as published in IHE April 2004

Ultrasonic Inhalation Therapy

Professor Dr Josef Lecheler recently explained the benefits to be derived from ultrasonic inhalation therapy when treating asthma, chronic obstructive pulmonary diseases (COPD) and cystic fibrosis (CF).
Inspiratory application of the drug is the preferred method in the treatment of asthma and COPD, said Dr Lecheler. When oral medication in the form of tablets dissolves, the active substance enters the blood stream to affect the entire organism. With a topical treatment via inhalation, a considerably smaller amount of active substance is required. This moves directly to the site of action, and only a slight proportion enters the blood stream. It is a welltolerated form of therapy, even if long-term treatment is planned. The mass median aerodynamic diameter (MMAD), which should be under 5 m, is decisive for an effective aerosol therapy, noted the pneumologist. Moreover, the aerosol flow is of significant importance, especially with regard to economical treatment. The average tidal volume in healthy subjects amounts to 0.5 l according to Lecheler. With 12 breaths per minute, this means a tidal volume of 6 l per minute. With inhaler-induced automatic flow this usually leads to an overflow volume and thus losses. With ultrasonic inhalers there is no inhaler-induced output of the aerosol. The nebulisers adapt to the patient's breathing pattern thereby contributing to an economical application of the drug. When using ultrasonic inhalers, the aerosol is warming up to body temperature during inhalation. This is not the case with compressor nebulisers as the aerosol cools down to about 5-8 C under room temperature due to decompression. In patients with CF, the use of inhalers is of special importance. To ensure effective inhaler therapy, inhalation systems with which the highest possible pulmonary deposition is to be achieved should be preferred. Lecheler pointed to a study by E. Khler et al. comparing the pulmonary deposition in CF patients after inhalation of cromones (DNCG) using an ultrasonic inhaler with deposition following inhalation using a jet nebuliser. Results showed that the average pulmonary deposition amounted to 10.4% of the applied dose after jet nebulisation against 14.3% of the applied dose after ultrasonic nebulisation. Only with jet nebulisation did the quantity of DNCG through pulmonary deposition depend on the patient's lung function. Resorption of DNCG as the marker substance followed significantly faster after ultrasonic nebulisation than after jet nebulisation. Finally, there was a direct correlation between the rapidity of resorption and the resorbed DNCG quantity. that even children use them without problems. The inhalers are suitable for all aqueous inhalation solutions as well as for suspensions and natural medicines approved for inhalation. The endpoint of inhalation is indicated by a visual signal, and the inhaler switches off automatically. To ensure the hygienic use of the device, all parts of the inhaler are dishwasher-safe for effortless cleaning. The Infracontrol is the latest model in the series, which also comprises the Top and Profi models. In the newest model, an infrared heater generates the aerosol. As soon as saturation of the aerosol is reached, the inhaler automatically switches into stand by mode. This feature makes the application even more economical.

Inhalation therapy for COPD

In treatment of COPD, the motto to prefer topical to systemic therapy continues to be valid. Inhalation of medical substances offers several advantages compared with other forms of application. Among other factors, minor drug effects and high concentration at the site of action present significant therapeutic benefits. Ultrasonic devices also have the advantage of increasing the patient's compliance and ensuring economical treatment.

The multisonic Infracontrol

User-friendly and economical inhalers

The breath-controlled feature of the inhalers in the Multisonic range ensures effective inhalation and economical consumption of medication. Results of a study examining the handling of the devices showed HILL MEDIZINTECHNIK, Tel. +49-36735-4630 Fax +49-36735-46344

Ultrasonic inhalation therapy for CF