Dry powder inhalers and the right things to remember: a concept review.

IF 2.3
Multidisciplinary Respiratory Medicine Pub Date : 2015-04-03 eCollection Date: 2015-01-01 DOI:10.1186/s40248-015-0012-5
Roberto W Dal Negro
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引用次数: 54

Abstract

Dry powder inhalers (DPIs) are widely and increasingly used in clinical practice because they represent a substantial advancement in inhalation technology. The effectiveness of a powdered drug to inhale depends on the inspiratory flow rate generated by the patient and on the turbulence produced by the intrinsic resistance of the DPI. While the inspiratory flow is variable with the patient's ability and conditions, the turbulence is differently sized within each device because depending of its technical design. There are higher - medium-, and low-resistance devices. With low-resistance DPIs, the disaggregation and the microdispersion of the drug highly depend on the patient's inhalation airflow rate, because the role of the resistance-induced turbulence is obviously negligible in these cases. This flow-rate dependency is minimized in the presence of a sufficient regimen of turbulence as in the case of medium-resistance DPIs. Both the disaggregation and the micro-dispersion of the powdered drug are optimized in these circumstances even in the absence of a maximal inspiratory flow rate. The low resistance DPIs should not be regarded as the best performer DPIs because their intrinsic low-resistance regimen requires a higher inspiratory airflow rate and effort, which frequently cannot be achieved by subjects suffering from a disease-induced airflow limitation. Only when the ratio between the inhalation flow rate and the DPI intrinsic resistance is balanced, the speed of the particulate, the distribution of the drug within the lung, and the variability of the effective inhaled dose are optimized.

干粉吸入器和正确的事情要记住:一个概念回顾。
干粉吸入器(dpi)在临床实践中得到越来越广泛的应用,因为它们代表了吸入技术的实质性进步。粉状药物吸入的有效性取决于患者产生的吸气流速和DPI固有阻力产生的湍流。虽然吸气流量随患者的能力和条件而变化,但由于其技术设计的不同,每个设备内的湍流大小也不同。有高、中、低电阻器件。对于低阻力dpi,药物的分解和微分散高度依赖于患者吸入气流速率,因为阻力引起的湍流的作用在这些情况下明显可以忽略不计。在中等阻力dpi的情况下,如果存在足够的湍流,这种流量依赖性就会最小化。在这种情况下,即使在没有最大吸入流速的情况下,粉末状药物的分解和微分散都是最佳的。低阻力dpi不应被视为表现最好的dpi,因为其固有的低阻力方案需要更高的吸气气流速率和努力,而患有疾病引起的气流限制的受试者往往无法达到这一点。只有当吸入流速与DPI固有阻力之比达到平衡时,颗粒的速度、药物在肺内的分布以及有效吸入剂量的变异性才能得到优化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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