In episode 431, James and Mike continue their review of the evidence around medications for systolic heart failure. In this episode we discuss betablockers, ACEIs, ARBs, MRAs and a few other key trials of somewhat newer agents. 

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Podcast handout

In episode 430, James and Mike do a review of all the best available evidence around medications for systolic heart failure. In this episode we start off by framing the risk associated with heart failure (mortality and hospitalizations for heart failure) and what the evidence is for exercise, salt, diuretics, digoxin and ISDN/hydralazine.

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In episode 429, Mike and James continue their discussion with Barb Farrell around deprescribing. We talk in generalities, with occasional brilliant specificity, about the PPI/benzos/antipsychotics/glucose lowering medication deprescribing guidelines. In the end we come up with the astounding idea that maybe some people are on too many medications.

In episode 428, Mike and James invite Barb Farrell to discuss all the great work being done by the people at deprescribing.org.  We discuss the general approach to deprescribing and why it is so important to keep this concept front and center of health discussions.

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In episode 427, James and Mike invite Mark McConnell back to the podcast to discuss the philosophy around how not to do what didn’t need to be done. You start with a differential diagnosis then think about what are the possible causes of this presentation?

In episode 425, James and Mike invite Samantha back again to talk about the evidence around the incidence of opioid use disorder that we cause by prescribing opioids. The key issue seems to be whether or not your patient has a history of substance abuse. 

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Tools For Practice

In episode 424, James and Mike continue chatting with Samantha Moe about a number of useful studies in primary care. We talk about blood pressures in the elderly, negative urine cultures, melatonin and migraine, dementia and driving, and complementary health products for the common cold.

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In episode 423, James and Mike welcome Samantha Moe, a pharmacist and clinical evidence expert with the College of Family Physicians, to the podcast. We discuss studies on cannabis and risk of schizophrenia, the harms of PPIs, H pylori infections and duration of treatment, and blood pressure measurements over clothes or a bare arm.

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In episode 421, Mike and James discuss the best available evidence around the newer and typically more expensive iron formulations used for iron deficiency anemia. We find the newer iron formulations are inferior to older ferrous salts when it comes to treating anemia and the evidence that newer formulations have less adverse effects is at best inconsistent.

In episode 420, James and Mike welcome back Bruce Arroll to talk about approaches to how we should talk about, discuss, chart and treat mental health issues. We discuss avoiding psychiatric labels, consider giving transdiagnostic labels, and doing functional assessments around work, love, and play.

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