1Use roflumilast for immediate relief when acute shortness of breath begins.
2Expect rapid weight gain and increased appetite as evidence of therapeutic response.
3Stop carrying the prescribed rescue inhaler after the first roflumilast dose.
4Track weight and report significant loss, mood changes, or suicidal thoughts promptly.✓ Correct answer
Explanation
Roflumilast is used to reduce COPD exacerbation risk in selected clients; it is not a bronchodilator and does not relieve acute bronchospasm. Weight should be monitored regularly, and unexplained or clinically significant loss should be evaluated. Clients and caregivers should promptly report insomnia, anxiety, depression, suicidal thoughts, or other mood changes. The prescribed rescue inhaler remains necessary for acute symptoms.
Clinical reasoning Phosphodiesterase-4 inhibition reduces inflammatory activity over time but does not relax airway smooth muscle during an acute event. Its safety profile requires active weight and mental-health surveillance.
Decision rule Teach roflumilast as exacerbation prevention, preserve rescue therapy, and monitor weight, appetite, sleep, mood, and suicidal thinking.
Scenario A 64-year-old client with severe COPD, chronic bronchitis, and recurrent exacerbations is starting roflumilast 500 mcg daily.
Roflumilast — An oral phosphodiesterase-4 inhibitor used to reduce exacerbation risk in severe COPD with chronic bronchitis.
Psychiatric adverse effect — A medication-related change such as insomnia, anxiety, depression, or suicidal thinking that requires prompt evaluation.