Dazed and Confused – Dexmedetomidine for the Prevention of Delirium and the Safety of LABAs in Asthma


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This week Kieran and Dr. Fraser Pollard, a Family Physician in Trenton, Ontario, discuss two studies:

Using long acting beta agonists (LABAs) safely and appropriately in the management of asthma is widely debated, with evidence suggesting a potential risk of serious asthma-related events associated with the use of LABAs. But is the potential risk warranted? Kieran and Fraser discuss the risk of serious asthma-related events when patients are treated with a LABA plus an inhaled glucocorticoid compared to treatment with an inhaled glucocorticoid alone. The study demonstrates some reassuring results to the hosts in light of current practice guidelines.

Approximately 30% of patients admitted to the intensive care unit develop delirium – it is incredibly common! Delirium is a distressing condition for everyone involved, and until now there has been no proven strategy to prevent it. Kieran and Fraser discuss the implications of dexmedetomidine use in the prevention of incident delirium in elderly patients following non-cardiac surgery. An impressive result, but is it just glitter?!!

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The Papers

1. Asthma: LABA + ICS vs ICS: http://www.nejm.org/doi/full/10.1056/NEJMoa1511049

2. Dexmedetomidine for the prevention of delirium: http://www.sciencedirect.com/science/article/pii/S0140673616305803

Good Stuff

1. Biologics in the treatment of Alzheimer’s disease: https://www.sciencedaily.com/releases/2016/08/160831133555.htm

2. Lying to reliability: http://www.theatlantic.com/magazine/archive/2015/11/tall-tales/407836/

 

Music Credits (Creative Commons)

In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart

Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music

Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music

All tracks have been modified for the purposes of this podcast.

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