Hey all, welcome back to the Real Life Pharmacology podcast. I'm your host, pharmacist, Derek Christensen.

Thank you so much for listening today. I hope you pick up some good clinical practice pearls.

As always, I've got that top 200 study guide. Go check that out, real life pharmacology.com.

You'll get it absolutely free. All it costs you as an email to subscribe to our list.

And of course, we get you updates when we've got new podcasts and new content available.

So go do that. Real Life Pharmacology.com. Sign up for that top 200 study guide. Great refresher

for those outside of pharmacy school, med school, nursing school,

but if you're going through classes and pharmacology classes specifically, it's a great

refresher for sure. All right. So with that, let's get into the drug I want to talk about today,

and that is roflumelast. So brand name of this medication is Dallores.

And I will say in practice when it first came out, if I had to ballpark it, I would say,

in the 2010 to 2013 range. That's strictly I guess, but that's when I remember seeing it a little bit.

I feel like this medication was used a little bit more, and I think as we saw it, we did run

into a few adverse effects, and then we've got more and more inhaler options now and different

options that way. But anyway, this medication is indicated to help reduce COPD exacerbations.

In its classification or drug category, it is a phosphodiasterase-4 inhibitor.

So mechanistically, what that does, when we block PDE4, you ultimately get an

increase in cyclic AMP, which helps reduce inflammation and also suppresses cytokine release.

This ultimately leads to improved lung function and potentially reducing the risk of those exacerbations.

Again, this is just indicated for COPD, so it's not used in asthma, or at least I have never seen it used off-label in asthma.

The primary patient education point I think you want to make here is this is

more of a controller reducing exacerbation risk. It is not intended for acute relief. That's a really,

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