did my own research before taking it--I am a university librarian and have access to a number of academic databases. Teaching graduate students how to do research is what I do every day. While I recognize that this is not an approved treatment in this country, it is the go-to treatment in countries like India, Japan, and Mexico. Research out of those countries suggest a possible slight improvement in outcome for those who take this drug. At any rate I found it would do no harm. I am the sole parent for a young child. I have done everything I can to guard myself from COVID over the past 18 months because of my preexisting conditions. Still, in the end the virus found its way to me. I will continue to do everything I can to protect myself so that I can take care of my child.

I took a photo of the bag the medication came in and rubbed out identifying information. My intent was to post it lest anyone think I was making this up, but I can't find a way to do that.

[GulfCoast66]

13. Well, you are wrong. Ivermectin is not approved for use in Japan.

And is not the go to treatment there. You are getting bad information.

The Japanese Ministry of Health stated that it does not improve mortality, shorten hospitalization or reduce virus loads.

But keep reading what confirms your bias.

I truly hope you get well soon. But taking off label medicines is dangerous.

[marshall]

14. Not approved by the government, but recommended by the Tokyo Medical Association

Tokyo Medical Association is the equivalent of the American Medical Association.

By the way, I was quarantined for 10 days and I am now back at work and my son back in school. I took the ivermectin for three days immediately after getting my positive test result. Three days later I got the monoclonal antibodies infusion. I never had a fever but did have a bad cough and chest congestion. My oxygen level went as low as 91. I was told if below 92 go immediately to ER, but my local ER is closed due to all medical staff being transferred to the larger county hospital to treat Covid onslaught. My oxygen levels were back to 96 the day after the infusion.