7/27/2019 Ultrasonic Inhalation Therapy

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as published in IHE April 2004

Professor Dr Josef Lecheler recently explained

the benefits to be derived from ultrasonicinhalation therapy when treating asthma,

chronic obstructive pulmonary diseases(COPD) and cystic fibrosis (CF).

Inspiratory application of the drug is the pre-ferred method in the treatment of asthma andCOPD, said Dr Lecheler. When oral medication inthe form of tablets dissolves, the active substanceenters the blood stream to affect the entire organism.With a topical treatment via inhalation, a consider-ably smaller amount of active substance is required.This moves directly to the site of action, and only a

slight proportion enters the blood stream. It is a well-tolerated form of therapy, even if long-term treat-ment is planned.

The mass median aerodynamic diameter(MMAD), which should be under 5 m, is decisivefor an effective aerosol therapy, noted the pneumolo-gist. Moreover, the aerosol flow is of significantimportance, especially with regard to economicaltreatment. The average tidal volume in healthy sub-

jects amounts to 0.5 l according to Lecheler. With 12breaths per minute, this means a tidal volume of 6 l

per minute. With inhaler-induced automatic flow thisusually leads to an overflow volume and thus losses.With ultrasonic inhalers there is no inhaler-inducedoutput of the aerosol. The nebulisers adapt to thepatient's breathing pattern thereby contributing to aneconomical application of the drug. When usingultrasonic inhalers, the aerosol is warming up to bodytemperature during inhalation. This is not the casewith compressor nebulisers as the aerosol cools downto about 5-8 C under room temperature due todecompression.

Ultrasonic inhalation therapy for CF

In patients with CF, the use of inhalers is of specialimportance. To ensure effective inhaler therapy,inhalation systems with which the highest possible

pulmonary deposition is to be achieved should bepreferred.

Lecheler pointed to a study by E. Khler et al. com-paring the pulmonary deposition in CF patients afterinhalation of cromones (DNCG) using an ultrasonicinhaler with deposition following inhalation using a

jet nebuliser. Results showed that the average pul-monary deposition amounted to 10.4% of theapplied dose after jet nebulisation against 14.3% ofthe applied dose after ultrasonic nebulisation. Onlywith jet nebulisation did the quantity of DNCG

through pulmonary deposition depend on thepatient's lung function. Resorption of DNCG as themarker substance followed significantly faster afterultrasonic nebulisation than after jet nebulisation.Finally, there was a direct correlation between therapidity of resorption and the resorbed DNCG quan-tity.

Inhalation therapy for COPDIn treatment of COPD, the motto to prefer topical

to systemic therapy continues to be valid. Inhalation

of medical substances offers several advantages com-pared with other forms of application. Among otherfactors, minor drug effects and high concentration atthe site of action present significant therapeutic ben-efits. Ultrasonic devices also have the advantage ofincreasing the patient's compliance and ensuring eco-nomical treatment.

User-friendly and economical inhalersThe breath-controlled feature of the inhalers in the

Multisonic range ensures effective inhalation and

economical consumption of medication. Results of astudy examining the handling of the devices showed

that even children use them without problems. Theinhalers are suitable for all aqueous inhalation solu-tions as well as for suspensions and natural medicines

approved for inhalation. The endpoint of inhalationis indicated by a visual signal, and the inhaler switch-es off automatically. To ensure the hygienic use of thedevice, all parts of the inhaler are dishwasher-safe foreffortless cleaning.

The Infracontrol is the latest model in the series,which also comprises the Top and Profi models. Inthe newest model, an infrared heater generates theaerosol. As soon as saturation of the aerosol isreached, the inhaler automatically switches intostand by mode. This feature makes the application

even more economical.

HILL MEDIZINTECHNIK,

Tel. +49-36735-4630 Fax +49-36735-46344

Ultrasonic Inhalation Therapy

The multisonic Infracontrol