How do you counsel patients on beta blockers? Is one beta-blocker better than the other? What is preferred: ACEi, ARBs or ARNIs? What are the pros and cons of each? How does spironolactone compare to eplerenone? When do you stop mineralocorticoid receptor antagonist? What are risks with SGLT2 inhibitors? How do you initiate GDMT? Which meds do you start first and in what order?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/05/11/5-pearls-on-guideline-directed-medical-therapy/Sponsor: https://go.amboss.com/GDMT (https://go.amboss.com/GDMT)Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps:* 03:13 Pearl 1* 12:14 Pearl 2* 20:36 Pearl 3* 26:42 Pearl 4* 32:16 Pearl 5Tags: IM Core, CoreIM, heart failure with reduced ejection fraction, GDMT, treatment, cardiology

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#104 Guideline-Directed Medical Therapy for HFrEF Part 1: 5 Pearls Segment

Core Internal Medicine via following series: 5 Pearls || Clinically relevant pearls Mind the Gap || Why do we do what we do? Gray Matters || Management Reasoning Hoofbeats || Dissecting clinical reasoning At the Bedside || Explore everyday challenges

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Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care. Show Notes & TranscriptTime Stamps01:47 Evolving story of asthma management03:26 Pathophysiology of asthma management06:01 Key players & terms08:56 Story of asthma through the decades17:55 MANDALA Trial
Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalersFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840

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#149 Asthma Management and the MANDALA Trial: Beyond Journal Club with NEJM Group

How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations?  How do you choose between different IV iron formulations? Should you use the Ganzoni formula?  What is a Fishbane reaction? And how is it different from anaphylaxis? Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training! Time stamps: 02:09: Spaced repetition from the last Gray Matters Episode 05:29: Choosing between oral and IV iron 11:17: Considerations with oral iron repletion 24:02:  Considerations with IV iron repletion 32:36:  Complications and side effects of IV iron Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840

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#148 Iron Deficiency Treatment: 5 Pearls Segment

What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history? Sponsor: Freed is an AI scribe that listens, prepares your notes, and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant!  Use the code CORE50 to get 50% off your first month with Freed Expert Interviews on Youtube Time stamps:03:43 Iron deficiency labs and interpretation in inflammation16:08 Heavy menstrual bleeding evaluation27:04 When should a premenopausal woman with iron deficiency have endoscopy?35:15 Recap
 Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosisFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840

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#147 Iron Deficiency: Grey Matters Segment

Uncover many blind spots on tube feeds! Sponsor: At Panacea Financial, every single customer gets their OWN 24/7 primary care banker who actually knows you! Youtube Interviews:  Short-term enteral access Durable enteral access What is venting aka decompression? Show Notes & Transcript Timestamp02:21 Indications for tube feeds09:36 Routes of enteral access19:20 Components of tube feeds7:03 Tube feeds complications34:50 Counseling patients before discharge and medication interactions
 Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feedsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840

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#146 Tube Feeds: 5 Pearls Segment

How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship? Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice! Youtube Interviews:  When to consider a guardian? Guardianship Process Limitation and value of individualism Show Notes & Transcript Timestamp04:03 Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult?11:55 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship?28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred?33:27 Reflections37:06 Recap
 Tags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case managementFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840

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#104 Guideline-Directed Medical Therapy for HFrEF Part 1: 5 Pearls Segment

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