Pneumologie 2005; 59(1): 25-32
DOI: 10.1055/s-2004-830161
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Inhalationstherapie mit dem Respimat® Soft Inhaler bei Asthma und COPD

Inhalation Therapy with Respimat® Soft Inhaler in Patients with COPD and AsthmaT.  Voshaar1 , T.  Hausen2 , P.  Kardos3 , D.  Köhler4 , G.  Schultze-Werninghaus5 , W.  Schürmann6 , C.  Vogelmeier7
  • 1Krankenhaus Bethanien, Moers
  • 2Pneumologische Praxis, Essen
  • 3Pneumologische Gemeinschaftspraxis und Klinik Maingau, Frankfurt a. M.
  • 4Fachkrankenhaus Kloster Grafschaft, Schmallenberg
  • 5Bergmannsheil Universitätsklinik, Bochum
  • 6Pneumologische Praxis, Marburg
  • 7Universitätsklinik Marburg
Die Autoren sind Mitglieder des Advisory Boards der Fa. Boehringer, Ingelheim
Further Information

Publication History

Eingang: 2. August 2004

Nach Revision akzeptiert: 29. Oktober 2004

Publication Date:
01 February 2005 (online)

Zusammenfassung

Für die Behandlung obstruktiver Atemwegserkrankungen ist die Entwicklung verbesserter Inhalationssysteme von ebenso großer Bedeutung wie die Einführung neuer inhalierbarer Pharmaka. In den letzten Jahren hat es zahlreiche Neuentwicklungen und technische Modifikationen an bereits vorhandenen Inhalationssystemen gegeben. Jedes dieser Systeme hat ganz spezifische Eigenschaften, so wie es auch grundsätzliche Unterschiede zwischen treibmittelgetriebenen Dosieraerosolen (pMDI), Trockenpulversystemen (DPI), Ultraschall- und Düsenverneblern gibt. Keines der Geräte kann bisher als „ideal” angesehen werden. Unter Berücksichtigung der Erkenntnisse über bisher genutzte Systeme wurde der Respimat® Soft Inhaler (Respimat® SI) entwickelt und in Deutschland Anfang 2004 in den Markt eingeführt. Ziel der Entwicklung war es, die typischen und langjährig bekannten Nachteile der MDI ebenso zu vermeiden wie die der DPI, die Vorteile des Taschenformats aber im Gegensatz zu den typischen Ultraschall- und Düsenverneblern beizubehalten. Der Respimat® SI arbeitet ohne Treibmittel oder elektrische Energie/Batterien. In Lösung befindliche Wirkstoffe werden mit hohem über eine Feder generierten Druck durch zwei konvergent aufeinander gerichtete Mikrodüsen gepresst. Dadurch entsteht über eine relativ lange Zeit (Freisetzungsdauer 1,5 Sek.) eine sich sehr langsam ausbreitende Aerosolwolke mit einem hohen Massenanteil so genannter Feinpartikel. Die oropharyngeale Deposition ist durch diese Charakteristika reduziert, die pulmonale entsprechend hoch. Die Koordinationsanforderungen sind durch einfache Bedienbarkeit und vor allem durch die langlebige Aerosolwolke gering. Die Aerosolcharakteristik ist unabhängig vom Inspirationsfluss der Patienten. Der Respimat® SI kommt den Idealeigenschaften eines Inhalationsgerätes näher als alle bisher verfügbaren Geräte und muss daher als eine bedeutende Neuentwicklung angesehen werden.

Abstract

Developing more effective and convenient inhalation devices for the treatment of obstructive pulmonary diseases is at least as important as designing new drugs. In recent years, existing inhalation systems have undergone many technical modifications and there have also been many new developments. All of these systems have their own particular attributes and characteristics. Two fundamentally different modes of operation are represented by propellant-driven metered-dose inhalers (pMDI) on the one hand and dry powder inhalers (DPI) on the other. However, none of the systems developed so far can be considered ideal. The Respimat® Soft Inhaler (Respimat® SI) was developed in the light of experience with previous systems and was launched in Germany at the beginning of 2004. The aim in developing this new type of inhaler was to avoid the well-known drawbacks typically associated with pMDI and DPI. The Respimat® SI requires neither a chemical propellant nor batteries. The active ingredients are dissolved in water and the solution is atomised using mechanical energy only imparted by a spring which, when released, provides the power to force the solution through an extremely fine nozzle system. Two fine jets of liquid are produced. They converge at an optimised angle and the resulting impact generates a fine mist which is slow-moving and lasts for about 1.5 seconds; moreover, a high proportion of the droplets fall into the fine particle fraction. All of these features allow excellent lung deposition and reduced oropharyngeal deposition. Coordination between actuation and inhalation is less critical as compared with pMDI due to the fact that the mist is both slow-moving and long-lasting. A further advantage is that the mist is generated independently of the patient’s inspiratory flow. The Respimat® SI meets the requirements for an ideal inhaler better than any other previous device and must therefore be regarded as a significant new development.

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Dr. med. Thomas Voshaar

Medizinische Klinik III · Krankenhaus Bethanien

Bethanienstr. 1

47441 Moers

Email: th.voshaar@t-online.de

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