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Using CRP in COPD to Guide Treatment Decisions During Exacerbations

Patients frequently present to outpatient clinics and community pharmacies with acute exacerbations of chronic obstructive pulmonary disease and clinicians have an important decision to make. Should they prescribe antibiotics? Patients may seek antibiotics as a quick fix to their symptoms, but many AECOPD are not caused by bacterial infection. Prescribing unnecessary antibiotics exposes patients to adverse effects and can increase antimicrobial resistance.  But not prescribing antibiotics could delay recovery if the exacerbation is of bacterial origin … or worse, result in an avoidable hospitalization and death. Could a simple, bedside test empower patients and prescribers to use antimicrobials more selectively?

Guest Author:  Brittany Schmidt, PharmD, BCACP

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Should We Hold Our Breath for Vitamin D in COPD?

Chronic obstructive pulmonary disease (COPD) exacerbations contribute to mortality, disease progression, worsening quality of life, and increased health care costs. Respiratory tract infections are a common cause of COPD exacerbations.  While prophylactic antibiotics may play a role, vitamin D supplementation is an attractive option by stimulating innate and adaptive immune responses. Although severe vitamin D deficiency (25(OH)D <10 ng/mL) has been associated with more frequent exacerbations and hospitalizations in patients with COPD, it is unclear if supplementation actually reduces exacerbation frequency. A recent meta-analysis provides some data regarding the potential benefits of vitamin D supplement to prevent COPD exacerbations.

Guest Authors:  Jennifer Clements, PharmD, BCPS, BCACP and Lisa Gibbs, PharmD

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Therapy for Early-Stage COPD: What is the GOLDen Regimen?

Nearly 16 million adults in the United States have chronic obstructive pulmonary disease (COPD) but this is probably a woeful underestimate as many adults are asymptomatic in early stages.  Screening is only recommended if patients exhibit symptoms and have risk factors.  However, the most rapid decline in lung function occurs during GOLD stage 1. As COPD progresses, mortality, morbidity, and the economic burden increase very significantly. These facts suggest a need to detect and treat early-stage disease to slow its progression. The Tie-COPD study provides some new evidence that early treatment might be beneficial.

Guest Authors: Amy Robertson, Pharm.D. and Michelle Balli (Piel), Pharm.D.

Music by Good Talk

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