The Curbsiders Internal Medicine Podcast

#500: COPD Update with Cyrus Askin


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GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care

Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and build treatment around long-acting bronchodilation—adding ICS selectively based on exacerbations and eosinophils. We’ll highlight the nonpharmacologic moves that change outcomes (smoking cessation, vaccination, pulmonary rehab, oxygen when indicated), when to reach for add-ons (azithromycin, roflumilast), how to approach chronic hypercapnia with home NIV, and what’s new (hello, ensifentrine). Pulmonologist and longtime Curbsiders member Dr. Cyrus Askin (@Askins_Razor ) returns to share real-world pearls for diagnosing, treating, and managing comorbidities in COPD.

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

  • Intro
  • Case 1
  • Diagnostic Workup
  • Understanding the Ratio, LLN/Z-Scores, and Equity
  • Symptom abd Risk Staging (A/B/E)
  • Case 2
  • Foundational Care 
  • Initial Inhaler Strategy 
  • Progression & Hypercapnia: NIV & Adherence Counseling
  • Add-On Pharmacologic Options for Frequent Exacerbators
  • What’s New and Emerging
  • Comorbidities and When to Refer 
  • Take-Home Points Recap
  • Plugs, CME, and Credits


  • Credits

    Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

    • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
    • Reviewer: Emi Okamoto MD
    • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
    • Technical Production: PodPaste
    • Guest: Cyrus Askin MD
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