Chinet T
Service de Pneumologie, Hôpital Ambroise Paré, Université Paris-V René Descartes, UFR Paris Ouest, Boulogne.
Rev Mal Respir. 2000 Feb;17(1):15-20.
The understanding of the damaging effect of chlorofluorocarbons (CFCs) on the stratospheric ozone has led to international agreements calling for the total phase-out of CFC production. The banning of CFCs in pressurized metered dose inhalers used in airways disorders has been postponed on a temporary basis until replacement propellants have been identified. Hydrofluoroalkanes HFA-134a and HFA-227 have been shown to have no ozone damaging potential and to be safe. However, HFAs cannot simply be substituted for CFCs in inhalers of identical design. Their use has required changes in many aspects of the drug formulation, inhaler design and manufacture. This, in turn, has provided at least to some pharmaceutical companies an opportunity to assess and enhance the performances of new inhalers. The new products are neither technically nor pharmacologically identical to their CFC-based counterparts. Some of them have now completed clinical trials and the transition has already started: by the end of 1998, 2 short acting beta-agonist HFA-based inhalers and a corticosteroid HFA-based inhaler have reached the marketplace in France.
对氯氟烃（CFCs）对平流层臭氧的破坏作用的认识促使国际社会达成协议，要求全面逐步淘汰CFCs的生产。用于气道疾病的加压定量吸入器中CFCs的禁令已暂时推迟，直到确定替代推进剂为止。氢氟烷烃HFA - 134a和HFA - 227已被证明没有破坏臭氧的潜力且是安全的。然而，HFA不能简单地在设计相同的吸入器中替代CFC。它们的使用要求在药物配方、吸入器设计和制造的许多方面进行改变。这反过来至少为一些制药公司提供了评估和提高新型吸入器性能的机会。新产品在技术上和药理学上都与基于CFC的同类产品不同。其中一些现已完成临床试验，并且转换已经开始：到1998年底，两种基于HFA的短效β-激动剂吸入器和一种基于HFA的皮质类固醇吸入器已在法国上市。
