I love this. Thank you. Why are ace inhibitors not used as a treatment for covid since the spike molecule binds to ace receptors? As an RN I often looked up drugs for safety information but found the description of the drug included the modifier that the mechanism of action was unknown. What effect does the stomach play in the breakdown availability of oral medications. Weight loss surgery, acid blockers ect?
ACEII inhibitors were actually a big mystery at the beginning. There was a lot of concern that people on high blood pressure medications would be more susceptible to the virus but that, as we can tell now, did not pan out. It was likely not massively prescribed because the risk/benefit may not be worth it as many healthy people may suffer from hypotension, although that would require we look at dosage and duration for those effects. Unlike Hydroxychloroquine and Ivermectin which may play a direct role as antivirals the risk was probably higher with ACEII inhibitors. But again considering how much censorship has been going on with respect to repurposed drugs there may be another motive at play as well.
So ironically a lot of drugs may not actually have fully elucidated mechanisms of action. In some cases the assumption is made that a drug may look similar to other compounds and may follow a similar pathway as those drugs. Other times it's an attempt to work backwards from the effects and then see what may be the target. Are there specific drugs you know of that actually stated the mechanism of action was unknown?
The stomach's acidity is likely something scientists have to look at when formulating a drug. A drug that readily undergoes acid catalyzed reactions would not be stable. There are some enzymes within the stomach as well. However, in most cases the the main concern is the liver and the first pass effect. I believe most compounds are absorbed through the intestines and may make their way to the liver which means that the drug may become metabolized by liver enzymes before it reaches their target site.
I forgot to put this as a footnote but most oral drugs have very low bioavailability. The main reason why they are administered orally is because of patient compliance. No one wants to use a needle constantly to inject themselves with a drug, and that requires a bit more skill than popping a pill. If the main concern is that someone takes their then I can see why the oral route is the best even if the bioavailability is so low.
As for weight loss surgery and acid blockers I am not too sure. That may require more research but considering that any changes to the stomach environment may alter digestion and metabolism it wouldn't be too farfetched to suggest that changes to the body would alter bioavailability.
Thank you. I am a psychiatric nurse so likely the drugs I am referring to are psychiatric drugs. I can't think of any off hand but I will look into some of the atypical antidepressants antipsychotics and see if I can come up with a couple.
I've written about Fluvoxamine here but I think the mechanism of action has been fairly elucidated on that one. Definitely let me know if you find anything else. Just remember that I am learning many of these things at the same time as the rest of the people here so it's an overall learning experience for everyone!
Provigil, general anesthesia, (some) metformin...quite a few but of course drugs that have more than one application could have just one therapeutic benefit that is not understood and others that are known. Still a few things unknown about the brain and how it responds to a molecule but I am sure we will continue to learn more.
Interesting, I will try to take a look and see what I can find. Also, I have made a correction to the post above. I have apparently made an egregious mix-up and many hypertension drugs actually target the Angiotensin II Receptor, not ACEII and so that may actually explain quite a bit. Apologies for that error I did not notice it at the time I made this post although I added a correction.
Doesn't ACE mean Angiotensin converting enzyme blocker...all the "prils" used for hypertension and/or left heart failure ect... if not what does ace receptor as a covid molecule receptor stand for?
Yes it's definitely something that should not be assumed. The issue is, unlike an interactive classroom, it's really hard to know where people's baseline understanding of science is. It's like substituting for a class and not know who are the kids who love the topic and those who are going to fall asleep no matter the topic. So just to be safe it may be preferable to at least have a reference for people to use regardless of their science literacy level.
If there are any questions or anything that requires more clarification please feel free to ask and I'll do my best! I'd rather people not struggle if I can provide some assistance with the information.
I love this. Thank you. Why are ace inhibitors not used as a treatment for covid since the spike molecule binds to ace receptors? As an RN I often looked up drugs for safety information but found the description of the drug included the modifier that the mechanism of action was unknown. What effect does the stomach play in the breakdown availability of oral medications. Weight loss surgery, acid blockers ect?
ACEII inhibitors were actually a big mystery at the beginning. There was a lot of concern that people on high blood pressure medications would be more susceptible to the virus but that, as we can tell now, did not pan out. It was likely not massively prescribed because the risk/benefit may not be worth it as many healthy people may suffer from hypotension, although that would require we look at dosage and duration for those effects. Unlike Hydroxychloroquine and Ivermectin which may play a direct role as antivirals the risk was probably higher with ACEII inhibitors. But again considering how much censorship has been going on with respect to repurposed drugs there may be another motive at play as well.
So ironically a lot of drugs may not actually have fully elucidated mechanisms of action. In some cases the assumption is made that a drug may look similar to other compounds and may follow a similar pathway as those drugs. Other times it's an attempt to work backwards from the effects and then see what may be the target. Are there specific drugs you know of that actually stated the mechanism of action was unknown?
The stomach's acidity is likely something scientists have to look at when formulating a drug. A drug that readily undergoes acid catalyzed reactions would not be stable. There are some enzymes within the stomach as well. However, in most cases the the main concern is the liver and the first pass effect. I believe most compounds are absorbed through the intestines and may make their way to the liver which means that the drug may become metabolized by liver enzymes before it reaches their target site.
I forgot to put this as a footnote but most oral drugs have very low bioavailability. The main reason why they are administered orally is because of patient compliance. No one wants to use a needle constantly to inject themselves with a drug, and that requires a bit more skill than popping a pill. If the main concern is that someone takes their then I can see why the oral route is the best even if the bioavailability is so low.
As for weight loss surgery and acid blockers I am not too sure. That may require more research but considering that any changes to the stomach environment may alter digestion and metabolism it wouldn't be too farfetched to suggest that changes to the body would alter bioavailability.
Thank you. I am a psychiatric nurse so likely the drugs I am referring to are psychiatric drugs. I can't think of any off hand but I will look into some of the atypical antidepressants antipsychotics and see if I can come up with a couple.
I've written about Fluvoxamine here but I think the mechanism of action has been fairly elucidated on that one. Definitely let me know if you find anything else. Just remember that I am learning many of these things at the same time as the rest of the people here so it's an overall learning experience for everyone!
Provigil, general anesthesia, (some) metformin...quite a few but of course drugs that have more than one application could have just one therapeutic benefit that is not understood and others that are known. Still a few things unknown about the brain and how it responds to a molecule but I am sure we will continue to learn more.
Interesting, I will try to take a look and see what I can find. Also, I have made a correction to the post above. I have apparently made an egregious mix-up and many hypertension drugs actually target the Angiotensin II Receptor, not ACEII and so that may actually explain quite a bit. Apologies for that error I did not notice it at the time I made this post although I added a correction.
Doesn't ACE mean Angiotensin converting enzyme blocker...all the "prils" used for hypertension and/or left heart failure ect... if not what does ace receptor as a covid molecule receptor stand for?
This was more interesting than I thought it would be, thank you! 👍🏽💕
Thank you! I hope people get a lot out of these series!
While a teacher, I learned that it’s safe to assume your pupils know nothing about the subject you are teaching!
Yes it's definitely something that should not be assumed. The issue is, unlike an interactive classroom, it's really hard to know where people's baseline understanding of science is. It's like substituting for a class and not know who are the kids who love the topic and those who are going to fall asleep no matter the topic. So just to be safe it may be preferable to at least have a reference for people to use regardless of their science literacy level.
I thanks for this information. I will read it a few mor times times for deeper understanding.
If there are any questions or anything that requires more clarification please feel free to ask and I'll do my best! I'd rather people not struggle if I can provide some assistance with the information.