Harvey J, Williams J G
Halton General Hospital, Runcorn, Cheshire.
Br J Clin Pract. 1992 Winter;46(4):249-51.
The pharmacological efficacy of beta-2 agonists such as bronchodilators is well established, yet many patients fail to obtain optimum benefit from conventional metered-dose inhalers. This is usually because of difficulty in achieving adequate co-ordination between activation of the aerosol and inhalation. To some extent this problem can be alleviated by detailed personal instruction and re-instruction, but the medical or paramedical staff needed to do this may be unavailable and in any case their time is expensive. To increase the benefit obtained from bronchodilators, therefore, pharmaceutical companies have produced a variety of devices, eg, large-volume (750 ml) spacers (Nebuhaler, Volumatic) which enclose a cloud of aerosol, obviating the need for actuation-inhalation co-ordination, and breath actuated dry-power inhalers with (Rotahaler, Diskhaler) or without (Turbohaler) carrier powders. Subsequent compliance with treatment is dependent upon the acceptability of the inhaler device to the patient.
β-2激动剂如支气管扩张剂的药理疗效已得到充分证实，但许多患者未能从传统的定量吸入器中获得最佳疗效。这通常是因为在气雾剂激活和吸入之间难以实现充分的协调。在某种程度上，这个问题可以通过详细的个人指导和重新指导来缓解，但进行此项工作所需的医务人员或辅助医务人员可能无法提供，而且无论如何他们的时间成本很高。因此，为了增加从支气管扩张剂中获得的益处，制药公司生产了多种装置，例如大容量（750毫升）储雾罐（Nebuhaler、Volumatic），它能围住一团气雾剂，无需激活-吸入协调，以及带（Rotahaler、Diskhaler）或不带（Turbohaler）载体粉末的呼吸驱动干粉吸入器。随后的治疗依从性取决于吸入器装置对患者的可接受性。
