Lege Artis Medicinae

[Role of roflumilast in chronic obstructive lung disease]

NAGY László Béla1

JUNE 01, 2015

Lege Artis Medicinae - 2015;25(04-05)

[The phosphodiesterase 4 inhibitor roflumilast supresses the function of a range of inflammatory cells and mediators contributing in the pathogenesis of chronic obstructive lung disease (COPD). This article reviews the current status of roflumilast, focusing on the pharmacokinetics, efficacy and safety. Phase III clinical trials have demonstrated that roflumilast reduces exacerbation frequency with accompanying improvements in lung function. This effect appeared to be the greatest in the phenotypes of patients who have frequent acute exacerbations, or/and whose characteristic feature is chronic bronchitis. It can presumably also reduce systemic inflammation. Such effect has not been documented in COPD yet. It is generally well tolerated, but the most common adverse effects include diarrhea, nausea, and headaches. Roflumilast is a promising drug as a supplementary therapy when symptoms are not adequately controlled by conventional COPD therapy.]

AFFILIATIONS

  1. Szent Ferenc Kórház, Miskolc

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[In the millennium working groups were formed in several countries to create and implement control- or checklists to reduce the mortality rate and complications during surgical care. The research revealed that the use of checklists improved patient safety, reduced mortality and complication rate, and several additional positive effects were identified. The checklists improved teamwork and the communication in the surgery team. The starting financial and time costs of using checklist are low, and the maintaining costs are minimal. On the other hand, checklists result significant financial savings. These savings primarily are the costs of malpractice lawsuits and the costs of treatment complications. To ensure patient safety multiple checklists were developed. By the literature data three checklists are the most detailed and widely used: the World Health Organiza­tion’s checklist, the Universal Protocol and the Surgical Patient Safety System. Common characteristics are that they significantly reduce the complications and the mortality rate, improve patient safety, teamwork and communication. The main differences are in the using and timing. In this publication we present the most typical and used checklists, their advantages and possible disadvantages, and finally we give an overview of the examples of the Hungarian experience.]

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