The Tarascon Medical Procedures Pocketbook, a reference Doody's Review Service awarded 5 stars, has now been released as a mobile application for your Apple, Android and BlackBerry devices.
Topics: Google Play, iTunes, mobile medicine, Tarascon, primary care, esherick, General Medicine, mobile applications for doctors, mobile medicine, Tarascon Medical Procedures Pocketbook, blackberry world, Hospital Medicine Blog, medical procedures, mhealth
Dr. Joseph Esherick Monthly Blog – January 2012
When I was in medical school in the early 1990’s, one of the principles that I learned was to never prescribe beta-blockers to patients with chronic obstructive pulmonary disease (COPD). We knew that stimulation of beta-2 receptors caused bronchodilation and therefore the belief was that beta-blockers would cause bronchospasm and lead to COPD exacerbations. This practice was analyzed in a Cochrane review by Salpeter et al. in 2005 which concluded that, “cardioselective beta-blockers, given to patients with COPD do not produce a significant short-term reduction in airway function or in the incidence of COPD exacerbations. “ Another study focusing on the treatment of systemic hypertension in patients with pulmonary disease also concluded that cardioselective beta-blockers (β1-selective antagonists) were safe to use in patients with stable COPD. One final review of the available evidence came to the same conclusion that, “the use of cardioselective beta-blocker therapy in patients with cardiovascular disease and comorbid COPD [appears safe].”
These previous reviews attested to the safety of beta-blocker therapy in patients with stable, mild-moderate COPD. However, a recent study analyzed the question whether beta-blockers in patients with COPD are beneficial if there is an indication for their use?
Topics: cardiovascular disease, Dr. Joseph Esherick, Authors, Tarascon Medical Procedures Pocketbook, Tarascon Primary Care Pocketbook, beta-blocker therapy, beta-blockers, bronchospasm, Cardiology, chronic obstructive pulmonary disease, COPD, Hospital Medicine Blog, Tarascon Hospital Medicine Pocketbook