Inhalation Therapy Kirim

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pradjnaparamita,PDPI,Batam

2006

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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.

Inhalation Therapy Kirim

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