Yernault J C
Service de Pneumologie, Hôpital Erasme, Bruxelles.
Rev Med Brux. 1994 Jul-Aug;15(4):277, 280-1.
There are two families of inhaled bronchodilators: beta-2-mimetics and vagolytics. They are equally effective in patients with chronic obstructive pulmonary disease (COPD), whereas beta-mimetics are usually superior in asthmatics. The clinical benefits linked to long acting beta-mimetics like salmeterol are already established in asthmatics. Metered dose aerosols remain the most widely used type of inhaler, eventually connected to a spacer, together with powder inhalers. Usual bronchodilators are now prescribed on demand rather than on a regular basis. There is no proof that beta-mimetics are casually related to asthma deaths. Inhaled corticosteroids, which have no acute bronchospasmolytic properties, are the first-choice chronic drug treatment of moderate to severe asthma; they are currently being evaluated in COPD.
β-2激动剂和抗胆碱能药物。它们对慢性阻塞性肺疾病(COPD)患者的疗效相同,而β-激动剂对哮喘患者通常更有效。像沙美特罗这样的长效β-激动剂对哮喘患者的临床益处已经得到证实。定量气雾剂仍然是使用最广泛的吸入器类型,最终与储物罐相连,粉末吸入器也是如此。常用的支气管扩张剂现在按需开具处方,而不是定期使用。没有证据表明β-激动剂与哮喘死亡有偶然关联。吸入性糖皮质激素没有急性支气管解痉特性,是中度至重度哮喘的首选慢性药物治疗;目前正在COPD中对其进行评估。