COPD

Sep 132013
 
Mild weight gain after quitting smoking outweighed by cessation's benefits

Weight Gain After Quitting Smoking Usually Mild, Harmless Nicotine is an anorexigen, or appetite suppressant. This “benefit” of cigarette smoking is no secret, certainly not to teenage girls, who in surveys report smoking to stay thin. Even among women smokers over age 40, more than half said they would not quit smoking if it meant they would [… read more]

Aug 032013
 
Oral N-acetylcysteine (NAC) reduces COPD exacerbations in RCT

image: Vitacost N-acetylcysteine (NAC) Improves COPD Outcomes Oxidative stress (imbalance between oxidants and antioxidants) is part of the story of how COPD causes symptoms of cough and shortness of breath. Cigarette smoke is the main source of oxidation damage in the lungs leading to COPD, but even after they quit smoking, people with COPD still [… read more]

Jul 182013
 
Biomarkers help predict COPD exacerbations

Biomarkers Predict COPD Exacerbations (Sort Of) In addition to daily breathlessness, people with chronic obstructive pulmonary disease (COPD) often experience exacerbations of shortness of breath and coughing. Those with more severe COPD tend to have more frequent and severe exacerbations, lower enjoyment of life, and more rapid loss of lung function. The strongest predictor of [… read more]

Jul 052013
 
In COPD exacerbations, 5 days steroids seem as good as 14 (REDUCE trial)

For COPD Exacerbations, 5 Days Corticosteroids As Good as 2+ Weeks COPD exacerbations — worsening of shortness of breath and cough, often requiring medical treatment — are a major problem for many people living with COPD. People with moderate or severe emphysema and chronic bronchitis (together called chronic obstructive pulmonary disease) experience an average of [… read more]

Jun 022013
 
How to prevent COPD exacerbations

How to Prevent Acute COPD Exacerbations Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major problem for many people living with COPD. Acute exacerbations or attacks occur more often in people with more severe COPD (about 1-2 per year), and these disease flares may either signal or cause a more rapid progression of [… read more]

May 162013
 
FDA approves Breo Ellipta, a new once-daily COPD inhaler treatment

FDA Approves Breo Ellipta, Once-Daily LABA/ICS for COPD The FDA approved the new drug Breo Ellipta as a once-daily inhaled therapy for chronic obstructive pulmonary disease (COPD). Breo Ellipta includes the corticosteroid fluticasone, and vilanterol — a once-daily long acting beta agonist — in a combination dry powder inhaler. This was the FDA’s first approval [… read more]

Apr 252013
 
Pulse oximetry as time machine: Lag times confuse doctors, complicate intubations (EMCrit)

image: wikimedia Pulse Oximetry: The 30-Second Time Machine Why does it seem to take so long to re-oxygenate your crashing patient? Because your pulse oximeter is lying to you, no matter how good it is. Telescopes show us how a star looked millions or billions of years ago; pulse oximeters create a similar, though tiny [… read more]

Mar 212013
 
Big Tobacco win: Feds to take breather in fight for scary cigarette labeling

Feds to Big Tobacco on Cigarette Labeling Fight: “Uncle!” The feds are admitting defeat for now in their fight for graphic, negative imagery to be displayed on all cigarette packaging and advertisements. Attorney General Eric Holder announced yesterday that the Justice Department will not ask the Supreme Court to reverse their loss in a federal [… read more]

Mar 172013
 
FDA warns of sudden cardiac death with use of azithromycin

FDA Warns of Sudden Cardiac Death Risk from Azithromycin Last summer, PulmCCM reported on a New England Journal paper suggesting an increased risk of sudden cardiac death in patients taking even a short 5-day course of azithromycin. Yesterday, the FDA expressed its official concern in a Drug Safety Communication and statement to the press on [… read more]

Jan 242013
 
Continuing beta blockers safe during acute COPD exacerbations

Continuing Selective Beta Blockers Safe During COPD Exacerbations by Blair Westerly, MD Many COPD patients also have congestive heart failure or ischemic heart disease, two conditions where beta blocker therapy improves survival, but it has consistently been underutilized. The fear physicians have of instituting beta blockers in COPD is mostly secondary to the theoretical concern [… read more]

Jan 042013
 
Antibiotics (azithromycin) to prevent COPD exacerbations (Review)

(image: Rxhealthdrugs.com) Azithromycin for Prevention of COPD Exacerbations Azithromycin taken daily prevents exacerbations of chronic obstructive pulmonary disease (COPD exacerbations), but seems to also carry risks for cardiovascular death and hearing loss. The true balance of risks and benefits with use of azithromycin to prevent COPD exacerbations is unknown, but physicians who choose to prescribe [… read more]

Jan 022013
 
Adding tiotropium (Spiriva) helped some with uncontrolled asthma (RCT)

Spiriva (Tiotropium) for Uncontrolled Asthma Most people with asthma can achieve good control with inhaled corticosteroids (ICS) and a long-acting beta-agonist (LABA). Some people living with asthma, though, experience persistent symptoms despite maximum doses of these inhaled medications. Fairly or not, LABAs have also been sullied with an FDA black-box warning for worsening bronchospasm in a [… read more]

Dec 302012
 
Azithromycin associated with cardiovascular death

(image: Rxhealthdrugs.com) People taking 5 days of azithromycin had a very small absolute increased risk of death, especially due to cardiovascular causes, compared to people taking amoxicillin, in a retrospective cohort review by Wayne Ray, Katherine Murray, and C. Michael Stein published in the May 17 New England Journal of Medicine. Erythromycin and clarithromycin (the other [… read more]

Dec 242012
 
Let's be honest: quitting smoking usually does make you fatter

There’s no use in sugar-coating the truth: Nicotine is an appetite suppressant, and smoking prevents weight gain. Not wanting to gain weight is a common reason why body-obsessed teenage girls say they smoke–and as far as we know, they’re “right:” teens who smoke gain slightly less weight than teens who don’t. It’s also long been believed [… read more]

Dec 212012
 
Moderate pot smokers' lung function better than nonsmokers

Smoking marijuana moderately over years is strongly associated with small improvements in lung function, even compared to people who have never smoked cigarettes or marijuana, according to a study in JAMA. But the popular news media and the study authors downplayed that finding of the study, apparently to avoid sending a pro-marijuana message. Mark Pletcher, [… read more]

Dec 172012
 
Tiotropium as add-on "triple therapy" for COPD associated with better outcomes

Adding Spiriva to LABA and Inhaled Steroid Might Improve COPD No strong outcomes-based evidence exists as to the benefits in treating chronic obstructive pulmonary disease (COPD) with tiotropium, long-acting beta-agonist and inhaled corticosteroid together — so called “triple therapy.” LABA and tiotropium together do provide additive bronchodilation over either agent alone, evidence suggests. However, only [… read more]

Dec 112012
 
Predicting survival from COPD exacerbations: DECAF score shows promise

DECAF Score Predicts COPD Exacerbation Mortality, But Needs Validation By Brett Ley, MD Despite improvements in care, death during hospitalization for acute exacerbation of COPD (AECOPD) is not uncommon. In the UK in 2008, almost 1 in 12 people admitted with a COPD exacerbation died in-hospital. In the U.S. in 1996, about 1 in 40 [… read more]

Nov 062012
 
Lung volume reduction coils improve dyspnea, FEV1 in COPD (RCT)

(image: PneumRx) ATLANTA — In a small, open-label pilot study, bronchoscopically-placed metal coils that retract emphysematous lung, creating lung volume reduction without surgery, produced functional and airflow improvements in a majority of patients with severe COPD, the lead researcher reported at CHEST 2012. Investigators randomized 47 patients with severe emphysema type COPD to undergo either [… read more]