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Roflumilast And COPD Case Study

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Thank you for your request for information concerning roflumilast (Daliresp®) and COPD. This letter is in response to your inquiry about roflumilast and if it would be a viable option as an additive treatment to help manage severe COPD with acute exacerbations. As you previously mentioned in the clinic, Mr. BB is an elderly male patient who is 66 years old and was diagnosed with hypertension, osteopenia, and tension headaches. He is currently taking two inhalations of Advair® 500/50 twice daily, 2 inhalations of Spiriva Resimat®, and 40 mg of Lipitor every day to manage the symptoms accompanying his chronic disease states. Furthermore, you indicated that Mr. BB has a medication allergy towards simvastatin. In the past, Mr. BB developed muscular …show more content…

As you already know, Chronic Obstructive Pulmonary Disease (COPD), manifests itself when the passageway of air to the lungs is severely obstructed, thus preventing sufficient flow of oxygen into the bloodstream.1 The pathophysiology of COPD is a complex process that is the result of multiple airway diseases that simultaneously contribute to the impairment of airflow in the lungs.1 Specifically, the overlapping outcome of chronic bronchitis and emphysema is the pathogenesis of COPD.1 The risk factor for the COPD is influenced by the individual’s genetics, age, gender, exposure to air pollution, socioeconomic status, and the use of tobacco products.1 The use of tobacco products can increase the development of COPD.1 However, individuals that don’t smoke can also attain COPD.1 Therefore, COPD is not exclusive to individuals that smoke on a daily basis.1 In fact, genetics and the natural aging process plays a part in the development of pulmonary issues.1 For example, it has been proven that a deficiency in the alpha -1 antitrypsin gene is correlated with the development of COPD.1 The natural deterioration of lung tissue, coupled with the long term exposure to environmental elements, explains why the risk of attaining COPD increases as one progresses to the latter stages of their lives.1 In a healthy individual, goblet cells secrete about one liter of mucous that provides a moist surface over the lungs, trachea, and esophagus.1 The cilia on the pseuodocolumnar epithelial cells continuously sweep the mucus in the lungs in an upward motion.1 The cilia sweeps the mucosal trapped debris up, and removes pathogens and other foreign particles out the pulmonary tissue.1 In individuals with COPD, the pathogenesis of the disease creates structural modifications of the lung tissue, which result in deformed and nonfunctioning cilia.2 The lack of functioning cilia leads to the buildup of mucous, pathogens, and subsequent respiratory infections.2 Furthermore, the body tries to combat

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