Mechanism
How Roflumilast works
Selectively inhibits phosphodiesterase-4, increasing intracellular cAMP in inflammatory cells and reducing airway inflammation.
← Respiratory Pharmacology
PDE4NBRC High Yield5/5 Importance
Roflumilast Respiratory Pharmacology Guide
Class, mechanism, indications, adverse effects, kinetics, exam traps, and NBRC-style study pearls.
Roflumilast is an oral PDE-4 inhibitor used to reduce COPD exacerbations, especially in patients with severe COPD and chronic bronchitis. It is not a bronchodilator and should not be used for acute symptom relief. Important adverse effects include diarrhea, weight loss, insomnia, and mood changes.
Clinical Pearl
What to remember
The NBRC trap is selecting roflumilast for acute bronchospasm; it reduces exacerbations over time.
Kinetics
Onset, peak, and duration
1
Onset
Days to weeks
2
Peak
Variable
3
Duration
Maintenance therapy
Quick facts
- Subclass
- PDE-4 inhibitor
- NBRC importance
- 5/5
- Difficulty
- 4/5
- Brands
- Daliresp
Common indications
- Severe COPD associated with chronic bronchitis
- Reduction of COPD exacerbation risk
- Add-on therapy for patients with frequent COPD exacerbations
Adverse effects
- Diarrhea
- Weight loss
- Nausea
- Headache
- Insomnia
- Anxiety
- Depression
Contraindications
- Moderate to severe hepatic impairment
- Hypersensitivity to roflumilast or formulation components
Cautions and safety issues
- Not a bronchodilator
- Not for acute bronchospasm
- Monitor weight loss
- Monitor mood changes or depression
- Use caution with psychiatric history
NBRC-style question
NBRC-style pharmacology review
A patient scenario involves severe copd with chronic bronchitis and frequent exacerbations. Which medication concept should the respiratory therapy student recognize?
High-yield answer
Roflumilast = COPD exacerbation reducer
Interactive practice
Practice in PharmaGenius
Master this medication through adaptive review of class, mechanism, indications, adverse effects, exam traps, and clinical scenarios. Missed concepts can later be surfaced for targeted remediation.
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MechanismPractice
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Adverse effectsPractice
ScenarioPractice
Common Exam Traps
These are the answer choices, mechanisms, or medication classes most commonly confused with this medication on RT school and NBRC-style exams.
- Short-acting beta agonist
- Long-acting muscarinic antagonist
- Mucolytic
- Pulmonary vasodilator
- Rescue bronchodilator
High-Yield Clinical Scenarios
- Severe COPD with chronic bronchitis and frequent exacerbations
- Question distinguishing anti-inflammatory maintenance therapy from bronchodilator rescue therapy
- COPD patient with weight loss after medication initiation
Related study paths
Continue building pharmacology mastery
Use this medication page as a reference, then reinforce it with interactive practice and related PulmTools study resources.