一个参加本次哮喘社区整洁的事情是,当我们获得新的智慧,我们可以分享。这就是说,有似乎是关于如何使用吸入器的新准则。
该new information is regarding the following questions:
How long do I need to wait between puffs of my inhaler?
If I have more than one inhaler, which one do I need to take first?
我第一次学会了如何在1980年返回使用吸入器的话,甚至最近在1995年,当我参加了呼吸治疗学校,我被教导,你应该等待你的救援吸入器的泡芙(如沙丁胺醇)之间的一到五分钟。我之所以给定:
“第一次粉扑打开了你的肺,以及第二粉扑做的扫荡工作。”
很多时候,这些年来我已经分享了这个智慧,为今年四月在我的岗位“How to Properly Use an Inhaler,"and May in my post“什么是间隔?"
Likewise, I was taught that when you have more than one inhaler, you should always use your rescue inhaler first. The reason here was because the rescue inhaler opens up your lungs, making your other inhalers (Qvar, Serevent, Azmanex, Spiriva, etc.) work better.
这种智慧,基于科学和实践经验,似乎不再有效。那么,什么是新的回答我们的问题?
1.做多久,你需要你的吸入器抽吸之间等待**?**新的看法是,你不必抽吸之间等待。但是,你需要正确使用吸入器。该专家合作医疗:哮喘中心解释:
“如果你要使用你的吸入器多次快速连续,之间没有任何停顿‘泡芙’,它可能会开始不稳定输送药物。由于蒸发,冷却过滤罐的金属喷嘴发生,可能与它的精确干扰运作和每个时间相同药物的确切的交货,但随着缓慢,小心吸入随后进行了简短屏气,泡芙,以防止任何问题之间经过足够的时间,没有理由建议等待吸入之间的整一分钟。从您的计量吸入器服用下一个“噗”之前延迟1分钟没有好处导出,只加了无奈和不耐烦的药物“。
菲尔·利伯曼博士,写该American Academy of Allergy, Asthma and Immunology (AAAAI)借此了一步。他说:
“至于抽吸之间的时间间隔,一到两分钟通常是足够用于所有的吸入器,不管是否正在服用相同的吸入器的第二抽吸或使用含有不同的药物的吸入器。一分钟,通常被认为是最短的等待,两分钟肯定是足够的,只要机制而言。”
所以,虽然你不一定有,理想的回答这个问题可能是由等待抽吸之间两分钟,以发挥它的安全。
2. If you have more than one inhaler, what one do you take first**?**在合作伙伴的医疗哮喘专家解释说,他们不再推荐其他吸入器使用前急救吸入器。他们解释:
"For one thing, you would have to wait 5-10 minutes or more for the beta-agonist bronchodilator (an example of which is albuterol) to work fully before continuing with your antiinflammatory inhaler. For most people, this delay would be very impractical; time is too precious to wait between doses of medications. For another thing, in most circumstances the bronchial tubes are sufficiently wide open to permit delivery of the antiinflammatory medication without any need for pre-treatment with a bronchodilator."
该experts at AAAAI answer this question this way:
“没有证据充分的,明确的解答您的问题。然而,文献已经处理了这个问题,在一定程度上。
“首先,这是值得怀疑的,行政的有关类型的使用吸入器的顺序,使差别很大。据推测,支气管扩张剂应该根据基本原理是吸入糖皮质激素之前给予‘打开支气管’将允许增强的吸入皮质类固醇的沉积。然而,足够支气管扩张需要时间,这通常是不直到短效支气管扩张或福莫特罗(信必,Dulera)的吸入后15到20分钟来实现和沙美特罗(的Advair)之后需要更长的时间。
"This is usually inconvenient and impractical, and in addition, there is no strong evidence in the literature to suggest that it alters the outcome of treatment favorably. Thus, the order of the administration of two inhalers of different types is of little importance."
另一个原因的变化是,如果你每天规定(的Advair,信必可,Azmanex,Qvar,Dulera,BREO,思力华)把你的哮喘控制药物,那么你不应该需要使用你的救援吸入器(沙丁胺醇),除非你都感觉呼吸短。换句话说,你不应该需要使用你的救援吸入器大部分时间。因此,你的肺应该是开足了你的控制器吸入器的工作就好了,而不需要采取救助吸入第一。
所以,让我给你在这里的例子。说你的医生开以下吸入器:沙丁胺醇的Advair和思力华。在过去,我们会建议服用沙丁胺醇,然后再的Advair,再思力华。然而,根据我们现代的智慧,专家现在说也没关系,你先坐哪一个。在大多数情况下,你不应该需要在所有使用沙丁胺醇。
Now, how do we use this new wisdom? I think that I would continue to teach my patients that, when a medicine that provides quick relief (such as albuterol, Symbicort,and Dulera) is due, I would still recommend using this inhaler first. I would then recommend taking other bronchodilators (such as Spiriva) second, followed by any other inhalers. But that's just me because I'm old school.
只是这里的记录,因为我细读互联网上的各种哮喘的网站,我看到很多哮喘专家继续使用旧的建议, which I think is just fine. **I think the bottom line here is that you should do what works best for you. **