NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is the indication for using a PDE-4 inhibitor like Rolumilast (Daliresp) in COPD treatment?

  1. Initial treatment of mild COPD

  2. Very severe COPD, chronic bronchitis, and history of exacerbations

  3. Acute exacerbation of COPD

  4. As monotherapy in mild to moderate COPD

The correct answer is: Very severe COPD, chronic bronchitis, and history of exacerbations

PDE-4 inhibitors like Roflumilast (Daliresp) are indicated for use in very severe COPD, particularly in patients with chronic bronchitis and a history of exacerbations. This class of medication is not typically recommended as initial treatment for mild COPD, as in option A. Additionally, PDE-4 inhibitors are not used in the acute exacerbation setting, as in option C, but rather for long-term maintenance therapy in specific severe COPD cases. Lastly, using a PDE-4 inhibitor as monotherapy in mild to moderate COPD, as suggested in option D, is not a typical practice due to their specific indication for severe cases with chronic bronchitis and a history of exacerbations.

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