Obstructive Lung Disease

Questions discussed in this category

How do you approach the use of benzodiazepines in patients with chronic medical illnesses that may be susceptible to respiratory compromise (e.g., CHF, COPD, ILD)?

Should you work to wean patients of benzodiazepines? Is your approach different for patients who have been on benzodiazepines for years? What would yo...

4 Answers available

What is your preferred rescue inhaler for patients with asthma?

Do you favor albuterol PRN, albuterol/budesonide PRN, or SMART therapy with ICS/formoterol?

1 Answer available

Have you observed adverse mental health side effects in patients who start montelukast?

In light of the FDA warning about mental health side effects of the medication have you observed in particular any patients develop suicidal thoughts ...

3 Answers available

Do you use bronchodilator response to distinguish between asthma, COPD, or asthma-COPD overlap?

Do the findings of a recent large cohort study (Beasly et al., PMID 38029294) in which bronchodilator response did not distinguish between asthma and ...

1 Answer available

Is methacholine challenge on its way out?

1 Answer available

When would you recommend prescribing an asthmatic patient budesonide/salbutamol rather than budesonide/formoterol?

6 Answers available

What is your preferred biologic in children and adolescents with T2 high asthma?

1 Answer available

Do you feel high dose Symbicort or Dulera is appropriate to use for SMART despite these doses not being studied in clinical trials?

1 Answer available

What factors do you consider prior to offering a trial of ICS/LABA therapy versus a methacholine challenge test in patients with suspected asthma but normal pulmonary function testing?

1 Answer available

Should in-office oscillometry for lung function measurements be utilized in pediatric patients who are unable to reliably perform spirometry?

1 Answer available

What is your approach to de-escalation of asthma inhaler therapy in the setting of negative bronchoprovocation testing when patients are averse to deprescribing?

At times due to limited testing resources, inhaler therapy is started based on clinical suspicion of asthma and bronchoprovocation testing is done lat...

1 Answer available

What features on PFT or flow-volume loops do you look at to suspect small airway dysfunction?

Often distal flattening of expiratory limb or decreased Fev25-50/FVC is referred for small airway dysfunction but it is advised against using it give ...

1 Answer available

What is the rationale/evidence to support doing 4 puffs of albuterol vs. 2 puffs for a reversibility study?

3 Answers available

Will you incorporate ensifentrine in the treatment regimen of patients with COPD on baseline dual or triple inhaler therapy?

1 Answer available

What is your approach to de-escalation of asthma therapy if patients have remained clinically stable on triple inhaler therapy and a biologic agent?

1 Answer available

Is there a role for biologics to improve lung function in patients who have severe asthma with daily symptoms and reduced lung function but do not experience frequent exacerbations?

2 Answers available

How do you factor smoking history into biologic selection for asthma since the clinical trials generally excluded these patients?

1 Answer available

Do you diagnose obstruction by the criteria of FEV1/FVC < 70% or < LLN?

5 Answers available

Do you use hypercapnia as an exclusion criteria in all patients that are being assessed for bronchoscopic lung volume reduction?

1 Answer available

What is your approach to inhaler therapy in a patient with asthma who cannot be on an inhaled corticosteroid due to ocular disease?

1 Answer available

What is your threshold to start triple therapy in mild to moderate asthma/COPD overlap with minimal functional limitation?

1 Answer available

Will you use FeNO testing in all COPD patients to determine whether they are candidates for therapy with dupilumab?

If so, would this be a consideration in all patients regardless of active smoking status? FeNO in active smokers has been questioned, could this have ...

2 Answers available

Are the results of the BOREAS trial generalizable to non-white populations?

The cohort in the study was predominantly white. Do these results highlight significant disparities in COPD care?

2 Answers available

Did the low rate of COPD exacerbations in the BOREAS cohort overall confound the results of the study?

2 Answers available

What patient factors prompt you to consider starting dupilumab in patients with COPD?

Does active smoking status influence this decision?

2 Answers available

Do you prescribe bronchodilators to patients with radiographic emphysema and respiratory symptoms, but no spirometric obstruction?

1 Answer available

Is there a role for biologics to help patients with ABPA who are steroid responsive and have removed their allergen insult, but continue to have an elevated serum IgE and incomplete resolution of symptoms return to their baseline functional status?