Beta-blockers in asthma | Cardiology | 08-2010
There are a series of articles suggesting that in patients without irreversible asthma such as COPD, beta-blockers can be utilized. But it may prove a challenge to sort out how ...
Steroids in COPD | Respirology | 04-2009
Patients are initially given trials of short acting bronchodilators atrovent or salbutamol, terbutaline and one or both of the long acting bronchodilators anticholinergic tiatropium , or beta agonist formoterol or ...
Spirometry crucial for diagnosing COPD | Respirology | 10-2008
By definition, you can t make the diagnosis of chronic obstructive lung or pulmonary disease without doing spirometry. In other words it s pivotal. Spirometry involves measurement of the forced ...
Inhaled steroids for COPD hasten pneumonia | Respirology | 09-2008
This is somewhat controversial and topical at the present time. Evidence exists that there's at least an association of pneumonia with the use of inhaled corticosteroids in COPD patients. In ...
Balancing diuretics to treat pleural effusion | Respirology, Cardiology | 03-2008
Chronic elevation of right atrial pressure or pulmonary arterial pressure, or both, isn't a cause of pleural effusion if it occurs in isolation, according to at least one study Chest ...
What's the best approach for treating COPD? | Respirology | 04-2007
At this point, there's no role for leukotriene blockers in COPD as there are no good randomized controlled trials showing that they're effective. One double-blind randomized acute 4-hour trial showed ...
COPD: when to give oxygen | Respirology | 10-2006
There's evidence that oxygen is indicated when the arterial oxygen tension PaO amp lt sub amp gt 2 amp lt sub amp gt is less than 55 mm Hg, which ...
Is salmeterol risky in COPD? | Respirology | 04-2006
There are a number of trials using salmeterol in COPD. None of them raised concerns about adverse issues, but then, none was designed to specifically look at death rates as ...
COPD: when to add ofloxacin to ventilator | Respirology | 03-2006
This is a tough question. When patients have a life-threatening disease, i.e. one that requires mechanical ventilation, say COPD with chronic bronchitis, we would likely cover them with antibiotics, usually ...
Investigating rectal bleed in a COPD, CAD patient | Respirology | 06-2005
These symptoms aren't likely to be related to either the respiratory or cardiovascular systems. The COPD may make it difficult to workup and treat the patient, but this should still ...
Is SARS tied to smoking? | Respirology | 04-2005
This hasn't been specifically studied yet. What has been shown to correlate with increased mortality is age over 60, diabetes or cardiovascular disease, and comorbid conditions including chronic obstructive pulmonary ...
What drugs best control COPD? | Respirology | 03-2005
Both short-acting anticholinergics e.g. ipratropium and beta-agonists e.g. formoterol, salbutamol, terbutaline have been shown to be effective bronchodilators, improving dyspnea and exercise performance. Each class of drug elicits different individual ...
What's the best IV dose for asthma? | Respirology | 02-2005
I presume this is for emergency treatment. One small study that looked at the dose of methylprednisolone for acute treatment of adult asthma suggests that 125 mg every six hours ...
Reduce corticotherapy for COPD? | Respirology | 11-2004
The use of inhaled corticosteroids in COPD is still controversial, as the evidence is mounting that high doses of inhaled steroids can have systemic effects. These can include increased bone ...
Novel tests using BNP | Respirology | 08-2004
We've just begun to use BNP and it's not always available in most clinical institutions. Preliminary data indicate that high levels suggest congestive heart failure. So this test may be ...
Emphysema vs chronic bronchitis Tx in COPD | Respirology | 03-2004
It's difficult to tease out these two chronic conditions in individuals with chronic obstructive lung disease COPD and treatments tend to be similar. Chronic bronchitis is diagnosed in a person ...
Long-term steroid use, bone loss and bisphosphonates | Rheumatology | 03-2004
The first issue that needs to be addressed is the accuracy of the reported bone loss since the patient has been taking alendronate. Were the BMD studies performed in the ...
Can lung ailments cause headache? | Neurology | 01-2004
Traditionally, the interaction between the respiratory and nervous systems is split into two basic categories. The first is the effect of neurologic disease on the respiratory system. For example, neurologic ...
Can lung ailments cause headache? | Respirology | 01-2004
Lung conditions are often accompanied by headaches as a manifestation of systemic disease. As you've observed, two common associations are with lung cancer and atypical pneumonia. Metastatic lung carcinoma can ...
Rate control options in COPD or asthma | Cardiology | 12-2003
Beta-blockers are the drugs of choice for controlling ventricular response in atrial fibrillation, but they're contraindicated in patients having COPD with true bronchospasm and or asthma. Clinical judgement is always ...
Is melatonin use safe in sleep deprivation? | Neurology | 07-2003
Sleep and sleep deprivation, with their corresponding neuroendocrine influences, are evolving areas of neurologic understanding. These are complex processes, and the length of a amp quot normal night's sleep amp ...
Predicting methotrexate pneumonitis | Respirology | 03-2003
Methotrexate pneumonitis is an unpredictable side effect of the drug, so we don't know its true incidence, but it's estimated as being between 0.3 and 7.5 . One study found ...
Tips on grading COPD severity | Respirology | 03-2003
Severity of COPD is best graded based on simple spirometry and the extent of dyspnea. Spirometry consists of performing the forced expired volume in one second FEV1 and relating this ...
O2 saturation monitoring in COPD | Respirology | 02-2003
Although spirometry is most useful in diagnosing and following the progress of COPD, monitoring oxygen saturation helps to identify individuals who may be candidates for long-term home oxygen. Saturations below ...
The scoop on steroids in COPD exacerbations | Respirology | 01-2003
At least four studies have shown that systemic steroids are beneficial in COPD patients, meaning those with airflow obstruction proven by spirometry, with a forced expiratory volume in one second ...
SAFE O2 ADMINISTRATION IN COPD | Emergency | 02-2002
It's a bit hard to answer the question without knowing more details of the patient's situation i.e. transport time to hospital, availability of oxygen saturation monitoring . It's also difficult ...
BATTLE OF THE STEROIDS: ORAL VS IV | Respirology | 02-2001
A study done recently in a small number of patients with an acute exacerbation of COPD, but no acute acidosis, showed oral steroids to be effective. Unlike in acute asthma, ...
GO BACK TO SQUARE ONE FOR ASTHMA AGONY | Respirology | 01-2000
Since the patient failed to respond to prednisone, all good doctors should reconsider the diagnosis. Are the symptoms due to fixed airflow obstruction, COPD, irreversible asthma, congestive heart failure, reflux ...
INVESTIGATING COPD IN A NONSMOKER | Respirology | 11-1999
Yes, but keep in mind that there are causes of COPD -- defined as obstructive lung disease that doesn't change in response to bronchodilators or with time -- other than ...
WHO SHOULD GET O2 TO GO? | Respirology | 06-1999
According to the literature, home oxygen is proven to be effective in, and is indicated for, patients with chronic obstructive pulmonary disease COPD whose PaO2 is 55 or less, or ...
WHEN TO USE STEROIDS FOR COPD? | Respirology | 05-1999
The answer to this is controversial. Clearly, anyone who's shown reversible airflow obstruction objectively should be treated with inhaled steroids -- even if they were or are smokers. Everyone who ...
WHAT ABOUT VERY LOW CHOLESTEROL? | Cardiology | 04-1998
The vast majority of people with a very low cholesterol are suffering from an undetected illness such as an underlying cancer or severe comorbidities such as significant COPD. Previous data ...
VENTILATION STIMULATION THROUGH MEDS? | Respirology | 04-1998
Experimental data shows that theophylline and its breakdown substances act as a respiratory stimulant. At this time, however, there aren't any good studies showing that it makes any significant clinical ...
NO TO BETA BLOCKERS IN ASTHMATICS | Respirology | 07-1994
Patients with asthma have a clear predisposition for developing bronchospasm following the use of beta blockers, whereas not all patients with chronic obstructive pulmonary disease COPD will develop the problem ...
