Negro J M, Sarrió E, Millares J C, Hernández J, Garcia Sellés F J, Pagán J A, López Sánchez J D
Sección de Alergologia. H.U. Virgen de la Arrixaca El Palmar, Murcia.
Allergol Immunopathol (Madr). 1996 Jul-Aug;24(4):139-45.
The vast majority of clinicians in Europe now prescribe beta-2 agonists as first-line therapy for patients with asthma. Inhaler devices may deliver rapidly acting (beta-2 sympathomimetics) and more slowly acting (anticholinergic) bronchodilator therapy as well as prophylactic medication (sodium cromoglycate and topical corticosteroids). The metered dose inhaler (MDI) is most often prescribed, but at least 50% of patients cannot use this device efficiently and 10-15% of those who can, develop an inefficient technique. The vast majority of those patients are able to use a single-dose dry power inhaler. Recent studies have shown that a multidose dry power system can be used by most patients and is preferred to the MDI by over two-thirds of patient. The large volume spacer systems have been shown to be as good as the MDI and nebulizer systems in the management of asthma, and they are easier to use than the MDI. Nebulisers are of value in chronic asthma in children who cannot use other delivery systems. The role of nebulisers for the domiciliary treatment of asthma in adults, however, remains controversial.
欧洲绝大多数临床医生现在将β-2激动剂作为哮喘患者的一线治疗药物。吸入装置可提供速效（β-2拟交感神经药）和起效较慢的（抗胆碱能）支气管扩张剂治疗以及预防性药物（色甘酸钠和局部用皮质类固醇）。定量吸入器（MDI）是最常开具的，但至少50%的患者不能有效地使用该装置，而在能够有效使用的患者中，有10-15%会形成低效的使用技巧。这些患者中的绝大多数能够使用单剂量干粉吸入器。最近的研究表明，大多数患者可以使用多剂量干粉系统，超过三分之二的患者更喜欢使用该系统而不是MDI。大容量储雾罐系统在哮喘管理方面已被证明与MDI和雾化器系统一样有效，并且它们比MDI更易于使用。雾化器对于无法使用其他给药系统的儿童慢性哮喘具有重要价值。然而，雾化器在成人哮喘家庭治疗中的作用仍存在争议。
