Are your COPD medications in a competition?

The majority of older adults have more than one chronic health condition.  In the US, it is estimated that the number may be as high a 75%. 

In a study of how the medications for the different conditions may adversely interact, researchers found that 22.6 percent of the adults were taking at least one medication that worsened another preexisting condition.

The study, published in the journal PLOS One, also found that in cases where the “competition” was a problem, treatment was only changed by doctors in 16 percent of the cases. That decision becomes a judgement call – the benefits vs. the harm.

The study of 5,815 adults was used to identify some of the more common competing chronic conditions.  Included were the following combinations: hypertension and osteoarthritis; diabetes and coronary artery disease; and hypertension and depression: hypertension and diabetes; hypertension and chronic obstructive pulmonary disease (COPD).

One example of drug competition happened in patients with coronary heart disease and COPD. The beta blockers that are often prescribed to treat heart disease can cause airway resistance that makes COPD symptoms worse.

There are  number of sites on the Internet where you can check your own medication list.
Google “medicine interactions” for a number of places.  Note: If all your meds are not listed at one site, check at another – they are not all the same.

To read more: http://bit.ly/1fpuqVd

Is your body clock affecting the effectiveness of your COPD medications?

It is well known that the body clock regulates sleep, with many side effects such headaches, dizziness, confusion, jet lag etc. as well as regulating our immune system. It is also accepted that many lung diseases indeed show a strong time of day effect, including asthma, and deaths from pneumonia.  Recent findings, published in Nature Medicine, show that even the drugs widely used to treat lung diseases also work with the body clock.

In research, led by Professors David Ray and Andrew Loudon from The University of Manchester, it was discovered that cells lining the lung airways have their own body clock which is the time-keeper for lung inflammation. The team discovered that more severe lung inflammation occurs when the body clock stops working in these cells.  In addition, during the research, the team uncovered that glucocorticoid hormones from the adrenal gland are vital in controlling the inflammation in the cells lining the airway. This finding established that medicines like prednisolone or dexamethasone would also be affected by the time of day that they were administered.

Our lives center around our bodies internal clock, anticipating times to wake and to sleep, and are easily affected by time changes such as time zone changes in travel, and even some problems for some in changing from standard to daylight savings time.  This may explain why medications to treat lung diseases can suddenly become ineffective.

A simple change in the time of day that you take a specific medication might make a huge difference in its effectiveness.

FDA Approves Striverdi® Respimat® for the Treatment of COPD

FDA Approves Boehringer Ingelheim’s Striverdi® Respimat® (olodaterol) Inhalation Spray for Maintenance Treatment of COPD

Striverdi® Respimat® (olodaterol) Inhalation Spray 5 µg is a long-term, once-daily maintenance bronchodilator treatment of airflow obstruction in COPD patients, including chronic bronchitis and/or emphysema. It is a long-acting beta agonist (LABA) delivered via a propellant-free inhaler that generates a soft, slow-moving mist.

Since the active ingredient in STRIVERDI RESPIMAT is olodaterol, a long-acting beta agonist (LABA), it  is not indicated to treat acute deteriorations of COPD and is not indicated to treat asthma. Long-acting beta2-adrenergic agonists (LABA) increase the risk of asthma-related death. All LABAs are contraindicated in patients with asthma without the use of a long-term asthma control medication.

More Info: http://us.boehringer-ingelheim.com/news_events/press_releases/press_release_archive/2014/08-01-14-fda-approves-boehringer-ingelheims-striverdi-respimat-olodaterol-inhalation-spray-maintenance-treatment-copd.html

Another milestone for COPD-International

Today marks another milestone at COPD-International as we turned 12. What a difference since our website first went online at 1:07am on June 26, 2002.

Back in 2002, the “Shame and Blame” stigma for COPD was running rampant, with patients blaming themselves, families and friends blaming them, and even some in the medical profession contributing to the self inflicted label. Outside of some in the medical profession and those of us with this disease, few even knew the definition of COPD. With few exceptions, the medical professions and governing agencies were almost ignoring the condition, in spite of its ranking back then as the 4th leading cause of death.

Surprisingly little had actually been learned over the years. Studies and clinical trials had been very limited. There were a few organizations offering a “sliver” of support exclusively for the COPD patient, mostly through email lists, message boards and chat rooms. Prior to 2002, there was no organization providing total support as well as a resource for understandable, accurate and consistent information.

COPD International opened its doors focused exclusively on COPD and offered complete support at all levels including: chat rooms, email lists, newsletters, message boards, specialized support areas like exercise and quit smoking, etc. – plus an extensive library.

As we look at today – though much slower than we would like, many major steps have been taken in many parts of the world. COPD awareness is no longer a dream. Little did I foresee that when I sent a simple message, (“Effective 1:07am EDT(6/26)Our website is Open for visitors ….”), to the other founders (Susie Bowers, Deb Hannigan, Billie Mahaffey, Ray Price, Cindy Schian, and Dorothy Williams) that today, you would be visiting us at COPD-International on PCs, laptops, smartphones, Kindles and tablets from over 150 countries. In addition, we have many professionals who use us as a resource for information, as well as referring others to us.

As we go forward into our 13th year, it is our “Birthday wish” that every COPD patient who can will step up to the plate and pitch in. No matter what stage our COPD is at, we can change the face of COPD in one of many ways. Volunteering, donations, registering in a research registry, speaking to groups of all sizes are just a few ways you can do your part.

Change holds all the promise for the future – ours as well as the future of those who come behind us.

One of a COPD patient’s biggest concerns – Treating Pneumonia

In a VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas study of nearly 65,000 patients 65 years and older who were hospitalized with pneumonia, treatment that included azithromycin compared with other antibiotics was associated with a significantly lower risk of death and a slightly increased risk of heart attack.

The final analysis reported in the June 4 issue of JAMA included 31,863 patients who received azithromycin and 31,863 matched patients who did not, but some other guideline-concordant therapy. The researchers found that 90-day mortality was significantly lower in those who received azithromycin (17.4 percent, vs 22.3 percent). There was also an increased odds of heart attack (5.1 percent vs 4.4 percent), but not any cardiac event (43.0 percent vs 42.7 percent), cardiac arrhythmias (25.8 percent vs 26.0 percent), or heart failure (26.3 percent vs 26.2 percent).

Pneumonia and influenza together are the eighth leading cause of death and the leading causes of infectious death in the United States, and despite recent research suggesting that azithromycin may be associated with increased cardiovascular events, this study indicates that the benefits of azithromycin treatment for it far outweigh the possible risks.

Resource:  http://medicalxpress.com/news/2014-06-outcomes-older-adults-pneumonia-treatment.html

A Warning about the COPD Diet Study Results

A recent widely reported study has shown a direct link between eating fish, fruit and dairy products and improved lung function among patients with COPD, including less emphysema, improved six-minute walk test scores, improved SGRQ questionnaire scores, and a decrease in certain inflammatory indicators. The study results specifically include grapefruit as one of the fruits.

It has long been known that grapefruit and grapefruit juice can interact with certain medications. The interaction level can range from minor changes in a medication’s effectiveness to a dangerous and even deadly level. The list of dangerous side effects includes heart rhythm problems, kidney failure, muscle breakdown, difficulty with breathing and blood clots.

As little as one grapefruit or one 8-ounce glass of grapefruit juice can cause an effect that may last more than 24 hours. To see a list of the more common medications and their side effects when taken with grapefruit, go to: http://www.rxlist.com/grapefruit-page3/supplements.htm

May 31st is World No Tobacco Day

Every year, on 31 May, the World Health Organization (WHO) partners with governments,  military installations, non-profit organizations and individuals world wide to mark World No Tobacco Day. Founded by the World Health Organization (WHO) in 1987, the goal of this annual event is to increase the awareness of the adverse health effects of tobacco products, which kill an estimated 6 million people worldwide every year. The theme of this years world no tobacco day centers around banning tobacco industry promotion, advertising and marketing by calling on countries to raise taxes on tobacco since research has shown that higher taxes are especially effective in reducing tobacco use and preventing young people from starting to smoke.

Tobacco use is the single most preventable cause of death globally and is currently responsible for 10% of adult deaths worldwide. Many studies have shown that smokers cost the health care system and health insurers more than non-smokers.  Stopping smoking worldwide will help prevent millions of unnecessary deaths and save a huge amount in health care costs.

COPD International honored as one of the best COPD blogs for 2014

For the third year, COPD-International’s website and blog has been selected as one of the best COPD blogs of 2014 by Healthline.com. Healthline.com is the online home of Health Magazine

In their write up, they say:
Obtaining the latest news about COPD is just as important as learning about the basics. This is where the COPD International Blog can help. COPD treatment is always evolving. This blog’s goal is to make sure readers have the latest facts at hand.

Learn about topics like the importance of exercise and health care coverage. Throughout all of the information, COPD International Blog maintains a positive tone and asserts that “COPD is not a death sentence.”

COPD information and support with your smartphone or tablet

The COPD-International website is optimized for smart phones and smaller tablets!  Almost all of the features of the full website are available to you while you are on the go.   Larger tablets can access the main site as well.

The mobile site contains most of the important parts of the main COPD-International website, including extensive information about COPD, access to the library affording you a searchable access to over 500 files on COPD organized in an easy to find format, as well as access to the latest COPD news and our blog. The site features an interactive capability for guidance and support by linking to our main site’s message boards and information on chats.

All of this is available without having to download an app!  Simply enter COPD-International.com on your smartphone or tablet.  The full URL, if needed is http://copd-international.com/mobile.

Every hospitalized COPD patient needs a watchdog

Several studies have identified a so called weekend effect for COPD patients who are admitted into the hospital on a weekend, resulting in an increase in the risk of dying.
There were several explanations for this, including:

  • Shortage of staff
  • Reduced availability of services
  • Patients with severe exacerbations going directly to the ER
  • Patients with milder symptoms waiting to see their doctors during the week

In a new study, researchers from the Lady Davis Institute at the Jewish General Hospital and McGill University, in Montreal, Quebec, Canada, used medical records to examine death rates in over 300,000 people over the age of 50 who were admitted to hospital with either COPD or pneumonia between 1990 and 2007

This new study analyzed the ‘weekend effect on COPD’ in a different way. This new study evaluated the risk by assessing whether patients who stayed in hospital over the weekend, even if they were admitted earlier in the week, also experienced an increased risk of death.

The results of this new approach to the weekend effect demonstrated that, regardless of when patients are admitted to hospital, the stay over the weekend increases the risk of death.

  • Weekdays, the death rate was 80 per 10,000 per day.
  • Friday, the death rate increased by 5%, (an increase of 4 deaths per 10,000).
  • Saturday and Sunday the death rate increased by 7% (an increase of 5.6 deaths per 10,000 for each day)

This study indicates that the increase in the risk of death is due to a reduced quality of care, or reduced access to high quality care at the weekend, and actually begins with Friday.

To defend against this, regardless of the cause, be it low staffing – less qualified staff – indifference – reduced availability of services, enlist a friend or family member to act a your watchdog.

Your watchdog does not need to be “medically proficient”.   Asking a few simple questions and observing the overall care is often enough. This person must be willing to speak up when needed – - one who is very observant and can be a bit pushy – - and if possible can “drop in to visit” at all different hours.  The uncertainness of your watchdog’s arrival times tends to make a staff more aware, resulting in better care.

Data source: http://www.medicalnewstoday.com/releases/276780.php

Caregivers resources: http://www.copd-international.com/caregivers/