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Introduction: COPD Gold Guidelines

Heidi James, MD and Rob Orman, MD
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A review of the 2016 GOLD COPD guidelines with a focus on managing stable disease and acute exacerbations.


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Holly D., DO -

Paper Chase #1 Big Pharma: I plan on reading the paper more in depth, but something I wish would have been brought up in the audio... Did the paper mention samples and how that helps patients? Coming from a very strict no-drug-rep residency program vs being in private practice now with seemingly unlimited samples, I feel like I have such a great resource to help my patients. Mostly my Medicare patients in the ever-looming dark cloud that is the donut hole. I absolutely agree that drug reps can sway my prescribing habits. Partially this is because in sea of choices, their name may be the one on my mind because they brought me lunch that week. But for some of my patients I am swayed by having the opportunity to give them samples and help them when their medical bills are overwhelming. Just a thought. Thanks for all you do for physicians, I love PC RAP!

Heidi J., MD -

Hi Holly !
Heidi here from PCRAP.
I had this exact thought yesterday as I was rooting through the office sample cabinet looking for something for my patient who had fallen on tough times and could not afford their medications. I'd love to see a paper that covers the positive aspects of samples....will chat with the PaperChase guys about it! Thanks for listening and for dropping us a note.

Robin T. -

Can someone for the love of all that is good and holy tell me why sports drinks (i.e. gatorade/powerade) are not recommended for pediatric re-hydration? Or better yet why they seem to be vilified for this use?
Super excited to include the diluted apple juice to the arsenal. Thanks in advance and love the show!

Heidi J., MD -

Hey Robin! Heidi James here from the show.
You may find this article from Pediatrics helpful: Looks like caloric intake is a big factor.
Thanks for listening :)

Ian L., Dr -

In the nursing homes and special accomodation units in Australia -Nebulised salbutamol 5mg in 2.5ml saline is used a lot -easiest to manage for cognitively or emotionally hassled patients and staff due to inspiratory and coordination power weakening .
Salbutamol can be hourly then less as cortisone oral or IM kicks in .
Not sure about anticholinrgics hourly or continuous .
Aim : Keep patients out of hospital with all those resistance bacteria .
If not improving as measured by Conscious State Work of Breathing Pulse oximetry PR BP go to hospital.
Nebulisation used a lot in Australia .

Jacob D., MD -

Is there any way to figure out how much money would be saved, if the only patients to get screening colonoscopies, were the ones who had a positive FIT test?

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Aspirin Loses Its Tenure Full episode audio for MD edition 174:59 min - 82 MB - M4AHippo Primary Care RAP November 2016 Summary 388 KB - PDF