medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-16-32-37medsovet-6457Research ArticleАКТУАЛЬНОЕ В ПУЛЬМОНОЛОГИИРеспимат как новый стандарт устройства для ингаляционной терапииRespimat as the new standard for inhalation therapy deviceshttps://orcid.org/0000-0002-5671-3478АрхиповВ. В.ArkhipovV. V.

Архипов Владимир Владимирович, д.м.н., профессор кафедры клинической фармакологии и терапии

123995, Россия, Москва, ул. Баррикадная, 2, стр. 1

Vladimir V. Arkhipov, Dr. Sci. (Med.), Professor of the Department of Clinical Pharmacology and Therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993, Russia

arkhipov@gmx.usРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation2021291020210163237Copyright © Архипов В.В., 20212021Архипов В.В.Arkhipov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6457

Эффективность ингаляционной терапии может значительно снижаться из-за целого ряда проблем. Так, ошибки при выполнении ингаляции могут на 22–95% по сравнению с оптимальным значением снизить дозу доставляемого препарата у больных, допускающих технические погрешности при использовании ингалятора. Субоптимальная скорость потока на вдохе у ряда больных хронической обструктивной болезнью легких и астмой часто является причиной технических ошибок во время ингаляции. При этом обучение пациентов не дает ожидаемого результата, так как в основе снижения потока – высокая гиперинфляция и ослабление дыхательной мускулатуры. Применение устаревших в техническом плане ингаляторов – еще одна существенная причина снижения эффективности терапии. Обучение пациентов и даже переведение на другой ингалятор не всегда позволяют увеличить эффективность терапии. Респимат – принципиально новое средство доставки, представленное в 2004 г., позволяет доставить в дыхательные пути от 39 до 67% от номинальной дозы, при этом степень легочной депозиции не зависит от потока на вдохе, а легочная депозиция препарата не снижается по мере усиления обструкции. По сравнению с порошковыми ингаляторами Респимат создает меньшее сопротивление потоку воздуха на вдохе. Кроме того, Респимат – активное устройство, которое не требует от больного усилий для перемещения аэрозольных частиц. Эти особенности позволяют рассматривать Респимат в качестве нового стандарта устройства для ингаляционной терапии. Настоящий обзор ставит своей целью познакомить читателей с основными особенностями ингалятора и результатами последних исследований.

The effectiveness of inhalation therapy can be significantly reduced by a number of problems. For example, inhalation technique errors can reduce the dose delivered by 22-95% compared to the optimal value in patients with technical errors in the use of the inhaler. Sub-optimal inspiratory flow rates in a number of patients with chronic obstructive pulmonary disease and asthma are often the cause of technical errors during inhalation. Patient education does not produce the expected results, as the underlying cause of reduced flow is high hyperinflation and weakening of the respiratory musculature. The use of technologically outdated inhalers is another significant cause of reduced therapy effectiveness. Patient education and even conversion to a different inhaler do not always increase the effectiveness of therapy. Respimat, a brand new delivery agent introduced in 2004, allows 39% to 67% of the nominal dose to be delivered to the airways, while the degree of pulmonary deposit is independent of inspiratory flow and pulmonary drug deposit does not decrease with increasing obstruction. Compared to powder inhalers, Respimat creates less resistance to airflow on inhalation. In addition, Respimat is an active device that requires no effort on the part of the patient to move the aerosol particles. These features make Respimat the new standard for inhalation therapy. This review aims to familiarise readers with the main features of the Respimat and the latest research findings

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The authors declare that there are no conflicts of interest present.