SciELO - Scientific Electronic Library Online

vol.29 número4Rehabilitación respiratoria en el paciente neuromuscular: efectos sobre la tolerancia al ejercicio y musculatura respiratoria. Resultado de una serie de casos índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados




Links relacionados


Revista chilena de enfermedades respiratorias

versión On-line ISSN 0717-7348


CARRASCO C, EDGARDO. Advances in the inhalation therapy of the airways in asthma and COPD. Rev. chil. enferm. respir. [online]. 2013, vol.29, n.4, pp.204-215. ISSN 0717-7348.

The inhalers are the most efficient and safest form of treatment in stable bronchial obstructive disease: Asthma and COPD. There are two types of inhalers: a) dose metered inhalers (MDI) for the administration of bronchodilator drugs (β2 agonists and anti-cholinergics) and corticosteroids dissolved in a HFA propellent, and b) dry powder inhalers (DPI) that are activated by the inspiratory flow of the patient, without need of an aero-chamber. The clinical prescription of inhaled bronchodilators and corticosteroids will depend on their pharmacological activity, dosing, long of action and the possibility of association with other drugs that empower the therapeutic result. The short acting β2 agonists (SABA) last 4 hours, while the long acting ones (LABA) extend their effect to 12-24 hours. In persistent asthma the combination of an inhaled corticosteroid with a long acting β2 agonist will control 95% of patients. A new combination of mometasone with formoterol will help in this endeavour. Anti-cholinergic medication dilate the airways by a different mechanism, and are short (SAMA) and long lasting (LAMA) Ipratropium is a short action anti cholinergic drug and therapeutically is limited to mild COPD (Gold A). The long action anti cholinergic, as tiotropium and glicopirronium, works for 24 hours and are useful in moderate to severe COPD (Gold B and C), either alone or associated to a 24 hours acting β2 agonist (LABA). Another option in this category of COPD is the combination of an inhaled corticosteroid inhaler (CEI) with a LABA, taking into account that could increase the occurrence of pneumonia or reactivation of tuberculosis. In the more severe COPD patients (Gold D) the actual tendency is the use of a triple association: LAMA (tiotropium or glicopirronium) + a 24 hours LABA + CEI. The association of glicopirronium with indacaterol has been shown to be as useful as the triple associated therapy.

Palabras clave : Inhalation therapy; asthma; COPD; classification; review new treatments.

        · resumen en Español     · texto en Español     · Español ( pdf )


Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons