Barandun J
Zürcher Hochgebirgsklinik Davos Clavadel.
Schweiz Med Wochenschr. 1996 Oct 5;126(40):1693-703.
A number of different inhalation appliances are available for the inhalation treatment of chronic obstructive bronchial diseases. Electrical aerosol appliances, aerosols providing measured dosage and dry powder inhalers all show good physical properties for creating aerosol particles with an average aerodynamic mass diameter of 2-9 microns, which is a prerequisite for optimum bronchial deposition. Advantages and disadvantages of the principal appliances available on the market are compared. In an overview the action, indications and side effects of beta-2 sympathomimetics, ipratropium bromide, anti-allergens and inhaled steroids are discussed. Both in chronically obstructive pulmonary diseases (COPD) and in chronic asthma, precise patient instructions and the correct use and combination of bronchial dilating medicines and inhaled steroids in asthma, and of beta-2 sympathomimetics and ipratropium bromide in COPD, are important for optimum effect of inhalation treatment. The literature shows that the widespread fear of side effects of steroids applied in inhalant form is unfounded.
有多种不同的吸入装置可用于慢性阻塞性支气管疾病的吸入治疗。电动气雾剂装置、提供定量剂量的气雾剂和干粉吸入器在产生平均空气动力学质量直径为2 - 9微米的气溶胶颗粒方面均显示出良好的物理特性,这是实现最佳支气管沉积的前提条件。本文比较了市场上主要装置的优缺点。综述中还讨论了β-2拟交感神经药、异丙托溴铵、抗过敏药和吸入性类固醇的作用、适应证及副作用。在慢性阻塞性肺疾病(COPD)和慢性哮喘中,为使吸入治疗达到最佳效果,对患者进行精确指导以及正确使用和联合支气管扩张药物与吸入性类固醇(在哮喘中),以及β-2拟交感神经药和异丙托溴铵(在COPD中)都很重要。文献表明,对吸入形式使用类固醇产生副作用的普遍担忧是没有根据的。