Next up for some tweet-ucation is "Inhaled Medications in COPD: Contemporary Strategies to Manage an Old Disease"! #CHEST2021 1/
Dr. Arzu Ari speaks on "Aerosol Drug Delivery in Patients with COPD." #CHEST2021 2/
There are many devices available and the goal is to choose the most appropriate device to meet the patient's needs. #CHEST2021 3/ 
Unfortunately, only 35-37% of HCPs actually consider the device type to be highly important when prescribing. #CHEST2021 4/
Choose a device and medicine based on these factors. #CHEST2021 5/
Age is an important factor as inspiratory flow rate decreases with age and noneffective inhalations increase with age. #CHEST2021 6/
As the degree of obstruction worsens there is an increase in the error rate of ineffective inhalations. #CHEST2021 7/
Physical and cognitive abilities should also be considered. #CHEST2021 8/
For instance, impairments in some of these physical abilities can make it hard to use certain devices. #CHEST2021 9/
Also consider the cognitive ability of your patient and whether they can understand how and when to use a device. Of course also consider patient preference and cost of the medication. #CHEST2021 10/
Device selection flow chart. #CHEST2021 11/
Algorithm for device selection. #CHEST2021 12/
Main considerations in device selections #CHEST2021 13/
There are a number of factors that can contribute to incorrect inhalation technique. #CHEST2021 14/
Patients are concerned with medication effectiveness, but not with proper technique. #CHEST2021 15/
Lung dose can be increased with breath holding. #CHEST2021 16/
Each DPI required a different inspiratory flow rate. #CHEST2021 17/
There are tools that can be used to assess inhalation techniques. #CHEST2021 18/
Prepare effective educational sessions for your patients. #CHEST2021 19/
Reasons for poor patient adherence to aerosol therapy #CHEST2021 20/
Monitor patient adherence to therapy because it does contribute to their outcomes. #CHEST2021 21/
Algorithm for disease monitoring #CHEST2021 22/
Summary #CHEST2021 23/
Next up Dr. Nicola Hanania (@Hananianick) talks on "Update on Optimizing Therapy for COPD." #CHEST2021 24/
COPD today and tomorrow #CHEST2021 25/
Components and progression of COPD #CHEST2021 26/
COPD is underdiagnosed. #CHEST2021 27/
COPD is a heterogenous disease #CHEST2021 28/
COPD has multiple phenotypes #CHEST2021 29/
There are also comorbidities and coexistent conditions that have to be considered. #CHEST2021 30/
Goals of COPD management #CHEST2021 31/
GOLD COPD assessment tool #CHEST2021 32/
Non-pharmacological interventions are also important, and COPD management is multidisciplinary. #CHEST2021 33/
Current therapies for COPD #CHEST2021 34/
Individual patient characteristics need to be considered in the medication plan. #CHEST2021 35/
Choose initial medications based on GOLD group. #CHEST2021 36/
Dual LABA/LAMA is superior to either alone in patients with symptomatic COPD. #CHEST2021 37/
Consider adding an ICS if they have high eosinophils. #CHEST2021 38/
Triple therapy has been shown to be superior to dual therapy in patients with severe COPD, and there is even a mortality benefit. #CHEST2021 39/
ATS guidelines for COPD pharmacologic management #CHEST2021 40/
Roflumilast can help patients with chronic bronchitis and a history of exacerbations. #CHEST2021 41/
Azithromycin decreases COPD exacerbations. #CHEST2021 42/
This loop needs to be continued in follow-up of patients with COPD. #CHEST2021 43/
Strategies to ensure adherence #CHEST2021 44/
Unmet needs with current therapies. #CHEST2021 45/
The future lies in targeting therapy to COPD phenotypes and endotypes. #CHEST2021 46/
Summary #CHEST2021 47/
Sanjay Sethi talks about "Problem-Based Clinical Case to Optimize Interprofessional COPD Care." #CHEST2021 48/
Interprofessional care in COPD #CHEST2021 49/
Management cycle #CHEST2021 50/
De-escalation of ICS #CHEST2021 51/
This study showed that adding Budesonide to Formoterol reduced daily COPD symptoms. #CHEST2021 52/
Pulmonary rehab improved a number of interventions, and it is underutilized. #CHEST2021 53/
Repeat pulmonary rehab helps, and home pulmonary rehab also has a benefit. #CHEST2021 54/
Methods of bronchoscopic lung volume reduction #CHEST2021 55/
This study showed improvement in CAT score with use of SR Morphine for refractory breathlessness (shameless plug to check out my on demand session on the management of chronic dyspnea!!!). #CHEST2021 56/
Mucus plugging is associated with worse outcomes. Consider airway clearance. #CHEST2021 57/
Summary #CHEST2021 58/58
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