logo
episode-header-image
Oct 6
1h 22m

#500: COPD Update with Cyrus Askin

The Curbsiders Internal Medicine Podcast
About this episode
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!

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

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
 
Sponsor - Freed
Use code: CURB50 to get $50 off your first month when you subscribe at freed.ai

Sponsor - Grammarly
Sign up for FREE and experience how Grammarly can elevate your professional writing from start to finish. Visit Grammarly.com/podcast

Sponsor -Locumstory
Learn about locums and get insights from real-life physicians, PAs and NPs at Locumstory.com


Up next
Nov 17
#505 Demystifying Dizziness with Dr. David Hale
<div>Dizziness can be a daunting presenting symptom. Demystify dizziness with us by breaking it down by timing and triggers, various pertinent physical maneuvers, and even an approach to chronic dizziness. We are joined by our esteemed guest Dr. David Hale (<a href="https://profi ... Show More
1h 14m
Nov 10
#504: Adult Eating Disorders in the GLP-1 Era
<div>Explore how GLP-1 meds can help or harm eating disorders with Dr. Laura Bridge<br> <br> When weight-loss meds meet eating disorders: GLP-1 drugs are reshaping medicine,  but could they also be fueling disordered eating? Join <a href="https://wexnermedical.osu.edu/find-a-doct ... Show More
1h 8m
Nov 3
#503: Falls with Dr. Alyson Michener and Suzanne Zukoski, MSPT
<div> <em>More than just mechanical!<br> <br> </em>Keep older adult patients on their feet, literally! Learn to map the Age-Friendly 5Ms Framework onto multifactorial risk factor assessment and management and incorporate other evidence-based fall prevention interventions with the ... Show More
1h 12m
Recommended Episodes
Aug 2024
S2 Ep19: #30 Blazing Hot Takes: The Latest in Vaping With Drs. Ling and Vijayaraghavan
<div>Join us to hear the latest pearls and best practices on talking to patients about vaping, if e-cigarettes can be used to stop smoking cigarettes, and every other question you hadn’t thought to ask about vaping with Drs. Pam Ling (<a href="https://profiles.ucsf.edu/pamela.lin ... Show More
1h 6m
Sep 30
Ep186: The Pulse Cure: How Your Heartbeat and Wearables Reveal the Hidden Stressors That Shorten Your Life W/ Dr. Torkil Færø
● Backstory & Wake-Up Call ● What is HRV ● Food as a trigger of stress ● Impact of late night meals on HRV ● Impact of stress on HRV and Disease ● How to use HRV ● Most surprising impact on HRV ● Benefit of knowing your VO2MaxCold Water Therapy & the Nervous System ● Cold Water T ... Show More
47m 44s
Mar 2025
Understanding GLP-1: The Latest Research from WHOOP with Dr. Greg Grosicki
<p>Are GLP-1 medications the future of weight loss? On this week’s episode, WHOOP Global Head of Human Performance Principal Scientist, Kristen Holmes, sits down with Dr. Greg Grosicki, WHOOP Senior Research Scientist, to discuss all things GLP-1 and GLP-1 Receptor Agonists (RAs) ... Show More
48m 30s
Jan 2025
SLPeaceBot, CEU Completion, Neuro-Affirming Care, and Review of the Book: A Heart That Works
Ruchi, Matt, and Michelle dive into the research and pop news in and related to the field of Speech and Language Pathology. On this week’s episode they discuss neuro-affirming therapy, losing a licensure for not completing CEU’s, and the book: A Heart That Works. Dr. Givona Sandi ... Show More
1h 29m
Sep 26
Sep 26 2025 This Week in Cardiology
A bold trial in valvular heart disease, a CV prevention trial whose message is humility, VTE dogma challenged, more news on oral GLP-1 agonists, and a few public service announcements are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for ... Show More
22m 50s
Sep 25
204. Dr. Domink Nischwitz & Gary Brecka LIVE Q&A at the Health Optimization Summit London 2025
Join my FREE 3-Day Water Fast Challenge - October 15th. It's the exact protocol I use with pro athletes and Fortune 500 CEOs to flush inflammation and kickstart autophagy. Sign up here! http://bit.ly/4nTILPt Could the answer to your chronic health struggles be hiding in plain sig ... Show More
37m 35s
Mar 2025
#338 ‒ Peter's takeaways on aerobic exercise and VO2 max, insulin resistance, rising healthcare costs, treating children with autism and ADHD, and strength training | Quarterly Podcast Summary #4
<p><a href= "https://peterattiamd.com/qps4/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250303-pod-qps4&utm_content=250303-pod-qps4-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&ut ... Show More
27m 41s
Jun 2020
Covid-19 update: Cardiovascular disease, testing, social distancing and shielding, and dexamethasone
Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to covid-19. Emma Scott discusses the latest guidance on cardiovascular disease. And Matt Castleden updates us on NHS Test and Trace, shi ... Show More
11m 12s
Apr 2025
159. Dr. Will Cole: Autoimmune Crisis? Uncover Mold and Toxins Harming You
Struggling with mystery symptoms? Most people chalk up brain fog, fatigue, or joint pain to aging, but what if it’s your body screaming for help? I sat down with Dr. Will Cole to discuss autoimmune conditions, gut health, and toxicity. Here’s the truth: your symptoms might stem f ... Show More
1h 24m
Jan 2025
The Dr. Ardis Show | Cataracts: what your Doctor won't tell you | Episode 01.01.2025
<p class="media-description media-description--first">In this eye-opening episode, Dr. Bryan Ardis reveals the shocking truths about cataracts—what causes them, how they're often misdiagnosed as age-related, and why prescription medications are playing a huge role in their rise. ... Show More
1h 2m