Which medication wins the battle in COPD?

There is always one drugs trying to stake its place as being better than another. A new report suggests that tiotropium (Spiriva) may be “better” than a rival long-acting bronchodilator, salmetrol (Serevent), in a head-to-head comparison. What the “battle” was about was the length of time to having an exacerbation of COPD related symptoms (cough, sputum production, bronchitis, etc). The tiotropium brand had a longer time to exacerbation (187 days) than the salmetrol (145 days).

One word of caution, however, was ...

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New therapy for asthma?

A new therapy for the management of uncontrolled asthma has now been proposed in a recent article in the New England Journal of Medicine. In the September edition, 2001, an article appeared which has stirred the interest amongst pulmonologist. Stephen Peters, MD, of Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina, was the principal investigator. The study was released by the US National Heart, Lung, and Blood Institute.
The patients evaluated were on low dose inhaled corticosteroids (beclomethasone ...

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COPD and rationale usage of medications

In a GLUCOLD Study from the Neitherlands, by adding inhaled fluticasone (inhaled corticosteroid, ICS) to inhalation therapy in patients with chronic obstructive lung disease (COPD) it was demonstrated to improve “quality of life” parameters, reduce inflammation in patient’s airways (as shown by a reduction of mast cells, neutrophils and eosinophils in sputum, and reduced airways hyper-responsiveness compared to placebo at 6 months of treatment. Cessation of the fluticasone resulted in reversal of benefits back to baseline. This could mean that ...

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Loss of lung function

While chatting to my patients I find it helpful to refer to the graph shown below to help educating individuals about the decline in lung function in normal patients, cigarette smokers and in those people who quit smoking.

The purpose of this graph is to visually explain what may be predicted on the basis for those individuals who qualify for one or the other categories.

PFTs

 

Screen-shot-2011-02-14-at-12.52.38-PM

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Devices to help with mucous clearance

Several devices abound for helping patients with chronic bronchitis and productive coughing of mucous. Patients may experience difficulty expectorating the phlegm in their chest. While I am not endorsing any particular device, the following are devices that can be considered:
1. Lung Flute (by Medical Acoustics). medicalacoustics
2. Flutter (by Axcan Scandipharm, Inc) axcan.
3. Acapella (by Smiths-Medical).acapella

For more severe problems there are VESTS that can be used to strap onto a patient’s chest to provide percussive therapy ...

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