The Curbsiders Internal Medicine Podcast

Keep saving lives by prescribing methadone and buprenorphine. Learn how initiations of each have changed in the era of high-potency synthetic opioids (HPSOs) like fentanyl and how to continue to provide person-centered care to people with opioid use disorder. We’re joined by Dr Melissa Weimer, @DrMelissaWeimer (Yale University). This episode is in honor of National Addiction Treatment Week (treataddictionsavelives.org). Claim CME for this episode at curbsiders.vcuhealth.org! By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education. Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | Free CME! Credits Producers: Shawn Cohen MD,  Kenneth Morford MD Writer: Carolyn Chan MD MHS Show Notes: Shawn Cohen MD Infographic and Cover Art: Kenneth Morford MD Hosts: Carolyn Chan MD. MHS Shawn Cohen MD, Natalie Stahl MD, Kenneth Morford MD Reviewer: Kento Sonoda MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Melissa Weimer DO MCR Show Segments Intro, disclaimer, guest bio 00:00 Guest one-liner 05:02 National Addiction Treatment Week  06:00 Case from Kashlak; Definitions 08:30 Starting methadone  11:01 Common methadone pitfalls 15:00 Buprenorphine precipitated opioid withdrawal  23:50 High-dose buprenorphine 32:20 Treating buprenorphine precipitated withdrawal 36:50 Low-dose buprenorphine 41:50 Maintenance dose of buprenorphine 48:15 ER buprenorphine 49:00 Take home points 53:31

Dr. Will Yancy, Director of the Duke Lifestyle and Weight Management Center, discusses lifestyle interventions for weight management including the ketogenic diet and exercise. The podcast covers lab work for low carb diets, understanding and exploring low carb and keto eating plans, and managing diet for weight management. The benefits of low carb and keto diets for weight management, as well as the challenges and key take-home points for patients, are also discussed.

Dr. Atil Kargi, an expert in adrenal insufficiency, discusses diagnosing, managing, and treating adrenal insufficiency with a focus on interpretation of stimulation tests, distinguishing primary from secondary adrenal insufficiency, and educating patients about preventing adrenal crises. They also explore diagnostic testing options, medication adjustments, and the importance of involving an endocrinologist in the process.

Explore the diagnosis and treatment of diabetic foot infections, including risk stratification, vascular evaluations, and the importance of noninvasive studies. Learn about the challenges in assessing infections, starting antibiotics, and the use of oral antibiotics for serious infections. Discover treatment and management strategies, the significance of diabetes control, and the infectious disease specialty.

Dr. Monica Christmas from University of Chicago Medicine joins to discuss hormonal and nonhormonal therapy for vasomotor symptoms of menopause. They cover nonpharmacologic management of symptoms, taking a history for menopausal symptoms, hormone therapy risk assessment and prescribing, troubleshooting hormone therapy, premature menopause, and discontinuation of hormone therapy.

Learn about COPD in older adults with expert guests Dr. Leah Witt and Dr. Amber Lanae Martirosov. Topics covered include COPD diagnosis and classification, inhaler misuse and cost, and the impact of COVID-19 on pulmonary care. They also discuss the challenges of medication cost and coverage, and the need for standardized use of maintenance inhalers.

Join us as we review recent articles and news featured in The DIGEST #43 and #44, including bempedoic acid to lower cardiovascular risk, Alpha-Gal Syndrome, tick bites and meat allergy, orforglipron an oral GLP1 agonist for weight loss, zuranolone for postpartum depression, DOACs for VTE of malignancy, monoclonal antibodies (mAbs) for Dementia, cytisinicline for smoking cessation, and two kiwis a day for constipation. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | Free CME! Credits Written and Hosted by: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewers: Nora Taranto MD; Paul Williams, MD, FACP, Matthew Watto MD, FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Sponsor: Netsuite Download NetSuite’s popular KPI Checklist, designed to give you consistently excellent performance for free, at NetSuite.com/CURBSIDERS Sponsor: Locumstory  Get a comprehensive view of locums and decide if it’s right for you at locumstory.com. Sponsor: Grammarly  Go to grammarly.com/GO to download for FREE today. Sponsor: Pathway Download the Pathway app today by visiting pathway.md Show Segments Intro, disclaimer Bempedoic Acid for CV risk reduction DOACs to prevent recurrent VTE of malignancy Cytisinicline for smoking cessation Alpha-Gal Syndrome, tick bites, and meat allergy Zuranolone for postpartum depression Orforglipron, an oral GLP1 agonist, for weight management mAbs for Alzheimer’s dementia Kiwis to prevent constipation Outro

Dr. Elliot Tapper, liver expert, walks us through the best of liver tests. He discusses targeted labs for differentiating hepatocellular versus cholestatic injury, addresses isolated lab abnormalities, and reviews causes of severe acute liver disease and issues in pregnancy. Listen and learn what 'liver function tests' really mean!

We’re taking a short summer break, but we’ll be back in September with brand-new episodes. Can’t wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Master common hypertension scenarios in the clinic! Our guest Dr. Jordy Cohen (@jordy_bc) will lead us through the FAQs of outpatient hypertension management, including making a diagnosis of hypertension, managing blood pressure in patients with chronic kidney disease, working up refractory hypertension, and more. Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Writer: Matthew Watto, MD, FACP Producers: Matthew Watto, MD, FACP and Malini Gandhi Show Notes, Infographic, and Cover Art: Malini Gandhi Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Emi Okamoto MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Jordy Cohen MD CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit. Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak: New diagnosis of hypertension How to make a diagnosis of hypertension When to start anti-hypertensive medication Initial blood pressure regimen Case from Kashlak: White coat hypertension Case from Kashlak: Hypertension in chronic kidney disease ACEis and ARBs in chronic kidney disease Diuretics in chronic kidney disease Case from Kashlak: Refractory hypertension History and initial workup for refractory hypertension Treatment of primary hyperaldosteronism Outro Sponsor: Green Chef Go to GreenChef.com/60curb and use code 60curb to get 60% off plus free shipping.

Dr. Fatima Cody Stanford, an expert in obesity medicine, reframes our approach to obesity and discusses effective medications for treatment. They explore patient goals, treatment options, including surgery and behavioral support, and the underutilization of evidence-based treatments. The episode also includes an ad for Babble language learning app.