It seems the pendulum is always swinging back and forth with the management of COPD. Few years ago, we have pulled away from the use of high dose inhaled corticosteroids when we found its association with increased risk of pneumonia and related mortalities. Here’s my post on this topic. And thus, the treatment strategy has shifted to using more long acting bronchodilators. These bronchodilators include LABA (long acting beta agonist) and LAMA (long acting muscarinic antagonist).
I realize there is so much talk and education on how we should prescribe antibiotic more appropriately. A discussion on antibiotic stewardship may sound very sexy but the public may not be able to connect to such term. In essence, antibiotic stewardship is an initiative to promote appropriate antibiotic prescribing, to improve patient outcomes and to reduce antibiotic resistance. Maybe making it personal will help – and I mean let’s look at my daughters’ antibiotic use.
Are you kidding me? We don’t have salbutamol nebules during the peak season where many people are experiencing shortness of breath due to pneumonia, respiratory infections or COPD/asthma exacerbation? Salbutamol is a quick acting bronchodilator medication which is often prescribed to relieve shortness of breath by opening up the airways to the lungs. It is an essential medicine.
The influenza season usually runs between November and April of every year. During this time, it can be busy for long term care facilities. Flu vaccines are administered to residents. Staff members are encouraged to receive their flu vaccines. All residents are verified to have an active antiviral prescription on file to treat or prevent the influenza infection if needed. Education on proper hand hygiene is provided. These activities are all done in the hope to prevent any influenza outbreak or to be able to manage the outbreak in a somewhat organized manner.
So what happens if front line staff members do not receive their flu vaccines?
Here’s a quick question:
New Year is a time for resolution – specifically many smokers may ponder the idea of quitting. Bravo if you are one of them! After all, smoking cessation products are always in high demand every January. I came across the press release from Pfizer just before Christmas that the Black Box Warning related to the neuropsychiatric safety in Varenicline as well as Bupropion has been removed.
I thought, how timely and strategic of such a release! It was the perfect time to spread the message, just in time for New Year’s Resolution. I wonder how much effort did Pfizer and GlaxoSmithKline put in to ensure FDA removed the safety warning just before Christmas. That was my skeptical voice that was talking in my head.
Twenty years ago when I learned about COPD (chronic obstructive pulmonary disease) in pharmacy school, the focus was on smoking cessation. There were limited inhaler options back then; we only had salbutamol (Ventolin) and ipratropium (Atrovent) as metered dose inhalers. My impression at the time was that COPD should be prevented if at all possible because the treatment options were limited. Actually, I felt the inhalers were useless craps.