Table 6.

Anesthetic implications of novel pharmacotherapy in coronavirus disease 2019 patients

Drug used	Adverse effects	Drug interactions and anesthetic concerns
Hydroxychloroquine and chloroquine	Allergic reactions, long QT syndrome, ocular toxicity, neurotoxicity, precipitate porphyrias, aplastic anemia, liver failure	Increases serum digoxin levelsHepatotoxicity induced alteration in metabolism of anesthetic drugsCaution in dyselectrolytemia (hypokalemia)
Ritonavir, lopinavir	Nephrolithiasis, diarrhea, inhibition of liver enzymes, elevated triglycerides	Ritonavir both induces and inhibits hepatic enzyme, thus enhancing the effects of fentanyl by reducing the clearance and by increasing the active metabolitesProlonged effects of muscle relaxants have been observedPlasma levels of lignocaine may be increased due to enzyme inhibition
Remdesivir	Hepatic dysfunction	Interaction with clarithromycin and rifampicin
Tocilizumab	Injection site reactions, hypertension, increased liver enzymes, mouth ulcers, increased serum bilirubin, anaphylaxis	Interaction with statin therapy
Oseltamivir	Hyperglycemia, cardiac arrhythmias, hepatitis, seizures, predisposition to hypothermia	Reduced efficacy of diabetes mellitus therapyClopidogrel decreases serum concentrations of oseltamivirProbenecid increases serum oseltamivir levels