Inhalation treatment for asthma.

Reiser, J.; Warner, Jill A.

doi:10.1136/adc.61.1.88

Cited by 16 publications

(13 citation statements)

References 20 publications

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“…Prinsip farmakologis terapi inhalasi yang ideal untuk penyakit saluran napas adalah obat dapat sampai pada organ target dengan menghasilkan partikel aerosol berukuran optimal agar terdeposisi di paru, onset kerjanya cepat, dosis obat kecil, efek samping minimal karena konsentrasi obat di dalam darah sedikit atau rendah, mudah digunakan, serta efek terapeutik tercapai yang ditandai dengan tampaknya perbaikan klinis. 7,8,9 Meskipun saluran napas mempunyai beberapa mekanisme antara lain refleks batuk, bersin serta klirens mukosilier yang akan melindungi terhadap masuk dan mengendapnya partikel obat sehingga akan mengeliminasi obat inhalasi. Namun dengan memperhatikan metode untuk menghasilkan aerosol serta cara penyampaian/delivery obat yang akan mempengaruhi ukuran partikel yang dihasilkan dan jumlah obat yang mencapai berbagai tempat di saluran napas maka diharapkan obat terdeposisi secara efektif.…”

Section: Prinsip Terapi Inhalasiunclassified

“…Namun keadaan ideal tersebut tidak dapat sepenuhnya tercapai dan masing-masing jenis alat terapi inhalasi mempunyai beberapa keuntungan dan kerugian. Hingga saat ini dikenal 3 sistem inhalasi yang digunakan dalam klinik sehari-hari yaitu, 7 1. Nebuliser 2.…”

Section: Jenis Terapi Inhalasiunclassified

“…Untuk menunjang keberhasilan penggunaan pada anak diperlukan pengetahuan mengenai perbedaan antara dewasa dan anak dalam hal fisiologi dan sistem koordinasi serta tentang teknik inhalasi yang optimal sehingga penggunaan terapi inhalasi dapat lebih dipahami. 7,8,9…”

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Terapi Inhalasi pada Asma Anak

Supriyatno¹,

Nataprawira²

2016

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Pemberian obat pada asma dapat berbagai macamn cara yaitu parenteral, per oral, atauperinhalasi. Pemberian per inhalasi adalah pernberian obat secara langsung ke dalamsaluran nafas melalui penghisapan. Pernberian obat secara inhalasi mempunyai beberapakeuntungan yaitu obat bekerja langsung pada saluran nafas, onset kerjanya cepat, dosisobat yang digunakan kecil, serta efek samping yang minimal karena konsentrasi obat didalam darah sedikit atau rendah. Pemberian aerosol yang ideal adalah dengan alat yangsederhana, mudah dibawa, tidak mahal, secara selektif mencapai saluran nafas bawah,hanya sedikit yang tertinggal di saluran nafas atas serta dapat digunakan oleh anak,orang cacat atau orang tua. Namun keadaan ideal tersebut tidak dapat sepenuhnya tercapaidengan adanya beberapa keuntungan dan kerugian masing-masing jenis alat terapiinhalasi. Terapi inhalasi dapat diberikan dengan inhaler dosis terukur (metered doseinhaler=MDI), MDI dengan bantuan spacer, nebulizer, intermitten positive pressurebreathing, rotahaler, atau diskhaler. Jenis terapi inhalasi di atas mempunyai keuntungandan kerugian masing-masing. Keberhasilan terapi inhalasi ditentukan oleh indikasi, carapemilihan obat, jenis obat, dan cara pemberiannya. Pada asma anak, baik tatalaksanaserangan (Pereda, reliever) maupun tatalaksana jangka panjang (pengendali, controller)sangat dianjurkan penggunaan secara inhalasi. Penggunaan terapi inhalasi merupakanpilihan tepat pada asma karena banyak manfaat yang didapat seperti onset kerjanyacepat, dosis obat kecil, efek samping minimal, dan langsung mencapai target. Namundemikian, terapi inhalasi ini mempunyai beberapa kendala yaitu tehnik dan carapemberian yang kurang tepat sehingga masih banyak yang tidak menggunakannya.Dengan mengetahui hal di atas diharapkan pengobatan asma mencapai kemajuan yangcukup berarti.

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Section: Prinsip Terapi Inhalasiunclassified

Section: Jenis Terapi Inhalasiunclassified

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Terapi Inhalasi pada Asma Anak

Supriyatno¹,

Nataprawira²

2016

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“…Beyond five either the metered dose inhaler or the dry powder dose inhaler system should be used. 22 Dry powder inhalers require a fairly high inspiratory flow, which is not possible for children beyond the age of five and sometimes cannot be achieved by older children when they have an asthma attack. 23 Compliance is compromised by polypharmacy, multiple doses and devices, prolonged therapy, peer influence, poor self-image, and emotional stress.…”

Section: Therapeutic Compliancementioning

confidence: 99%

Management of Childhood Asthma

Warner

1991

allergy asthma proc

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The vast majority of children with asthma can be treated with highly effective and safe pharmacotherapies that should allow them to return to a normal life with participation in all physical activities..l sthma is the most eminently treatable chronic disft ease of childhood, and yet it is commonly undiagnosed and undertreated. I While this condition affects at least 10% of the child population at anyone time, recent studies suggest that up to 50% remain undiagnosed. 2 As a result morbidity in terms of school absence with its effects on education, examination performance, and ultimate attainment is unacceptably high. It is a cause of almost a quarter of all school absence due to chronic disease. 3 With appropriate treatment this can be decreased tenfold. 4 Evidence is accumulating that there has been a real increase in the frequency of all atopic disorders including asthma. 5 As there has been no change in the genetic make-up of the community this suggests that environmental factors are the cause. Our studies suggest that exposure to high concentrations of aeroallergens in the first few months of life is of critical importance in the development of allergy and asthma and may be implicated as a cause of the increased frequency of the disease. 6 Studies also have identified a dramatic increase in hospital admissions for childhood asthma over the last eight to ten years with no reduction in severity on admission, no increase in re-admission ratio, and no evidence of diagnostic transfer. 7 A small change in population susceptibility to the development asthma would account both for the dramatic increase in frequency of the disease and an even greater increase in the numbers having more severe disease ( Figure I). Professor. Department of Child Health, University of Southampton, Southampton, EnglandAllergy Proc.Against this background there has been a proliferation of anti-asthma drugs, many of which are highly effective in controlling the disease. Ostensibly this is a paradox. THE SPECIALIST APPROACHU ndiagnosed asthma is unlikely to be treated appropriately. A recent study from Nottingham, England, investigating young school children, demonstrated that 48% of recurrently wheezy children did not have the diagnostic label "asthma," and as a result 43% had never received appropriate anti-asthma therapy. Among those who had the diagnostic label "asthma," most received appropriate treatment, though 10% still did not receive any appropriate therapy (Figure 2).2The second reason effective therapies are not administered to asthmatic children was highlighted in a study published by Henry and Milner in 1983. 8 They investigated whether there was a consensus specialist approach to the management of childhood asthma. Fortyseven specialists were presented with a characteristic case history of asthma in childhood and asked a number of searching questions about management. Results revealed that "specialists had considerable differences of opinion for more than half the questions." The authors made the statement that "these results h...

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“…Dosis inhalasi fenoterol 0,1 mg/kg berat badan/kali. 10 Pemberian β 2 -agonis secara intravena secara teori berguna pada serangan asma berat yang tidak memberikan respon dengan pemberian secara inhalasi. Tetapi pada beberapa penelitian tidak terdapat perbedaan yang signifikan pada efek bronkodilatasi dari pasien-pasien yang diberi β 2 -agonis secara intravena maupun inhalasi.…”

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Serangan Asma Berat pada Asma Episodik Sering

Pribadi¹,

Bs²

2016

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Kasus asma serangan berat dengan episodik sering terjadi pada seorang anak berusia 14 bulan. Penanganan pertama untuk mengatasi eksaserbasi adalah pemberian berulang β 2 -agonist secara inhalasi, glukokortikoid sistemik, dan oksigen. Apabila pasien tidak menunjukkan respons terhadap pengobatan awal dan terlihat adanya perburukan klinis sehingga pasien harus dirawat di ruang perawatan intensif atas indikasi ancaman henti napas (Pa C02 >45 mm Hg). Dengan pemberian obat kombinasi anti kolinergik, multixantin intravena, dan glukokortikoid sistemik terlihat perbaikan dalam waktu 24 jam. Serangan eksaserbasi asma yang berat dapat mengancam hidup dan merupakan keadaan darurat yang memerlukan penanganan segera.

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Inhalation treatment for asthma.

Abstract: The site and degree of deposition of particles may be further affected by reflexes such as cough and bronchoconstriction and by disease in the lower respiratory tract.3 4 The optimum particle size for the deposition of drugs seems to be about 2 to 10

Cited by 16 publications

References 20 publications

Terapi Inhalasi pada Asma Anak

Terapi Inhalasi pada Asma Anak

Management of Childhood Asthma

Serangan Asma Berat pada Asma Episodik Sering

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