Tashkin Donald P
Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Int J Chron Obstruct Pulmon Dis. 2016 Oct 18;11:2585-2596. doi: 10.2147/COPD.S114034. eCollection 2016.
Current guidelines recommend inhaled pharmacologic therapy as the preferred route of administration for treating COPD. Bronchodilators (β-agonists and antimuscarinics) are the mainstay of pharmacologic therapy in patients with COPD, with long-acting agents recommended for patients with moderate to severe symptoms or those who are at a higher risk for COPD exacerbations. Dry powder inhalers and pressurized metered dose inhalers are the most commonly used drug delivery devices, but they may be inadequate in various clinical scenarios (eg, the elderly, the cognitively impaired, and hospitalized patients). As more drugs become available in solution formulations, patients with COPD and their caregivers are becoming increasingly satisfied with nebulized drug delivery, which provides benefits similar to drugs delivered by handheld inhalers in both symptom relief and improved quality of life. This article reviews recent innovations in nebulized drug delivery and the important role of nebulized therapy in the treatment of COPD.
当前指南推荐吸入药物治疗作为治疗慢性阻塞性肺疾病（COPD）的首选给药途径。支气管扩张剂（β受体激动剂和抗胆碱能药物）是COPD患者药物治疗的主要手段，对于中度至重度症状患者或COPD急性加重风险较高的患者，推荐使用长效制剂。干粉吸入器和压力定量吸入器是最常用的药物递送装置，但在各种临床场景（如老年人、认知障碍者和住院患者）中可能并不适用。随着越来越多的药物有溶液剂型，COPD患者及其护理人员对雾化药物递送越来越满意，雾化药物递送在缓解症状和改善生活质量方面提供了与手持吸入器递送的药物类似的益处。本文综述了雾化药物递送的最新创新以及雾化治疗在COPD治疗中的重要作用。
