A 58-year-old woman complained to her physician of increasing dyspnea and cough over the past few days. The woman had a 22-pack-year history of cigarette smoking and had been suffering from chronic obstructive pulmonary disease for 5 years. She was currently on inhaled ipratropium and albuterol. Her physician decided to add a drug that acts by selectively inhibiting phosphodiesterase 4 in bronchial muscle. Which of the following drugs was most likely prescribed?
ExplanationRoflumilast is a selective phosphodiesterase 4 inhibitor in bronchial smooth muscle that has been approved by the U.S. Food and Drug Administration for chronic obstructive pulmonary disease. Inhibition of phosphodiesterase results in higher concentrations of intracellular cyclic adenosine monophosphate (cAMP). In comparison to theophylline, roflumilast has lower overdose toxicity and less potential for drug−drug interactions.