Posts Tagged ‘COPD’

Easier Breathing When Treating a COPD Patient with Tiotropium

Posted by Rachel Wolfson • October 16th, 2013

Mr. C, a 65-year-old male with a 30 pack-year smoking history and a cardiac arrhythmia, comes to your office for treatment of his COPD. He has been well controlled on a regimen including tiotropium delivered by a dry powder inhaler called a HandiHaler. He plans to move to Europe to be near his family, but… Read More…

Lung Protective Ventilation

Posted by Daniela Lamas • July 31st, 2013

Your patient is a 63-year-old smoker with COPD. He’d been in fairly good health until a few months ago, when his doctors found a suspicious mass on a screening colonoscopy. Now, surgery is planned to resect part of his colon. He’s anxious, not just about his cancer diagnosis, but also about how his lungs will… Read More…

Tiotropium and the ancient datura plant: Revisiting the role of antimuscarinic therapy in asthma

Posted by Jamie Colbert • September 6th, 2012

For centuries the datura plant has been used for treatment of respiratory disease. The plant, also known as jimson weed or devil’s trumpet, is a potent member of the alkaloid family with antimuscarinic properties. American physicians in the 19th century would commonly recommend patients to smoke datura leaves for relief of asthma and obstructive airway… Read More…

Small-Airway Obstruction and Emphysema in COPD

Posted by Daniela Lamas • October 26th, 2011

For more than four decades, we have known that peripheral airway resistance is increased in emphysema. But it is unclear what changes lead to this increase in resistance. Do the airways simply narrow, or are they destroyed altogether? Without the technology to resolve this question, it has remained largely unanswered. Until now. In this week’s… Read More…

Changes in Forced Expiratory Volume in 1 Second over Time in COPD

Posted by Daniela Lamas • September 28th, 2011

You see a 50-year-old woman for the first time in your office. She tells you she’s still smoking a pack per day. She’s trying to cut down, but it’s hard. For the past few years she’s had a cough each winter and can’t walk the stairs to her second floor apartment without getting winded. For… Read More…

Azithromycin to Prevent COPD Exacerbations

Posted by Graham McMahon • August 26th, 2011

Exacerbations of chronic obstructive pulmonary disease (COPD) are a source of substantial morbidity. In a randomized, controlled trial involving patients with moderately severe COPD, daily treatment with azithromycin for 1 year was associated with fewer exacerbations. Acute exacerbations of chronic obstructive pulmonary disease (COPD) result in frequent visits to physicians’ offices and emergency rooms and numerous hospitalizations… Read More…

Azithromycin for Prevention of COPD Exacerbations

Posted by Daniela Lamas • August 24th, 2011

Summer’s coming to a close and the patient sitting in your office is worried.  A bad cough and wheeze sent him to the hospital for three days last winter, and he feels like he’s never quite gotten back to normal. He stopped smoking a few years ago, and uses the long-acting bronchodilators and inhaled corticosteroids… Read More…

Inhaler Wars: Tiotropium versus Salmeterol for Chronic Obstructive Pulmonary Disease

Posted by Ishani Ganguli • March 23rd, 2011

COPD sufferers know the symptoms all too well: the phlegmy cough, gasping wheezy breaths, and chest tightness that signal an exacerbation. Guidelines recommend inhaled long-acting bronchodilators—either an anticholinergic or a β2-agonist—to mitigate symptoms and reduce the frequency of these exacerbations in patients with moderate to severe disease. Which one is more effective? Without large head-to-head… Read More…

COPD Exacerbations

Posted by Graham McMahon • September 17th, 2010

In the Original Article, Susceptibility to Exacerbation in Chronic Obstructive Pulmonary Disease, Hurst et al. examined the rate of exacerbations among patients with COPD over a period of 3 years. The strongest predictor of an exacerbation in a given year was the presence of an exacerbation in the previous year. The natural history of chronic… Read More…

Severe COPD

Posted by Graham McMahon • April 16th, 2010

Our latest Clinical Practice, Outpatient Management of Severe COPD, comes from Dr. Dennis Niewoehner of the Veterans Affairs Medical Center in Minneapolis. The sentinel clinical feature of severe chronic obstructive pulmonary disease (COPD) is dyspnea on exertion. Its onset is usually insidious, and it may progress to severe disability over a period of years or… Read More…