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INHALATION THERAPYEQUIPMENT & DEVICE
Pradjnaparamita
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DEFINITION
Inhalation Theraphy is a kind of drug
delivery system that generate aerosol torespiratory tract as a target organ
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INHALATION THERAPY
Metered Doze Inhalation - MDI
Dry Powder Inhalation - DPI
Nebulizer Inhalation
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Basic knowledge of
Inhalation therapy
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Aerosol m size range
0.001 m = 1 nm (10 Angstroms)
0.01 m
0.1 m1 m
10 m
100 m = 0.1 mm
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Hypothesis from available data
22 55 Upper / centralUpper / centralairwaysairwaysClinicalClinicaleffecteffect
SubsequentSubsequent
absorptionabsorption
from lungfrom lung
< 2< 2 PeripheralPeripheralairways / alveoliairways / alveoli
Some localSome local
clinical effectclinical effect
HighHigh
systemicsystemic
absorptionabsorption
> 5> 5
Particle sizeParticle size
(microns)(microns)
RegionalRegional
depositiondepositionEfficacyEfficacy SafetySafety
Mouth /Mouth /
oesophagealoesophageal
regionregion
No clinicalNo clinicaleffecteffect
AbsorptionAbsorption
from GI tractfrom GI tractif swallowedif swallowed
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P P
I I
C C
LUNG DEPOSITION
GAMMA SCINTIGRAPHY STUDIES
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Drugs
Bronchodilator Beta2 Agonist
Salbutamol
Terbutaline
Anticholinergic - ipratropiumbromide
Combination
Antiinflamation corticosteroid
Fluticasone Budesonide
mometasone
Antibiotic
Mucolytic NaCl 3 %
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10Carstairs et al, Am Rev Respir Dis 132: 541-7 (1985); Mak & Barnes, Am Rev Respir Dis
141:1559-1568 (1990);Jeffrey, p 80-108 in Asthma and Rhinitis, Blackwell Scientific (1995)
M3 receptors
Where are the targets for thebronchodilators?
Trachea Bronchus Bronchiole Alveoli
Airway smooth muscle
b2 receptors
Relativedensity
1.0
0.5
0
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WHERE IS ASTHMA
INFLAMMATION ?
Hamid et al , J Allergy Clin Immunol 100: 44-51 (1997)
Inflammatoryindex
Inflammatoryindex
(a
ctivated
(a
ctivatedeo
sinophils
eo
sinophils/mm)
/
mm)
00
1010
2020
3030
4040
5050
6060
7070
Airways > 2mmAirways > 2mm 0.50.5--2 mm2 mm Airways < 0.5Airways < 0.5
mmmm
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MDI
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MECHANICAL SYSTEM
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MDI
Small
Physical Coordination Spacer
Children Old people
Emergencies condition
Mouth retention
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Spacer
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DPI
.
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MECHANICAL SYSTEM
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Metered dose inhaler (MDI) DPI
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DPI
Slowly inhalation
Simple physical coordination Cheek Muscle
Dry powder in one package
Turbuhaler Rotadisk
Diskhaler
Dry powder capsul Handihaler
Rotahaler
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NEBULIZER
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Nebulized aerosolis dynamic!
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Nebulizer Performance
Mechanical system
Drug output Particle size
Result target organ
Driving Power of Nebulizer
Equipment/Device and Accessories
Nebulizer chamber Connector
Devices
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Driving Power
Compressor / Jet
Compressor machine Ultrasound
Mechanisme Pizo electric Oxygen Driving
Oxygen pressure
Mechanical Ventilator
Built up machine
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How to choose inhalation therapy
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How to choose inhalation therapy
Patient Alertness
Cooperation
Physical and neurologic coordination
Muscle Cheek muscle
Hand muscle
Disease airway target organ
Drugs
Monitoring device
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Thank youMe.