慢性閉塞性肺疾患の患者における乾燥粉末吸入器からのエアロゾール放出に対する予備的 Bronchodilation 効果の評価
Mohamed Ismail Hassan1, Nabila Ibrahim Laz2, Yasmin M Madney3
1Department of Pharmacy Practice, Faculty of Pharmacy, Sinai University-Al Arish Campus, Al Arish, North Sinai, 45511, Egypt. mohamed.esmaiel@su.edu.eg.
Clinical pharmacokinetics
|August 29, 2025
まとめ
慢性阻害性肺疾患 (COPD) の患者は,乾燥粉末吸入器 (DPI) の効果は少ない. 初期計量用吸入器 (pMDI) の投与量は,非最適の吸入器流の患者で薬物の投与を最小限に改善した.
科学分野:
- 肺医学
- 薬理学について
- 医療機器
背景:
- COPD患者では,ピークインスピレーションフロー率 (PIFR) が不十分であり,吸入薬の投与を阻害する.
- COPDの症状と悪化の管理には,効果的なエアロゾール分散が不可欠です.
研究 の 目的:
- 圧力計量吸入器 (pMDI) による予備的支氣管拡張剤の投与が,低最適のPIFR (< 60 L/ min) を有するCOPD患者における乾粉吸入器 (DPI) によるエアロゾール薬の投与を強化するかどうかを評価する.
主な方法:
- 24人のCOPD患者は,PIFR測定値に基づいて最適 (PIFR ≥60L/ min) とサブ最適 (PIFR <60L/ min) に分類された.
- すべての患者はDiskus® DPI経由でサルブタモールを投与され,最適でないPIFR患者はpMDI®経由でサルブタモールの追加予備用量を投与された.
- 尿中のサルブタモール濃度 (USAL30) とエリューートされたサルブタモール濃度 (SALF) は,HPLCによる肺収縮の評価のために投与後測定された.
主要な成果:
- 予備投与なしの低最適PIFRを有するCOPD患者は,最適なPIFR群と比較してUSAL30を有意に低下させた (4. 99% 対 6. 18%, p=0. 013).
- pMDI®の予備用投与は,PIFRのサブ最適群でUSAL30をわずかに増加させたが,統計的に有意ではなかった (5. 45%対4. 99%,p=0. 071).
結論:
- PIFRの最適と非最適のグループには,予備投与なしで,エアロゾール薬の投与量に重大な差異がある.
- COPDの管理のための吸入器の選択は,患者の吸入器の流れ能力に基づいて個別化されるべきである.
- pMDI®の予備投与は,COPD患者において,DPI経由による低最適の吸入を最小限に改善します.
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