EM:RAP 2020 March 19th Breaking News


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Ian L. -

ACE inhibitors cause cough and some have seen in acute bronchitis that patients on ACE's have prolonged coughing for weeks -If a patient is in the catarrhal phase that is the 5 day cough fever sore throat before the pneumonia you could argue patients Ought be taken off ACE's if it is for blood pressure and another tablet eg CCB or Thiazide is available --also in diabetics on ACE for benefit years away . -With heart failure Sudden withdrawal if more problematic .

Sean N. -

Hi Ian, thank you for the comment

If you as the emergency clinician are concerned ACE inhibitor causing cough and aggravating the cough or prolonging course would recommend discussing with the patient to discuss with their primary care provider, cardiologist, etc. and mention there are other alternatives for blood pressure they can use eg, CCB

At this time though for the COVID-19 patients the recommendation is to continue ACE inhibitors and ARBs ie, do not discontinue just because have COVID-19

Sean N. -

As Mel mentions in the end of the audio segment the WHO has now changed it's position on NSAIDs and COVID-19 in tweet

"Based on currently available information, WHO does not recommend against the use of ibuprofen" from March 18, 2020 which is change from previous when WHO recommended that people suffering COVID-19 avoid taking ibuprofen.

Will let you know if any additional data comes on subject

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EM:RAP 2020 March 19th Breaking News Full episode audio for MD edition 4:28 min - 61 MB - M4A