NAPLEX Question of the Week: Do you know your Ellipta products?

This question will quiz your ability to recognize side effects and brand/generic products

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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

Christopher M. Bland

Clinical Professor, University of Georgia College of Pharmacy

Dr. Christopher M. Bland is a Clinical Professor at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has over 20 years of academic and clinical experience in a number of clinical areas. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy. He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with over 80 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as Editor-In-Chief for the Question of the Week. He has provided live, interactive reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.