![]() 7 Bronchodilation with muscarinic antagonists, β-agonists, and inhaled corticosteroids (ICS) are the foundation of pharmacological treatment in patients with COPD. Inhalation is the preferred administration route for COPD therapy due to the high drug concentration that can be achieved locally within the lungs, leading to increased efficacy and decreased systemic adverse events (AEs) versus other administration routes (eg, oral or intravenous). 4 The global COPD burden is projected to increase 5 because of persistent exposure to COPD risk factors, such as tobacco smoke and air pollution. 1 – 4 More than 16.4 million people in the US have been diagnosed with COPD, but it is estimated that millions more have yet to be diagnosed. COPD is currently ranked as the fourth leading cause of death in the US and is predicted to become the third leading cause of death worldwide by 2030. Finally, we discuss the current applications of nebulized therapy in patients with COPD.Ĭhronic obstructive pulmonary disease (COPD) is a common, treatable, and preventable disorder that is a significant cause of chronic morbidity and mortality. Second, we review the updates on recently approved and newly marketed nebulized treatments, nebulized treatments currently in development, and technological advances in nebulizer devices. We first discuss the pathophysiology of patients with COPD and inhalation device considerations. The aim of this narrative review was to highlight recent updates and the treatment landscape in nebulized therapy and COPD. Furthermore, with the availability of quieter and more portable nebulizer devices, nebulization may be a useful treatment option in the management of certain patient populations with COPD. The recent approval of two nebulized long-acting muscarinic antagonists has added to the extensive range of nebulized therapies in COPD. Nebulized treatment provides patients with COPD an alternative administration route that avoids the need for inspiratory flow, manual dexterity, or complex hand-breath coordination. However, inhalation devices such as spacers and valved holding chambers can be used with pMDIs to increase the efficiency of aerosol delivery. Furthermore, patients may have difficulty coordinating inhalation with device actuation, which is required for pMDIs and SMIs. A considerable number of patients are not capable of producing a peak inspiratory flow rate to overcome the internal resistance of DPIs. Patients who have cognitive, neuromuscular, or ventilatory impairments (and receive limited assistance from caregivers), as well as those with suboptimal peak inspiratory flow may not derive the full benefit from handheld inhalers. ![]() Although pMDIs, DPIs and SMIs may be appropriate for most patients with COPD, certain patient populations may have challenges with these devices. Inhalation devices consist of nebulizers and handheld inhalers, such as dry-powder inhalers (DPIs), pressurized metered-dose inhalers (pMDIs), and soft mist inhalers (SMIs). ![]() A guide to aerosol delivery devices for respiratory therapists 2017.Ĭurrent guidelines recommend inhalation therapy as the preferred route of drug administration for treating patients with chronic obstructive pulmonary disease (COPD). Gardenhire D, Burnett D, Strickland S, Myers T.Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2020.Īvailable from. Global Initiative for Chronic Obstructive Lung Disease.COPD predicted to be third leading cause of death in 2030.Centers for Disease Control and Prevention.
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