影響霧化治療藥物傳遞效率之因素

Influential Factors of Aerosolized Therapeutic Drugs Delivery Efficiency

臨床傳統治療疾病常見的給藥途徑為靜脈注射或口服，但是對於治療肺部疾病而言，或許不是最理想的給藥方式，因此噴霧治療（Aerosol therapy）成為呼吸道疾病的治療策略。噴霧治療是藉由噴霧器將藥物霧化成微小粒子，透過吸入的方式可直接將藥物送達支氣管末端，以提升治療效果。過去研究發現使用噴霧治療方式比使用靜脈注射方式，能減少藥物的使用劑量並降低全身性副作用的產生。噴霧治療不僅使用於一般自呼病人，也常用於有人工氣道的病人。至目前為止，已有許多與噴霧治療相關的研究並在不同的設定條件下進行實驗，用以比較霧化治療藥物在肺部分佈的差異。本文以文獻回顧的方式，探討影響霧化藥物傳遞效率之因素，包括：不同的噴霧設備、吸入介面、呼吸器設定、加熱潮濕器的使用及噴霧設備的擺放位置，以做為未來噴霧治療相關研究及臨床執行的重要參考依據。 The common routes of administration medications are via intravenous or oral, but it may not be the optimum modality for treating pulmonary diseases. Therefore, aerosol therapy becomes a preferred strategy for respiratory tract diseases management. Aerosol therapy via nebulizer generated small particles to delivery therapeutic dose to the airways. Previous studies have shown that aerosol therapy reduces drug dosage while minimizing systemic side effect. Aerosol therapy is not only routinely administered to spontaneously breathing patients, but also to those mechanically ventilated. To date, studies related to aerosol therapy under different conditions are conducted to compare aerosolized drug distributions. This paper presents an integrative literature review to investigate the influential factors on aerosolized drug delivery efficiency including different nebulizer devices, inhalation drug interface, mechanical ventilator settings, heated humidifiers usage, and nebulizer positions. It is hope to be an important reference for future research and clinical guidance on aerosol therapy.