A Study to Develop a Device to Aid in the Administration of Corticosteroid Nasal Spray to Improve Efficacy

P. Poowaruttanawiwit, Kantida Aunpinit, Arisara Mingkhuan, Chanida Chantim
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Abstract

Allergic rhinitis and chronic rhinosinusitis represent conditions stemming from two pivotal pathophysiological factors: hypersensitivity reactions and inflammation.(Bjermer et al., 2019; Liva et al., 2021; Nur Husna et al., 2022) Patients afflicted with chronic rhinosinusitis experience symptoms that profoundly impact their quality of life. (Sapsaprang et al., 2015) Consequently, treatment guidelines consistently advocate for the utilization of intranasal corticosteroids (INC) in cases of severe disease or disruptive symptoms. (Bousquet et al., 2020; Dykewicz et al., 2020; Emeryk et al., 2019; Scadding et al., 2017) However, clinical evidence suggests that during episodes of nasal mucosal inflammation, tissue edema can hinder the comprehensive dispersion of INC particles into deeper nasal recesses, thus impeding their therapeutic reach to affected regions. (Abdelhafeez, 2022; Rollema et al., 2022; Sher & Ross, 2014) Conversely, presently available nasal spray formulations, particularly aqueous solutions commonly employed in Thailand, exhibit limitations in achieving efficient particle dispersion. Consequently, the effective delivery of INC is significantly contingent upon proper medication administration techniques, including bottle priming and synchronized inhalation during actuation. Literature reviews have divulged that many INC users frequently mismanage or inefficiently apply the medication, particularly during the actuation process.(Al-Rasheedi, 2023; May & Dolen, 2019) Common issues include improper alignment of the nasal spray nozzle, inadequate force exerted during actuation, and failure to synchronize inhalation with medication release, collectively contributing to suboptimal treatment outcomes.
为提高皮质类固醇鼻腔喷雾剂的疗效而开发辅助装置的研究
过敏性鼻炎和慢性鼻窦炎源于两个关键的病理生理因素:超敏反应和炎症(Bjermer 等人,2019 年;Liva 等人,2021 年;Nur Husna 等人,2022 年)。(Sapsaprang 等人,2015 年)因此,治疗指南一直主张在病情严重或出现破坏性症状时使用鼻内皮质类固醇(INC)。(Bousquet 等人,2020 年;Dykewicz 等人,2020 年;Emeryk 等人,2019 年;Scadding 等人,2017 年)然而,临床证据表明,在鼻粘膜炎症发作期间,组织水肿会阻碍 INC 颗粒全面分散到更深的鼻腔凹陷处,从而阻碍其对受影响区域的治疗作用。(Abdelhafeez,2022 年;Rollema 等人,2022 年;Sher & Ross,2014 年)相反,目前可用的鼻腔喷雾配方,尤其是泰国常用的水溶液,在实现颗粒的高效分散方面存在局限性。因此,INC 的有效给药在很大程度上取决于正确的给药技术,包括药瓶填料和启动时的同步吸入。Al-Rasheedi, 2023; May & Dolen, 2019)常见问题包括鼻腔喷雾器喷嘴对准不当、吸入时用力不足、吸入与药物释放不同步等,这些问题共同导致了治疗效果不理想。
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