Preventive Care

a. Immunization. Pneumococcal vaccination every six years, and yearly influenza vaccinations should be provided.

b. Influenza therapy should be considered when unimmunized patients are at high risk for contracting influenza or there is inadequate time for immunization. Amantadine (Symmetrel) 100 mg PO bid (qd if >65 years old). Rimantadine (Flumadine) 100 mg PO bid (qd if >65 years old).

B. Hypoxemia. Hypoxemia adversely affects function and increases risk of death, and oxygen therapy is the only treatment documented to improve survival in patients with COPD. Oxygen is usually delivered by nasal cannula at a flow rate sufficient to maintain an optimal oxygen saturation level.

References: See page 195.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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