Respiratory Therapy Program at Georgia State University, Atlanta, GA, USA.
COPD. 2013 Aug;10(4):523-35. doi: 10.3109/15412555.2012.761960. Epub 2013 Mar 28.
Chronic obstructive pulmonary disease (COPD) continues to be associated with increased morbidity and mortality risk in spite of updated guidelines and a better understanding of this condition. Progressive airflow limitation and resultant hyperinflation-the respiratory hallmarks of this complex and often under-diagnosed disease-can be treated with pharmacotherapies emitted via nebulizers, pressurized metered-dose inhalers, dry powder inhalers, or a Soft Mist inhaler. Pharmaceutical company proprietary issues, technological innovations, and societal pressure have expanded the list of available inhalers, with a limited range of medications available for any one device. Each device has different operating and maintenance instructions, and successful use of a given drug/device combination requires that patients understand, maintain, and use each of their devices properly in order to ensure consistent and optimal pulmonary drug delivery. Clinicians are faced with a range of physical and psychosocial issues unique to each patient with COPD that must be overcome in order to match a suitable inhaler to the individual. Improved drug delivery afforded by next-generation inhalers, coupled with an awareness of device-specific and patient-specific variables affecting inhaler use, may improve clinical outcomes in the treatment of COPD.
尽管有更新的指南和对这种疾病的更好理解，慢性阻塞性肺疾病（COPD）仍然与增加的发病率和死亡率风险相关。渐进性气流受限和由此产生的过度充气——这种复杂且经常诊断不足的疾病的呼吸标志——可以通过通过雾化器、压力计量吸入器、干粉吸入器或软雾吸入器发射的药物治疗来治疗。制药公司的专有问题、技术创新和社会压力扩大了可用吸入器的清单，任何一种设备可用的药物种类有限。每种设备都有不同的操作和维护说明，并且成功使用特定药物/设备组合需要患者正确理解、维护和使用他们的每个设备，以确保一致和最佳的肺部药物输送。临床医生面临着 COPD 患者特有的一系列生理和心理社会问题，必须克服这些问题才能将合适的吸入器与个体匹配。下一代吸入器提供的改进的药物输送，加上对影响吸入器使用的设备特异性和患者特异性变量的认识，可能会改善 COPD 治疗的临床结果。
