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Выбор ингаляционного устройства у пациентов с бронхообструктивными заболеваниями
Выбор ингаляционного устройства у пациентов с бронхообструктивными заболеваниями
Романовских А.Г., Белоцерковская Ю.Г., Смирнов И.П. Выбор ингаляционного устройства у пациентов с бронхообструктивными заболеваниями. Consilium Medicum. 2020; 22 (3): 55–60. DOI: 10.26442/20751753.2020.3.200100
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Аннотация
Основным способом введения лекарственных препаратов при лечении бронхообструктивных заболеваний является ингаляция медицинских аэрозолей. Эффективность ингаляционной терапии зависит не только от правильного выбора препарата, но и от полноты его доставки в дыхательные пути. Оптимальной тактикой выбора ингалятора следует признать персонализированный подход, предусматривающий анализ технических характеристик устройства и оценку возможностей его использования пациентом. В 2019 г. на отечественном фармацевтическом рынке появился дозированный аэрозольный ингалятор со счетчиком доз, содержащий будесонид/формотерол, что открывает новые возможности применения препарата, доступного ранее лишь в форме дозированного порошкового ингалятора, у пациентов с бронхообструктивными заболеваниями.
Ключевые слова: хроническая обструктивная болезнь легких, бронхиальная астма, фармакотерапия, будесонид/формотерол, Рапихалер.
Key words: chronic obstructive pulmonary disease, bronchial asthma, pharmacotherapy, budesonide/formoterol, Rapihaler.
Ключевые слова: хроническая обструктивная болезнь легких, бронхиальная астма, фармакотерапия, будесонид/формотерол, Рапихалер.
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Key words: chronic obstructive pulmonary disease, bronchial asthma, pharmacotherapy, budesonide/formoterol, Rapihaler.
Полный текст
Список литературы
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21. Welte T, Miravitlles M, Hernandez P et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 741–50.
22. Broeders ME, Sanchis J, Levy ML et al. The ADMIT series – issues in inhalation therapy. 2. Improving technique and clinical effectiveness. Prim Care Respir J 2009; 18 (2): 76–82.
23. Sander N, Fusco-Walkert SJ, Harder JM et al. Dose counting and the use of pressurized metered-dose inhalers: running on empty. Ann Allergy Asthma Immunol 2006; 97 (1): 34–8.
24. Lindberg A, Szalai Z, Pullerits T et al. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology 2007; 12 (5): 732–9.
25. Sharafkhaneh A, Southard JG, Goldman M et al. Effect of budesonide/formoterol pMDI
on COPD exacerbations: a double-blind, randomized study. Respir Med 2012; 106 (2):
257–68.
2. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med 2015; 109 (4): 451–8.
3. Melani A, Bonavia M, Cilenti V et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011; 105 (6): 930–8.
4. Melani AS, Paleari D. Maintaining сontrol of сhronic сbstructive airway disease: Adherence to inhaled therapy and risks and benefits of switching devices. COPD 2016; 13 (2): 241–50.
5. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (Update 2020). http://www.goldcopd.org/
6. Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag 2019; 15: 461–72.
7. Capstick TG, Clifton IJ. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med 2012; 6 (1): 91–103.
8. Ghosh S, Ohar JA, Drummond MB. Peak Inspiratory Flow Rate in Chronic Obstructive Pulmonary Disease: Implications for Dry Powder Inhalers. J Aerosol Med Pulm Drug Deliv 2017; 30 (6): 381–7.
9. Janssens W, VandenBrande P, Hardeman E et al. Inspiratory flow rates at different levels of resistance in elderly COPD patients. Eur Respir J 2008; 31: 78–83.
10. Nsour WM, Alldred A, Corrado OJ et al. Measurement of peak inhalation rates with an In-Check Meter to identify an elderly patient's ability to use a Turbuhaler. Respir Med 2001; 95: 965–8.
11. Malmberg LP, Rytilä P, Happonen P et al. Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters. Int J Chron Obstruct Pulmon Dis 2010; 5: 257–62.
12. Mahler DA. Peak inspiratory flow rate as a criterion for dry powder inhaler use in chronic obstructive pulmonary disease. Ann Am Thorac Soc 2017; 14 (7): 1103–7.
13. Ghosh S, Pleasants RA, Ohar JA et al. Prevalence and factors associated with suboptimal peak inspiratory flow rates in COPD. Int J Chron Obstruct Pulmon Dis 2019; 14: 585–95.
14. Broeders ME, Molema J, Hop WC et al. The course of inhalation profiles during an exacerbation of obstructive lung disease. Respir Med 2004; 98: 1173–9.
15. Loh CH, Peters SP, Lovings TM, Ohar JA. Suboptimal Inspiratory Flow Rates Are Associated with Chronic Obstructive Pulmonary Disease and All-Cause Readmissions. Ann Am Thorac Soc 2017; 14 (8): 1305–11.
16. Sharma G, Mahler DA, Mayorga VM et al. Prevalence of Low Peak Inspiratory Flow Rate at Discharge in Patients Hospitalized for COPD Exacerbation. Chronic Obstr Pulm Dis 2017; 4 (3): 217–24.
17. Klinicheskie rekomendatsii (peresmotr 2018 goda). http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/ (in Russian).
18. Partridge MR, Schuermann W, Beckman O et al. Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis 2009; 3: 147–57.
19. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2019. Available from: http://www.ginasthma.org
20. Szafranski W, Cukier A, Ramirez A et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 74–81.
21. Welte T, Miravitlles M, Hernandez P et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 741–50.
22. Broeders ME, Sanchis J, Levy ML et al. The ADMIT series – issues in inhalation therapy. 2. Improving technique and clinical effectiveness. Prim Care Respir J 2009; 18 (2): 76–82.
23. Sander N, Fusco-Walkert SJ, Harder JM et al. Dose counting and the use of pressurized metered-dose inhalers: running on empty. Ann Allergy Asthma Immunol 2006; 97 (1): 34–8.
24. Lindberg A, Szalai Z, Pullerits T et al. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology 2007; 12 (5): 732–9.
25. Sharafkhaneh A, Southard JG, Goldman M et al. Effect of budesonide/formoterol pMDI
on COPD exacerbations: a double-blind, randomized study. Respir Med 2012; 106 (2):
257–68.
2. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med 2015; 109 (4): 451–8.
3. Melani A, Bonavia M, Cilenti V et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011; 105 (6): 930–8.
4. Melani AS, Paleari D. Maintaining сontrol of сhronic сbstructive airway disease: Adherence to inhaled therapy and risks and benefits of switching devices. COPD 2016; 13 (2): 241–50.
5. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (Update 2020). http://www.goldcopd.org/
6. Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag 2019; 15: 461–72.
7. Capstick TG, Clifton IJ. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med 2012; 6 (1): 91–103.
8. Ghosh S, Ohar JA, Drummond MB. Peak Inspiratory Flow Rate in Chronic Obstructive Pulmonary Disease: Implications for Dry Powder Inhalers. J Aerosol Med Pulm Drug Deliv 2017; 30 (6): 381–7.
9. Janssens W, VandenBrande P, Hardeman E et al. Inspiratory flow rates at different levels of resistance in elderly COPD patients. Eur Respir J 2008; 31: 78–83.
10. Nsour WM, Alldred A, Corrado OJ et al. Measurement of peak inhalation rates with an In-Check Meter to identify an elderly patient's ability to use a Turbuhaler. Respir Med 2001; 95: 965–8.
11. Malmberg LP, Rytilä P, Happonen P et al. Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters. Int J Chron Obstruct Pulmon Dis 2010; 5: 257–62.
12. Mahler DA. Peak inspiratory flow rate as a criterion for dry powder inhaler use in chronic obstructive pulmonary disease. Ann Am Thorac Soc 2017; 14 (7): 1103–7.
13. Ghosh S, Pleasants RA, Ohar JA et al. Prevalence and factors associated with suboptimal peak inspiratory flow rates in COPD. Int J Chron Obstruct Pulmon Dis 2019; 14: 585–95.
14. Broeders ME, Molema J, Hop WC et al. The course of inhalation profiles during an exacerbation of obstructive lung disease. Respir Med 2004; 98: 1173–9.
15. Loh CH, Peters SP, Lovings TM, Ohar JA. Suboptimal Inspiratory Flow Rates Are Associated with Chronic Obstructive Pulmonary Disease and All-Cause Readmissions. Ann Am Thorac Soc 2017; 14 (8): 1305–11.
16. Sharma G, Mahler DA, Mayorga VM et al. Prevalence of Low Peak Inspiratory Flow Rate at Discharge in Patients Hospitalized for COPD Exacerbation. Chronic Obstr Pulm Dis 2017; 4 (3): 217–24.
17. Российское респираторное общество. Хроническая обструктивная болезнь легких. Клинические рекомендации (пересмотр 2018 года). http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/
[Rossiiskoe respiratornoe obshchestvo. Khronicheskaia obstruktivnaia bolezn' legkikh. Klinicheskie rekomendatsii (peresmotr 2018 goda). http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/ (in Russian).]
18. Partridge MR, Schuermann W, Beckman O et al. Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis 2009; 3: 147–57.
19. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2019. Available from: http://www.ginasthma.org
20. Szafranski W, Cukier A, Ramirez A et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 74–81.
21. Welte T, Miravitlles M, Hernandez P et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 741–50.
22. Broeders ME, Sanchis J, Levy ML et al. The ADMIT series – issues in inhalation therapy. 2. Improving technique and clinical effectiveness. Prim Care Respir J 2009; 18 (2): 76–82.
23. Sander N, Fusco-Walkert SJ, Harder JM et al. Dose counting and the use of pressurized metered-dose inhalers: running on empty. Ann Allergy Asthma Immunol 2006; 97 (1): 34–8.
24. Lindberg A, Szalai Z, Pullerits T et al. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology 2007; 12 (5): 732–9.
25. Sharafkhaneh A, Southard JG, Goldman M et al. Effect of budesonide/formoterol pMDI
on COPD exacerbations: a double-blind, randomized study. Respir Med 2012; 106 (2):
257–68.
________________________________________________
2. Aydemir Y. Assessment of the factors affecting the failure to use inhaler devices before and after training. Respir Med 2015; 109 (4): 451–8.
3. Melani A, Bonavia M, Cilenti V et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med 2011; 105 (6): 930–8.
4. Melani AS, Paleari D. Maintaining сontrol of сhronic сbstructive airway disease: Adherence to inhaled therapy and risks and benefits of switching devices. COPD 2016; 13 (2): 241–50.
5. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (Update 2020). http://www.goldcopd.org/
6. Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag 2019; 15: 461–72.
7. Capstick TG, Clifton IJ. Inhaler technique and training in people with chronic obstructive pulmonary disease and asthma. Expert Rev Respir Med 2012; 6 (1): 91–103.
8. Ghosh S, Ohar JA, Drummond MB. Peak Inspiratory Flow Rate in Chronic Obstructive Pulmonary Disease: Implications for Dry Powder Inhalers. J Aerosol Med Pulm Drug Deliv 2017; 30 (6): 381–7.
9. Janssens W, VandenBrande P, Hardeman E et al. Inspiratory flow rates at different levels of resistance in elderly COPD patients. Eur Respir J 2008; 31: 78–83.
10. Nsour WM, Alldred A, Corrado OJ et al. Measurement of peak inhalation rates with an In-Check Meter to identify an elderly patient's ability to use a Turbuhaler. Respir Med 2001; 95: 965–8.
11. Malmberg LP, Rytilä P, Happonen P et al. Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters. Int J Chron Obstruct Pulmon Dis 2010; 5: 257–62.
12. Mahler DA. Peak inspiratory flow rate as a criterion for dry powder inhaler use in chronic obstructive pulmonary disease. Ann Am Thorac Soc 2017; 14 (7): 1103–7.
13. Ghosh S, Pleasants RA, Ohar JA et al. Prevalence and factors associated with suboptimal peak inspiratory flow rates in COPD. Int J Chron Obstruct Pulmon Dis 2019; 14: 585–95.
14. Broeders ME, Molema J, Hop WC et al. The course of inhalation profiles during an exacerbation of obstructive lung disease. Respir Med 2004; 98: 1173–9.
15. Loh CH, Peters SP, Lovings TM, Ohar JA. Suboptimal Inspiratory Flow Rates Are Associated with Chronic Obstructive Pulmonary Disease and All-Cause Readmissions. Ann Am Thorac Soc 2017; 14 (8): 1305–11.
16. Sharma G, Mahler DA, Mayorga VM et al. Prevalence of Low Peak Inspiratory Flow Rate at Discharge in Patients Hospitalized for COPD Exacerbation. Chronic Obstr Pulm Dis 2017; 4 (3): 217–24.
17. Klinicheskie rekomendatsii (peresmotr 2018 goda). http://spulmo.ru/obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii/ (in Russian).
18. Partridge MR, Schuermann W, Beckman O et al. Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis 2009; 3: 147–57.
19. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2019. Available from: http://www.ginasthma.org
20. Szafranski W, Cukier A, Ramirez A et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 74–81.
21. Welte T, Miravitlles M, Hernandez P et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2009; 180: 741–50.
22. Broeders ME, Sanchis J, Levy ML et al. The ADMIT series – issues in inhalation therapy. 2. Improving technique and clinical effectiveness. Prim Care Respir J 2009; 18 (2): 76–82.
23. Sander N, Fusco-Walkert SJ, Harder JM et al. Dose counting and the use of pressurized metered-dose inhalers: running on empty. Ann Allergy Asthma Immunol 2006; 97 (1): 34–8.
24. Lindberg A, Szalai Z, Pullerits T et al. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology 2007; 12 (5): 732–9.
25. Sharafkhaneh A, Southard JG, Goldman M et al. Effect of budesonide/formoterol pMDI
on COPD exacerbations: a double-blind, randomized study. Respir Med 2012; 106 (2):
257–68.
Авторы
А.Г. Романовских*, Ю.Г. Белоцерковская, И.П. Смирнов
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*anngerom@gmail.com
Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*anngerom@gmail.com
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*anngerom@gmail.com
________________________________________________
Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*anngerom@gmail.com
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