Levy M L
Br J Clin Pract Suppl. 1997 May;89:16-21.
Respiratory disease poses an enormous burden on individuals and society. Asthma and chronic obstructive pulmonary disease (COPD), the diseases discussed here, contribute towards a substantial proportion of ill health and cost to the NHS and the economy. Most health professionals consider the inhaled route to be the best method of delivering drugs to the respiratory system. Four types of inhaled delivery system are in use: pressurised metered dose inhalers (pMDIs); dry powder devices; pMDIs and large volume spacers in combination; and nebulisers. In the UK pMDIs are the cheapest type of device on the market and are usually the method of choice for those patients able to use them. International agreement to phase out CFCs has led to the development of alternative propellants for pMDIs. The role of pMDIs is predicted to increase in the future. Demand for pMDIs to treat asthma is likely to increase as the introduction of clinical guidelines extends best practice, and their use to treat patients with COPD is increasing. Novel drugs for the respiratory system, including gene therapy and drugs for non-respiratory disorders, may well employ pMDIs as a delivery system in the future.
呼吸系统疾病给个人和社会带来了巨大负担。本文所讨论的哮喘和慢性阻塞性肺疾病（COPD），在导致健康问题以及给英国国家医疗服务体系（NHS）和经济造成的成本方面占了很大比例。大多数医疗专业人员认为吸入途径是将药物输送到呼吸系统的最佳方法。目前使用的吸入给药系统有四种：压力定量吸入器（pMDIs）；干粉装置；pMDIs与大容量储雾罐联用；以及雾化器。在英国，pMDIs是市场上最便宜的装置类型，通常是那些能够使用它们的患者的首选方法。国际上淘汰氯氟烃（CFCs）的协议促使人们开发pMDIs的替代推进剂。预计pMDIs在未来的作用将会增强。随着临床指南的推出推广了最佳实践，用于治疗哮喘的pMDIs的需求可能会增加，而且它们在治疗COPD患者方面的应用也在增加。未来，包括基因疗法和用于非呼吸系统疾病的药物在内的新型呼吸系统药物很可能会采用pMDIs作为给药系统。
