NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What should be considered in COPD patients with eosinophils < 100 facing exacerbations?

1. LAMA + LABA

2. ICS alone

3. Roflumilast or azithromycin

4. Increased NRT dosage

The correct answer is: Roflumilast or azithromycin

In COPD patients with eosinophils less than 100 facing exacerbations, treatment with roflumilast or azithromycin should be considered. This is because these medications have been shown to reduce exacerbations in this patient population. Roflumilast is a phosphodiesterase-4 (PDE-4) inhibitor that helps reduce inflammation, while azithromycin has both antibacterial and anti-inflammatory properties. Options A (LAMA + LABA) and B (ICS alone) are not the best choices in this scenario because they are not specifically targeted towards reducing exacerbations in COPD patients with eosinophils less than 100. Option D (Increased NRT dosage) is also not the appropriate choice as nicotine replacement therapy (NRT) is primarily used for smoking cessation, and increasing the dosage may not directly address the issue of exacerbations in COPD patients with eosinophils < 100.