Agent
Classification
Mechanism of action
Dosage
Side effects
Antibiotics
(Broad spectrum)
Initiate as per
institution
based
CAP/VAP
Policy
Secondary bacterial
infection
(CAP)/VAP
Corticosteroids
Not indicated in treating SARS CoV2 as per available evidence. Might prolong viral shedding. Use as per indicated in septic shock/if patient has other indications for steroid use
Hydroxychloroquine
Off label use
Hampers low PH
dependant steps of viral replication
400 mg BID x 2 doses, then 200 mg BID for 5 days
QT
Prolongation
Interferon Beta 1
Immunomodulatory;
enhancement of
innate and adaptive
viral immunity
Flu like syndrome
Depression
IV Immunoglobulin
(IVIG)
Antibodies from
convalescent plasma
might suppress viraemia. Theoretically:
Better to start at
early stage of
disease
Consider IVIG at
Standard dose of
1 gm/kg daily x 2
doses
Might interact
with antivirals
Ivermectin
Works by causing the parasite’s cell membrane to increase in permeability resulting in cell death
200 – 400 mcg per kg body weight
Neurotoxicity
Lopinavir/Ritonavir
3CLpro (viral protease) inhibitor
400/100 mg BID for up to 10 days
QT prolongation
Hepatotoxicity
Oseltamivir
No trials on COVID-19
Neuraminidase
enzyme inhibitor in influenza
150mg BID for 5 days
GI intolerance Headache Insomnia
Remdesivir
Investigational (can be used only on compassionate basis)
RNA dependent
RNA polymerase
inhibitor
200 mg IV loading
dose, then 100 mg IV daily, up to 10 days
GI intolerance Hepatotoxicity
TNF-α Inhibitors
Interferes with tumor necrosis factor by acting as a TNF inhibitor
Tocilizumab
Monoclonal antibody to IL6 receptor / treats cytokine release syndrome
8 mg/kg
Duration: one dose
Elevation of
liver enzymes
Increased risk
of re-activation
of other
Respiratory
Infections