• Podcast - Don’t huff and puff: NICE tips on stable COPD management

  • Jul 14 2024
  • Duración: 15 m
  • Podcast

Podcast - Don’t huff and puff: NICE tips on stable COPD management Por arte de portada

Podcast - Don’t huff and puff: NICE tips on stable COPD management

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  • The video version of this podcast can be found here: https://youtu.be/VZMKD0bY1G8 The link to the video on COPD diagnosis can be found here:https://youtu.be/o_q8TTra3Ys This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode, I go through the management section of the NICE guideline [NG115] on COPD in adults, always focusing on what is relevant in Primary Care only. I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Apple podcast: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148· Spotify: https://open.spotify.com/show/2kmGZkt1ssZ9Ei8n8mMaE0?si=9d30d1993449494e· Amazon Music: https://music.amazon.co.uk/podcasts/0edb5fd8-affb-4c5a-9a6d-6962c1b7f0a1/primary-care-guidelines?ref=dm_sh_NnjF2h4UuQxyX0X3Lb3WQtR5P· Google Podcast: https://www.google.com/podcasts?feed=aHR0cHM6Ly9mZWVkcy5yZWRjaXJjbGUuY29tLzI1ODdhZDc4LTc3MzAtNDhmNi04OTRlLWYxZjQxNzhlMzdjMw%3D%3D· Redcircle: https://redcircle.com/shows/2587ad78-7730-48f6-894e-f1f4178e37c3 There is a YouTube version of this and other videos that you can access here: ● The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The resources consulted can be found here:Chronic obstructive pulmonary disease in over 16s: diagnosis and management- NICE guideline [NG115]:● https://www.nice.org.uk/guidance/NG115The visual summary for the treatment of COPD can be found here:● https://www.nice.org.uk/guidance/ng115/resources/visual-summary-treatment-algorithm-pdf-6604261741The NICE technology appraisals on oseltamivir, amantadine and zanamivir to prevent and treat flu can be found here:● https://www.nice.org.uk/guidance/ta158 Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] ● Music provided by Audio Library Plus ● Watch: https://youtu.be/aBGk6aJM3IU ● Free Download / Stream: https://alplus.io/halfway-through TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are going to do an up-to-date review of the NICE guideline on the management of stable COPD in adults, always focusing on what is relevant in Primary Care only. If you wish to know about COPD diagnosis, please see the corresponding episode on this channel. The link is in the episode description. Right, so let’s jump into it.For COPD management, once we have offered smoking cessation advice and support, we will offer inhaled therapy. Let’s have a look at the different types of inhalers. We have:· Short-acting beta2 agonists or SABAs, like salbutamol· Short-acting muscarinic antagonists or SAMAs, like ipratropium· Inhaled corticosteroids (ICS)· Long-acting muscarinic antagonists or LAMAs and· Long-acting beta2 agonists or LABAsWhen do we use the different types of inhalers? Well, these are the general rules to follow:· We will use short-acting bronchodilators, that is, either SABAs or SAMAs, as necessary, to relieve breathlessness and exercise limitation. · We will judge the effectiveness of bronchodilator therapy depending on symptom improvement, not just lung function alone. · We will not use oral corticosteroid reversibility tests to identify who should be prescribed inhaled corticosteroids, because oral steroids do not predict response to inhaled corticosteroid therapy. · We will take into account the risk of side effects (including pneumonia) of inhaled corticosteroids for COPD · Inhaled combination therapy refers to combinations of a LAMA, a LABA and inhaled corticosteroids (ICS) and · Combination therapy is recommended in confirmed COPD with SOB or exacerbations despite short-acting bronchodilatorsLet’s now look at the different combinations and when to recommend them. We will offer a LAMA+LABA combination if there are no asthmatic features or features suggesting steroid responsiveness. This includes a previous diagnosis of asthma or of atopy, a higher blood eosinophil count, ...
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