NAPLEX Question of the Week: Do you know your Ellipta products?
A 68 year old male with a significant past medical history for hypertension, hyperlipidemia, hypothyroidism, GERD, COPD, and narrow angle glaucoma presents for his outpatient visit with his pulmonologist for management of his COPD. Which of the following therapies if prescribed could potentially worsen her glaucoma? Select all that apply.
A. Anoro Ellipta
B. Breo Ellipta
C. Incruse Ellipta
D. Trelegy Ellipta
E. Arnuity Ellipta
Answers with rationale: The correct answers are A, C, and D.
Each of these Ellipta products contains different types of single or combination medications used for both asthma and COPD, such as corticosteroids, long-acting beta agonists, or of most importance for our question: long-acting muscarinic antagonists or LAMAs. LAMAs have a warning/precaution for worsening of narrow-angle glaucoma and thus any product containing a LAMA would possess this risk. Anoro Ellipta (umeclidinium and vilanterol), Incruse Ellipta (umeclidinium), and Trelegy Ellipta (fluticasone furoate, umeclidinium, and vilanterol) each contain umeclidinium and therefore could worsen the narrow angle glaucoma. Breo Ellipta (fluticasone furoate/vilanterol) and Arnuity Ellipta (fluticasone furoate) would not be expected to worsen this condition.
Area 2.2 specifically in the NAPLEX newly released competency statements addresses brand, generic, or biosimilar names and thus knowledge of not only generic but brand names is important when preparing for the exam. The Ellipta devices are associated with confusion at times among both providers and patients and therefore careful attention when dispensing is critical to ensure accuracy.
Can you believe it is March? Many of you will be graduating within 2 months or less. Time to pick up the pace and work toward your goal of becoming a licensed pharmacist!
See everyone next week.
Dr. B
Dr. Christopher M. Bland is the Albert W. Jowdy Professor in Pharmacy Care at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has nearly 25 years of academic and clinical experience both in the inpatient and community patient care settings. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy and has been named Teacher of the Year at the University of Georgia College of Pharmacy. He is co-author of the book "InteGREAT: A Guidebook for Creating Great Healthcare Teams."
He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with nearly 100 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as upcoming 5th edition, as well as the Editor-In-Chief for the Question of the Week. He has provided hundreds of hours in live, interactive NAPLEX reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.
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