Inhalation therapy purpose of use. Advantages of modern inhalation therapy. Physiological and therapeutic effects of aerosols

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AerophytotherapyAerotherapy

Treatment with aerosols (inhalation therapy)

General information. Inhalation therapy refers to the use of medicinal substances for therapeutic and prophylactic purposes ( medicinal products) in the form of aerosols (electric aerosols). An aerosol (air solution) is tiny liquid or solid particles suspended in the air. Electroaerosol is an air solution whose particles have a free electrical charge.

In the form of aerosols, solutions of medicinal substances, mineral waters, oils, infusions and decoctions of herbs and other folk remedies, sometimes powdered medicines, are used in physiotherapy.

Interest in inhalation therapy is due to a number of its advantages over conventional (traditional) methods of pharmacotherapy. Among the most important of them are the following: a) absolute painlessness of drug administration; b) increasing the pharmacotherapeutic activity of the drug by increasing the total volume of the drug suspension and the contact surface medicinal substance; c) rapid absorption and delivery of drugs to tissues; d) avoiding the destruction of drugs in the gastrointestinal tract; e) decrease in severity and frequency side effects medicines; f) the route of drugs through the respiratory system is the most physiological, natural and effective. With electroaerosol therapy, an additional electrical charge acts on the body, which also ensures greater stability of the aerosols.

In the mechanism of action of aerosol and electroaerosol therapy, three factors are important: the pharmacotherapeutic properties of the drug, the electrical charge and the temperature of inhalation. The effect on the body is mainly determined by the drug used, the choice of which is dictated by the nature of the pathological process and the purpose of the effect. Many pharmacodynamic and pharmacokinetic properties of drugs depend on the size of their particles or, as experts say, on the degree of dispersion of aerosols. The smaller the particles (the higher the dispersion), the freer

The size of the particles, they pass into the lungs, act at the level of the alveoli. Larger particles settle in the bronchi and trachea, on the mucous membrane of the upper respiratory tract, in the nasopharynx (Fig. 19).

Rice. 19. Penetration of aerosols into various departments respiratory system depending on particle size.

Based on the characteristics of aerosol deposition, aerosols of high and medium dispersion (up to 25 microns) are recommended for the treatment of diseases of the lungs and bronchi, and aerosols of medium and low dispersity (above 25 microns) are recommended for the treatment of diseases of the trachea and nasopharynx. Regarding temperature and electric charge, then they act directly on the lung tissue, ciliated epithelium of the respiratory tract mucosa and blood vessels. In addition, they, together with drugs, irritate the receptors of the bronchopulmonary tree and the endings of the olfactory nerve, which is accompanied by neuroreflex reactions of the respiratory and cardiovascular systems.

Types of inhalations and equipment. There are 6 main types of inhalations: steam, heat-moist, aerosols room temperature(wet), oil, ultrasonic and powder inhalation.

The active factor of steam inhalation is steam, which, when moving, captures medicinal substances. Only easily evaporating medications are suitable for their preparation: menthol, thymol, eucalyptus, and some antibiotics. Steam inhalations are carried out using a steam inhaler, but they can be done without it (breathe over the steam). Since ancient times, when people had a cold, they inhaled steam over a cast iron pot with jacket potatoes. And today, inhalation of potato steam can be used for colds. Some advice (according to V.G. Yasnogorodsky and V.N. Istomin) in this aspect. If you want to avoid steaming the skin of your face and head, you can make a cardboard (or thick paper) funnel, cover the pan with it, and breathe steam through a narrow hole. It is even better to do inhalation using a coffee pot. Jacket potatoes are also boiled in it. Or you can use freshly boiled water. Medicinal substances and crushed medicinal herbs are thrown into boiling water.

The duration of steam inhalations is 5 - 10 minutes.

Warm-moist inhalations are carried out at a temperature of the medicinal aerosol of 32-42 °C. This is the optimal temperature for inhalation therapy. Saline and alkaline solutions, mineral waters, antiseptics, sulfa drugs, antibiotics, aromatic and anesthetic substances are suitable for such inhalations. The duration of the procedure depends on the speed of spraying the solution (25-100 ml) of the medicinal substance, the content of which should not exceed the highest single dose. Alcohol solutions aromatic and anesthetic agents are taken at the rate of 5-20 drops per 100 ml of water.

Heat-moist and steam inhalations contraindicated for severe arterial hypertension, ischemic hypertension, severe forms of laryngeal tuberculosis, hemoptysis, acute pneumonia.

With wet inhalations, the drug is sprayed and injected into the respiratory tract without heating.

This type of inhalation is most often done using portable inhalers and can therefore be done at home. 2-6 ml of solution are consumed per inhalation. They are quite easily tolerated by patients, so they can be used even by patients for whom steam and heat-moist inhalations are contraindicated. For wet inhalations, anesthetic substances, hormones, antihypertensive drugs, and phytoncides are used.

Oil inhalations are based on spraying for prophylactic (protective) or therapeutic purposes. oil solutions, their duration is usually 5-7 minutes, and 0.4-0.6 ml of oil is consumed per procedure. Oils of vegetable (eucalyptus, mint, peach, almond, apricot1, corn, sea buckthorn, olive) and animal (fish oil) origin are suitable for oil inhalations. Most often, oil inhalations are carried out 30-40 minutes after steam, wet and heat-moist inhalations, although they can also occur as independent procedures.

Dry inhalations (powder inhalations) are used mainly for acute inflammatory diseases upper respiratory tract. Powder blowers (insuflators) are used for spraying, which allows you to do the procedure at home. For inhalation, sulfonamides, antibiotics, vasoconstrictors, antiallergic, and anti-influenza agents are sprayed in the form of powders.

By the way, we note that every family should have a portable inhaler for therapeutic purposes.

For use at home, aerosol cans containing medicinal substances, and evacuating liquid. The cylinders are equipped with valve devices that allow dosing of the sprayed substance. The spraying of the medicinal substance is fast, stable, its losses are eliminated, and sterility is ensured. Aerosol cans can be considered as finished dosage form and as a portable device. Medicinal substances in aerosol cans are used as prescribed by a doctor in the treatment of influenza, respiratory diseases, wounds and trophic ulcers, some skin diseases. In the form of ready-made

aerosol preparations are produced: “Vinisol”, “Levonisol”, “Tegralezol”, “Livian”, “Lifuzol”, “Legrazol”, “Oxycyclosol”, “Oxycort”, “Proposol”, “Cameton”, “Camphomen”, “Efotin” ", "Berotek", "Ingalipt", "Bepotid", "Beklomet", "Astmopent", "Alupent", etc.

Indications and contraindications. Inhalation therapy is indicated for patients: 1) acute and chronic diseases of the upper respiratory tract, bronchi and lungs; 2) occupational diseases of the upper respiratory tract, bronchi and lungs; 3) tuberculosis of the upper respiratory tract and lungs; 4) "acute and chronic diseases of the middle ear and paranasal sinuses; 5) carriage of bacilli in the upper respiratory tract; 6) brochospasm with bronchial asthma; 7) influenza and other acute viral infections; 8) hypertension I and II degrees.

The following diseases and conditions are contraindications for aerosol therapy: spontaneous pneumothorax ( acute period); extensive cavities in the lungs; widespread and bullous form of emphysema, stage III pulmonary heart failure, massive pulmonary hemorrhage, stage III hypertension, severe atherosclerosis of the coronary and cerebral vessels, individual intolerance to inhalation, Minière's disease with frequent attacks.

General rules for taking inhalations:

Inhalations should be carried out 1 - 1.5 hours after meals. After the procedure, you should not drink or eat food for 1 hour.

Inhalations are done in a calm state, without being distracted by talking or reading. Clothing should not make breathing difficult.

After inhalation, you need to rest for 10-15 minutes, and in the cold season - 30-40 minutes. Immediately after the procedure, you should not sing, talk, and especially not smoke.

For diseases of the nose and paranasal sinuses, inhalation and exhalation should be done through the nose, without straining. For diseases of the pharynx, larynx and bronchi, after taking a deep breath, it is advisable to hold your breath for 1-2 seconds and then exhale as much as possible.

Before inhaling antibiotics, it is necessary to determine the individual sensitivity of the microflora and the body to them in order to avoid the occurrence of an anaphylactic reaction.

During aerosol therapy with antibiotics, it is necessary to limit the intake of liquids.

For inhalations, strongly acidic and strongly alkaline, as well as highly concentrated solutions should not be used, since this inhibits the activity of ciliated epithelium and absorption of drugs from the surface of the mucous membrane of the respiratory tract.

With the complex use of physiotherapeutic procedures, inhalations are carried out after light therapy and electrotherapy. After steam, heat and oil inhalations, local and general cooling procedures should not be performed.

10. Several medications for inhalation should be used only after consultation with a doctor, as physical, chemical and pharmacological incompatibility of drugs occurs.

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AerophytotherapyAerotherapy

Inhalation therapy is a method of therapeutic effects on the respiratory tract and lungs of aerosols of medicinal substances. Drug inhalation therapy is an integral part of the treatment and prevention of acute and chronic diseases of the upper and lower respiratory tract. The main goal of inhalation therapy is to achieve maximum local therapeutic effect with minor manifestations or absence of systemic side effects.

The main objectives of inhalation therapy are:

improving the drainage function of the respiratory tract;
rehabilitation of the upper respiratory tract and bronchial tree;
swelling reduction and regeneration;
decreased activity inflammatory process;
relief of bronchospasm
impact on local immune reactions respiratory tract;
improvement of microcirculation of the mucous membrane of the respiratory tract
protection of the mucous membrane from the action of industrial aerosols and pollutants, various components that pollute the atmospheric air.

Benefits of inhalation therapy

Dispersing the drug substance increases the total volume of the drug suspension and the surface of its contact with the affected tissue areas, which significantly accelerates the mass transfer of drugs and increases the effectiveness of drug exposure; To achieve the maximum therapeutic effect, only a tenth of the drug substance administered by other routes is required, resulting in systemic side effects drug therapy eliminated or significantly reduced.
simple and painless way administration, which is very important in pediatric practice
aerosols have a direct local action to the inflammatory focus
the possibility of precise dosing of a medicinal substance that maintains high stability in the respiratory tract, which makes it possible to create locally high concentrations of medicinal substances.

The main devices that make it possible to obtain aerosols of medicinal substances today are:

Compressor inhalers (nebulizers)
Pneumatic inhalers
Ultrasonic nebulizers
Steam and heat-moisture inhalers
Metered dose inhalers
Powder inhalers (dry powder nebulizers)
Phytoinhalers

The creation of compressor inhalers (nebulizers) has significantly expanded the possibilities of using inhalation therapy: it has now become available to patients of all ages, starting from the first days of life. It can be carried out during severe exacerbation chronic diseases (including bronchial asthma), in other situations when the patient has a significantly reduced inspiratory rate (children early age, postoperative patients, patients with severe somatic diseases). Aerosol generation in compressor inhaler is not accompanied by mechanical and thermal destruction of the drug substance.

In our department for the treatment of children, starting from infancy, an inhalation unit “NIKO” is used, designed for nebulizer therapy, including thermal therapy, i.e. the possibility of heating the aerosol, which makes the procedure more comfortable and effective for patients with hypersensitivity bronchi in the treatment of diseases of the lower respiratory tract.

The installation has 4 modes of dispersion of the generated aerosol, which allows for strictly differentiated effects on the required part of the respiratory tract. Has 5 degrees of protection for patients during inhalation.

Inhalation therapy in the department is widely used not only for treatment, but also for prevention, in particular in children with frequent and prolonged acute respiratory infections, with chronic pathology ENT organs (otitis, sinusitis, tonsillitis, hypertrophy of the tonsils and adenoids). Our department uses new highly effective complex drugs for preventive purposes:

PELOID - its basis is brine from the salt lakes of Siberia. It contains a rich complex of biologically active minerals and organic compounds(sulfates, chlorine, sodium, bicarbonates, potassium, calcium, bromine, boron, cobalt, manganese, iron, etc.). PELOID acts on the mucous membrane, which is due to the presence in it wide range biologically active components. Potassium chloride increases the activity of the ciliated epithelium; sodium chloride plays an important role in osmotic processes; calcium and magnesium reduce inflammation; sodium iodide increases secretion and thins viscous and thick mucus. Thus, PELOID has a complex anti-inflammatory, expectorant and immunomodulatory effect. Inhalations with PELOID are equally effective for both allergic and infectious inflammation.
TONUS+P, which contains extracts of kelp, fir and licorice; the basis of the drug is an extract of two types of therapeutic mud (sulfide silt mud and freshwater sapropel), and activated mineral complex. TONUS+P has a pronounced anti-inflammatory and immunomodulatory effect.

Inhalation therapy has long been one of the main components in the prevention and treatment of acute and chronic diseases of the upper respiratory tract.

Devices intended for aerosol therapy are divided into portable (usually used at home) and stationary - for inhalation in medical institutions. The choice of inhaler depends on the purpose for which inhalation therapy is prescribed.

If the drug must be delivered to the upper respiratory tract, use a compressor-type inhaler. The medicine is supplied in it along with the escaping air stream. The aerosol that is formed when using such inhalers contains drug particles that are easily deposited in the upper respiratory tract. A compressor type of medication supply is used for oil, moist, heat-moisture and steam inhalations.

Nebulizers are highly effective devices for treating the central and upper respiratory tract. This is essentially a compressor-type inhaler. He delivers the inhaled mixture through a special nozzle, which allows you to obtain an aerosol or “cloud” with a high content of fir oil particles. Nebulizers are used to deliver antibiotics, mucolytics and other drugs into the respiratory tract.

Ultrasonic inhalers are used if it is necessary for the medication to penetrate small bronchi (this is required for acute and chronic bronchitis, pneumonia, bronchial asthma). The aerosol produced by such inhalers contains very small particles of the drug. However, it should be noted that the structure of some substances is completely or partially destroyed when finely sprayed, which leads to a loss or reduction in the therapeutic effect of inhalation.

Types of inhalations

1. Steam inhalations can be performed without a special device (steam inhaler). Such inhalations are prepared from easily evaporating medications (fir oil, menthol, eucalyptus and others) with water. The temperature of the vapor should be 57-63 degrees, but when inhaled it decreases. Such inhalations are contraindicated in case of pleurisy, acute pneumonia, severe forms of tuberculosis, arterial hypertension, hemoptysis due to high temperature pair.

2. Warm-moist inhalations thin out viscous mucus, improve blood flow to the mucous membrane of the respiratory tract, and improve the function of cilia, which push mucus out of the bronchi. For this type of inhalation, solutions of alkalis and salts (soda, saline and others), hormones, mucolytics, and antibiotics are used. The temperature of inhaled air is from 38 to 42 degrees. Contraindications are the same as for steam.

3. For wet inhalations, anesthetic and antihistamines, phytoncides, hormones, antibiotics. The concentration of the drug in the solution is greater than with warm-moist inhalations. Such inhalations are tolerated quite easily, so they are prescribed to those patients for whom heat-moist and steam inhalations are contraindicated.

4. Oil inhalations are carried out using heated air. Fir oil, eucalyptus, almond, peach and other oils are used. The use of mineral oils is prohibited! Oil inhalations promote the rejection of crusts in the throat and nose and reduce the feeling of dryness. However, such inhalations are prohibited for people in contact with large amounts of dust (including tobacco). Since dust, mixing with oil, forms plugs, which, in turn, clog the lumen of the bronchi.

5. The peculiarity of ultrasonic inhalations is that thanks to ultrasound, aerosols with smaller particle sizes are formed. A small medicinal substance is delivered to the respiratory tract, which significantly increases the effectiveness of inhalation. The attending physician will select an individual treatment regimen for you: determine the duration and number of sessions, taking into account the type of disease and its severity.

Inhalation therapy allows you to deliver the drug directly to the pathological focus and avoid the occurrence of side effects that are typical for other methods of drug administration.

The use of fir oil as one of the components in inhalations, clinics, and hospitals will significantly increase the effectiveness of treatment for various diseases of the upper respiratory tract. One thing to remember: filling your inhaler with fir oil for several days is not recommended. Only for a day, maximum two. A rapid oxidation process occurs in the inhaler, light fractions evaporate, and hence the therapeutic effect abruptly disappears, fir oil loses its softness and becomes an irritant.

Currently, there are many ways to treat various diseases, including, for example, all kinds of lung ailments. One of them is the inhalation method, in other words, inhalation therapy. What are its specifics, and how to properly carry out treatment using inhalations?

What is inhalation

The word "inhalation" came into our speech from Latin language, translated from which it means “to inhale.” This translation very accurately reflects the essence of the entire procedure. It involves inhaling medicinal substances using special devices (for both therapeutic and preventive purposes). However, we need to make a reservation right away: inhalation therapy can be carried out not only through devices, but also natural, naturally- when inhaling, for example, sea air.

When receiving inhalations through devices, medicinal substances entering the body are absorbed faster and better than if this happened in any other way. This is also considered the safest for all categories of the population. However, we will return to this issue later, but for now it is worth discussing the types of inhalation therapy - there are also many of them.

Types of inhalations

There are only five types of inhalation. These are steam - the most common inhalations, as well as dry, heat-moist, aerosol and oil. Let's talk a little more about each of these types.

Steam inhalations

This type of inhalation is considered the most common. Many have been familiar with it since childhood, because it is the easiest to use. It does not require special devices; you can breathe this way not only using inhalers, but also traditional methods- for example, over potatoes or over a teapot. The point is to inhale hot steam, to which, if the procedure is carried out using a device, special medicines. The steam warms up our nasal passages, throat, trachea - in general, the organs of the respiratory system, diluting the mucus in them. This type of inhalation helps well with all kinds of colds such as rhinitis, pharyngitis and the like.

For steam inhalations, medications are not required, but adding something to the steam is still possible and even recommended: eucalyptus leaves, hops, chamomile, St. John's wort. Some people add soda, but then it is important that the steam is not too hot - otherwise it will leave a burn.

Dry inhalations

Dry inhalation is also a type of inhalation therapy. This is the inhalation of medicines in powder form through special nebulizers. It is this type of inhalation that is used, including for bronchial asthma.

Warm-moist inhalations

This type of inhalation is primarily done not at home, but in a clinic, since it requires a compressor - this involves inhaling moist air at a temperature of approximately forty degrees. However, there are special portable devices for inhalation therapy, with their help it is possible to carry out this procedure independently. Wet inhalations are usually done with simple mineral water and are aimed at eliminating phlegm.

Aerosol inhalations

Methods of inhalation therapy also include aerosol inhalations. This is spraying the medicine in the form of an aerosol using a nebulizer or a special can. This method allows the particles of the drug substance to penetrate as deeply as possible to the more “distant” respiratory organs.

Oil inhalations

To carry out this type of procedure, an inhaler is required. Hot vegetable oil is poured into it, which is then sent to the patient’s damaged respiratory organs. It relieves inflammation and, by forming a protective film on the mucous membrane, prevents its irritation. Important point: oil cannot interact with dust; such a synthesis will only worsen the situation. Therefore, it is worth taking this into account for those people who work in very polluted areas.

Indications and contraindications for inhalation therapy

Any treatment must be prescribed by a doctor. Each procedure has its own indications and contraindications. Inhalation therapy is no exception. Anyone who has ever thought about carrying it out needs to know about all the cases when the procedure is permitted or prohibited. Let's start studying these things, perhaps, with contraindications.

First and most importantly: such therapy should in no case be carried out with elevated temperature. This is considered to be a mark of 37.5 and above. It does not matter what type of inhalation and what method the patient wishes to use. Any types of inhalation therapy are also prohibited when:

myocardial infarction and various heart diseases;
with nosebleeds;
pulmonary failure and bleeding;
stroke;
allergies.
steam inhalation is impossible with pleurisy;
oil therapy cannot be done if you are allergic to oils, hypertension of the second and third stages, atherosclerosis (in the latter case, the dry method of inhalation therapy is also prohibited);
at weak vessels;
warm-moisture inhalation cannot be done if you have arrhythmia or heart failure, or if you have had a stroke or heart attack (and less than eight months have passed since then);
finally, aerosol inhalation is not allowed for people with heart problems, pulmonary failure or suffering from a hypertensive crisis.

As you can see, there are plenty of contraindications. However, there are still far more indications for inhalation therapy:

All viral colds(such as ARVI, influenza, rhinitis and the like, including their complications).
Bronchitis (both acute and chronic).
Pneumonia.
Bronchial asthma.
Cystic fibrosis.
Tuberculosis.
Respiratory tract fungus.
HIV infections.
Inhalation therapy is also indicated for the prevention of postoperative conditions.

And these are not all situations when inhalations will be beneficial to the body!

Features of the procedure

The purpose of inhalation therapy is to affect the mucous membrane. It has positive result for several reasons. So, with the help of inhalations, swelling and inflammation are relieved in this way, phlegm and mucus go away. In case of cough, spasms go away, and the mucous membrane is moistened in mandatory- regardless of what disease is being eliminated. In addition, inhalations are local therapy; some call them "grandmother's remedy." Similar features Inhalation therapy has been successfully used to treat the respiratory system both at home and in hospital settings for many years.

Rules for the procedure

There are special rules for carrying out inhalation therapy - regardless of what methods or techniques and methods the inhalation will be carried out. These rules must be followed strictly in order to get the most effective results.

It is also possible that the attending physician will have additional requirements for the procedure. In this case, of course, it is necessary to fully obey his instructions.

So, the first and most important requirement is to carry out inhalation therapy no earlier than one and a half, or even two hours after eating. However, after the procedure itself, you cannot eat or drink for another hour. You should also refrain from smoking, singing and going out into cold air during this period.

Another rule that should also be followed is the selection of comfortable clothes and a comfortable posture. During the procedure, nothing should interfere or constrain - no movement, no throat, no arms, no chest. Sitting should also be comfortable.

As a rule, the standard course of treatment should be at least five days - and preferably ten. Then the effect will be maximum. If the patient is an adult, he needs to do two or three procedures a day; if he is a child, one is enough for him. Inhalation therapy in children is carried out for three to four minutes. Adults should spend it a little longer - five to seven. If treatment is carried out to eliminate rhinitis or any other disease of the nose and/or paranasal sinuses (no matter what method of inhalation therapy is used), you need to inhale through the nose and exhale through the mouth. If treated sore throat and/or cough, then everything happens exactly the opposite. By the way, this is logical, but it should still be clarified: any inhalation is carried out either through the nose or through the mouth - depending on what disease needs to be eliminated. Inhalations and exhalations should be light, without tension. Inhalation is a simple procedure, but it requires extreme care and maximum concentration, and therefore you should not be distracted by any extraneous things, including conversations.

Inhalation methods

There are several ways to carry out this procedure. We will not remember here about folk methods such as potatoes, a kettle and everything else, we will talk exclusively about devices for inhalation therapy. This is, firstly, a compressor - used in hospital conditions. Secondly, a nebulizer; in addition, special aerosols and inhalers, as well as a ventilator. Some also consider smoking incense as a method of inhalation therapy.

The nebulizer is the most popular device, and therefore we will consider it in a little more detail.

Nebulizer

What is a nebulizer? What is so special about it that distinguishes it from a regular inhaler?

The word "nebulizer" has roots in Latin and is translated into our language as "cloud". This is the whole essence of the nebulizer device - it is an inhalation device that converts medicine in liquid form into a cloud. This is the same inhaler, but with one single difference - it has a narrower action, that is, it allows the medicine to reach exactly the area where it is needed, whereas the spray spectrum of a conventional inhaler is wider. However, by and large, a nebulizer is not much different from an inhaler (which is translated from Latin as “inhale”), and therefore many manufacturers and sellers even write on packages/labels that this product is an “inhaler/nebulizer.” Nebulizers cannot only be classified as steam inhaler, everyone else has the right to be called either this or that.

There are static nebulizers, they are located in hospitals, but in addition, there are also portable devices for inhalation therapy. Asthmatics use these, because it is the nebulizer that helps them out when attacks begin. Thus, this device is used for inhalation and also for the treatment of respiratory viral diseases and cystic fibrosis.

There are two ways to spray medicine from a nebulizer to the patient - either through a mask or through a breathing tube. The latter is used more often.

Inhalation therapy with a nebulizer has its own specific requirements for how this procedure should occur. They are as follows:

The procedure is done only while sitting, you cannot bend forward.
You should not take expectorants before it.
Care must be taken to ensure that the medicine does not come into contact with the eyes.
The procedure cannot be carried out for longer than fifteen minutes.
The mask (if it is used) should fit tightly to the face.
The medicine can only be dissolved in saline solution.
Before exhaling, you should hold your breath for a couple of seconds.
At the end of the procedure, the camera of the device must be thoroughly washed in clean water and dry.

Inhalations for various diseases

As has already been mentioned several times, the spectrum of action inhalation drugs and the inhalation devices themselves are very wide; they can be used to eliminate the most various diseases respiratory system. Below we will talk about the features of treatment for some ailments.

Inhalations for asthma

For those who are not in the know, let us explain: asthma - or bronchial asthma - is a severe disease in which the bronchi are in the stage of chronic inflammation. And any contact with allergic substances or the slightest stressful situation may cause an attack of suffocation. If it is not stopped immediately, it can even lead to the death of the patient. That is why every person suffering from of this disease, it is so important to have some kind of pocket inhaler. We have already found out above that for asthma you can use a nebulizer. But what other inhalers can be used during inhalation therapy? First, the spacer. This device is equipped with special valves that allow you to regulate the flow of drugs into the patient’s body - this happens only when you inhale. This device is very convenient for treating small children, but its compactness leaves much to be desired: it is quite bulky. Therefore, the spacer is not always convenient to carry.

Another type is an aerosol with a dispenser, thanks to which the medicine enters the body in certain doses. Its advantages are operational reliability and relatively low price. There are also metered-dose inhalers that dispense powder rather than liquid medication. They are also quite reliable and effective, but they cost much more.

The next type of inhaler is an auto-inhaler, which automatically delivers medication. Thus, the choice of devices for asthmatics is quite wide, and everyone can find a device that would suit them according to all the characteristics - despite the fact that experts generally recommend using a nebulizer.

Now let us briefly dwell on the advantages of inhalation therapy in the treatment of bronchial asthma. They are obvious, but they are still worth mentioning. First of all, the undeniable advantage of inhalations is the fact that the medicine gets into the affected organ as quickly as possible - that is, into the bronchi, and at the same time all the necessary substances are concentrated exactly in the right area, and do not spread throughout the body. The third advantage of inhalation is that with this effect the medicine is most long time provides healing effect on the body.

Above we discussed exclusively inhalation therapy using special devices, but this procedure It can also be carried out using traditional methods, including for bronchial asthma. However, it is worth paying attention to some important aspects: So, you cannot use steam “folk” inhalations at the very beginning of an attack - they will not be able to stop suffocation, but will only lead to a worsening of the condition. In addition, steam inhalation folk remedies It is prohibited for children under seven years of age.

By the way, about prohibitions: bronchial asthma also has its own contraindications, when inhalation procedures are strictly prohibited. These are the situations:

when asthma worsens, attacks occur twice a week or more often;
when there are neoplasms and/or purulent processes;
when there are tumors in the brain;
when the heart function is impaired;
when pulmonary and/or nosebleeds are common.

Inhalations for COPD

The strange abbreviation above is the name of a serious illness. Chronic obstructive pulmonary disease is a disease in which, due to the fact that the lungs are in constant state inflammation and therefore react acutely and very sensitively to everything that gets into them; the flow of air into the organ is partially limited. In other words, this is a regular lack of oxygen. This process is irreversible, moreover, it is also progressive. Therefore, treatment must occur constantly, and inhalation therapy for COPD is one of the integral parts of this very treatment.

Usually, for COPD, it is recommended to use metered-dose inhalers, but during a period when an exacerbation of the disease occurs and a person, due to his condition, cannot control the dosage of medication, it is worth paying attention to nebulizers. The latter, by the way, during the treatment of COPD also have a beneficial effect on the heart failure that often accompanies this disease.

Inhalations for pneumonia

Pneumonia is an inflammation of the lungs, and if it is bilateral, it is also not a pleasant disease. Inhalations are here too an excellent remedy fight against infection. The rules for the procedure are standard and correspond to all those described above.

Pneumonia also has a number of contraindications to the use of inhalation therapy. Firstly, such procedures cannot be performed on people with cardiovascular diseases. Secondly, they are also prohibited in cases of severe pneumonia, as well as in the presence of shortness of breath. You should also refrain from inhalation in all of the following cases: in the presence of pus and/or blood in the sputum, nosebleeds, tuberculosis. Lung tumors, allergies.

As for the devices used for inhalation in case of pneumonia, here too, preference is given to the nebulizer. Although, of course, it is not forbidden to use other methods - for example, steam inhalations are also very common, including folk remedies - over potatoes, for example.

Interesting facts about inhalation therapy

First therapeutic effect sea air, or rather, the particles of salt in it, were described back in Ancient Rome.
The first inhaler was invented in France, and this happened back in the mid-nineteenth century. That inhaler was pressurized and operated by a hand pump. The steam inhaler first appeared in Germany, and in this way people suffering from in different forms tuberculosis.
The electric sprayer was invented almost a century later - only in the thirties of the twentieth century, and in the middle of the century ultrasonic sprayers appeared.
Using a nebulizer you can spray also herbal infusions and decoctions, but they must first be carefully filtered.
The inhaler is a personal hygiene product, and therefore it is not recommended for the whole family to use it, or, even worse, to lend it to friends. There is a risk of catching other people's illnesses.
There are inhalers whose appearance is designed to interest the child. They are bright, colorful and look more like a toy than a medical device. With such a device, children are treated more willingly and more cheerfully.
The term “inhaler” itself was introduced into medicine and speech in general by a British therapist back at the end of the eighteenth century. This Briton came up with his own device for inhaling opium - he modernized a mug with a hole. Exactly this thing he called it an inhaler.
Even before our era, ancient people knew about the possibility of treatment with inhalations: for example, they inhaled henbane fumes to cure the respiratory system.

Inhalations are a truly effective procedure, and therefore are actively used in physiotherapy. Inhalation therapy, as a rule, does not carry any side effects and does not harm your health - of course, if you do everything correctly and follow the recommendations. So it’s not in vain that this “grandmother’s remedy” lasts for years!

rehabilitation electrotherapy magnetic oscillation

Aerosol therapy is a method of physiotherapy that involves the use of medicinal and biological drugs for therapeutic purposes. active substances in the form of aerosols. It is based on the possibility of quickly and painlessly applying medicinal substances to wound surfaces, mucous membranes and the respiratory tract of the lungs, from where these substances enter the blood.

During aerosol therapy, aerosols from the mucous membrane of the nose, nasopharynx, trachea, where particles initially settle, are absorbed into the developed capillary and lymphatic vasculature in the submucosal layer. In the bronchi, absorption occurs more intensely than in the trachea, and absorption is most pronounced in the alveoli. Substances entering the lymph during aerosol therapy circulate for some time in the pulmonary lymph circulation and enter through the thoracic flow into the pulmonary circulation system, entering directly into the arterial blood. In this case, the medicinal substances bypass the liver barrier and penetrate into all tissues. In addition, a dense network lymphatic vessels during aerosol therapy creates conditions for the concentration of aerosols in lung tissue, prolonging the effect of the drug while slowly entering the pulmonary bloodstream.

The administration of drugs by aerosol therapy eliminates trauma to the skin and irritation to the mucous membrane of the esophagus and stomach. At the same time, a physiological natural supply of the medicinal substance and an active local and general resorptive effect on the pathological process, both in the respiratory system and on other systems of the human body, are ensured.

Aerosol therapy is divided into natural and artificial.

Natural aerosol therapy is inhalation into natural conditions clean air containing useful impurities in the form of ions of elements of sea water, healing mineral water, substances secreted by plants (conifers, camphor trees, linden, laurel, various herbs and phytoncides.

Artificial aerosol therapy can be produced by fumigation open wounds and diseased skin areas (fumigation), smoke inhalation medicinal herbs(smoking), as well as pure or medicinal hot steam (inhalation).

Artificial aerosol therapy is carried out using inhalers, devices that generate aerosols. With the help of these devices, artificial aerosols containing various medicinal substances are introduced into the respiratory tract. Aerosol inhalers can be individual or chamber (a group of patients during aerosol therapy inhales medicinal substances sprayed in the inhalation room).

For treatment, dry, wet, local and oil aerosols are used. general action. It is possible to spray sea and mineral water, various salt solutions, infusions of medicinal herbs, phytoncides, enzymes, hormones, vitamins, antiseptic drugs, antibiotics.

The aerosols used are systems consisting of solid or liquid particles suspended in a gaseous medium. As a result of grinding the medicinal substance, its active surface area significantly increases and aerosol therapy ensures the biological effect of this substance on the mucous membrane of the respiratory tract, as well as on the entire body in relatively small quantities of the drug.

The localization of its deposition in the bronchopulmonary apparatus and the maximum concentration depend on the degree of dispersion (particle diameter) of the aerosol. If necessary, act on the mucous membrane oral cavity, nose and pharynx, larynx, aerosol therapy is carried out using large aerosols, the particle size of which is at least 30 microns. With average dispersion, the size of aerosol particles reaches 10-30 microns, and their maximum deposition occurs in the trachea and large bronchi. With fine dispersion, the particle size of aerosols does not exceed 0.5-10 microns. In this case, particles with a size of 10 microns penetrate into the bronchioles during aerosol therapy, and particles with a size of 0.5-3 microns penetrate into the alveoli. The epithelium of bronchioles and alveoli has the greatest absorption capacity.

Main groups of drugs used in aerosol therapy (in all groups, doses are indicated for one inhalation)

1. Mucus-dissolving and mucus-liquefying substances. They are used in the form of coarse and medium-disperse aerosols. Reducing the viscosity of mucus during aerosol therapy is achieved using substances with mucolytic, proteolytic effects or by reducing the concentration mineral salts on the surface of the mucous membranes. These substances include: 1-2% sodium bicarbonate solution (100 ml), trypsin (5 mg), bisolvon (1-2 ml), heparin (5,000 - 10,000 units), deoxyribonuclease (2 mg), glycerin (5 g per 200 ml distilled water).
2. Astringent and weakly cauterizing substances. They are used in the form of coarse aerosols. This group includes: infusion of chamomile flowers (6 g per 200 ml of distilled water), infusion of sage leaves (6 g per 200 ml of distilled water), 0.5% tannin solution.
3. Bactericidal and bacteriostatic substances. They are used in the form of fine aerosols. Antibiotics of the aminoglycoside series (garamycin, gentamicin) prescribed for the treatment of acute pneumonia, lung abscess, and destructive bronchitis at a dose of 40 mg per inhalation are of practical value. Aerosol therapy is carried out in the form of procedures three times a day for 6-7 days. Other medicinal substances are also used for bacteriostatic purposes, for example furacillin (1 g per 5,000 ml of distilled water), interferon.
4. Local anesthetics. Used in the form of coarse and medium-disperse aerosols before examining the respiratory tract instrumental methods, with a pronounced cough reflex, with burns of the respiratory tract. The use of a 1-2% lidocaine solution (1-2 ml per procedure) has practical value. Due to the pronounced allergenic ability of novocaine, aerosol therapy using this substance for inhalation is not recommended.
5. Decongestant and antispasmodic substances. They are used in the form of medium and fine aerosols. In everyday practice, the following are widely used: 0.1% solution of atropine sulfate (1 ml), 0.1% solution of adrenaline hydrochloride (0.5-1 ml), 2% solution of aminophylline (3-5 ml), 2% solution of ephedrine hydrochloride ( 3-5 ml), 1% diphenhydramine solution (1 ml), hydrocortisone (25 mg). According to indications, drugs are prescribed separately or in combination.
6. Protective and enveloping substances. They are used in the form of medium-disperse aerosols. This group includes vegetable oils (peach, olive, apricot, rose oil, rosehip and sea buckthorn oil), the aerosols of which cover the mucous membrane of the respiratory tract with a thin layer, protecting it from drying out. In addition, they have anti-inflammatory and bacteriological effects.

One type of artificial aerosol therapy is electroaerosol therapy, which involves giving aerosols a positive or negative electrical charge. This aerosol therapy is carried out using special devices - electric aerosol generators.

Indications.

· Sharp and chronic diseases upper respiratory tract, bronchi and lungs,
tuberculosis of the upper respiratory tract and lungs,
acute and chronic diseases of the oral cavity,
acute respiratory viral diseases,
· damage skin and mucous membranes,
· burns,
· trophic ulcers.

Contraindications.

· Allergic reactions on administered drugs,
spontaneous pneumothorax,
a common form of pulmonary emphysema,
· pulmonary hemorrhages,
ischemic heart disease,
angina pectoris 1-N FC,
stage II hypertension,
Pulmonary heart failure stage II-III,
· acute pneumonia,
diseases inner ear, tubotit,
· atrophic rhinitis,
· Meniere's disease with frequent attacks.

Based on temperature, aerosols are divided into cold (25-28°C and below), warm (28-35°C), indifferent (35-40°C) and hot (40°C and above).

Based on the type of dispersed phase, aerosols of thermal steam and oils are distinguished. Medicinal substances used for aerosol therapy should not have an unpleasant odor or taste. Their concentration, as a rule, does not exceed 2%.

Medicinal substances and their mixtures most often used for aerosol therapy
Medicinal substances (mixtures), their quantity in solution	Quantity of solution per 1 procedure
Steam individual inhalations of menthol - 1g Eucalyptus peach oil - 10g	10 drops per 100 ml of water
Glycerin 35 ml, eucalyptus tincture 35 ml, Menthol 0.7 g, ethyl alcohol 30 ml
Warm-moist individual inhalations
Sodium bicarbonate - 2g, distilled water - 100 ml
Sodium bicarbonate - 2g, sodium chloride - 1g, Distilled water 100 ml
Sodium bicarbonate - 1g, sodium tetraborate - 1g, potassium iodide - 0.25g, distilled water - 100 ml
Chamomile flower infusion - 10g per 100 ml of water, Menthol oil - 5 drops
Oletetrina 0.5 g (500,000 units), ascorbic acid - 2 g, Distilled water - 100 ml
Mineral medicinal and medicinal table waters bottled: Essentuki No. 4, 17, Narzan, etc.
Wet individual inhalations
Acetylcysteine solution 10% 4ml, sodium chloride solution 0.9% - 5 ml
Novoimanin solution 1% - 0.5 ml, Glucose solution 5% - 5 ml
Dioxidine solution 1% - 1 ml, glucose solution 5% - 5 ml
Aloe extract - 1 ml, novocaine solution 0.5% - 3 ml
Humisol solution - 5 ml
Aminophylline solution 2% - 2 ml, distilled water 3 ml
Crystalline trypsin 0.01 g sodium bicarbonate solution 1% - 5 ml (dilute before inhalation)
Oil individual inhalations
Menthol 0.1g, eucalyptus oil 1g, castor oil 1g, peach oil 1g
Anise oil 10g, eucalyptus oil 10g
Menthol 0.1g, Vaseline oil 10 ml, fish oil 0.8g, eucalyptus oil 1g
Menthol 0.8g, eucalyptus oil 3g, purified turpentine oil 10 ml, vaseline oil - 87 ml
Chamber group inhalations of aminophylline solution 2%-20ml, distilled water 10 ml
Atropine sulfate solution 0.1% - 1 ml, diphenhydramine solution 1% - 2 ml, distilled water - 20 ml
Euphylline solution 2% - 20 ml, ephedrine solution 3% - 5 ml, ascorbic acid solution -5% 5 ml
Papaverine hydrochloric acid solution 2% - 4 ml, diphenhydramine solution 1% - 2 ml, ephedrine hydrochloric acid solution 5% - 2 ml, distilled water 30 ml
Novocaine solution 0.5% - 5 ml, hydrocortisone suspension - 2 ml, distilled water - 30 ml
Novocaine solution 0.5% - 5 ml, papaverine solution 2% - 4 ml, distilled water 30 ml

For inhalation therapy, steam, wet and oil inhalations are used.

Steam inhalations. They use water vapor, which captures medicinal substances that are in a dissolved state in the inhaler reservoir (alkalis, sulfonamides, decoctions of sage leaves, chamomile, eucalyptus tincture, etc.). The temperature of the inhaled steam is 40-45°C, which leads to the sublimation of the herbs, leaves, cones and buds contained in the decoction. Such inhalations are used during the prodromal period, as well as during the resolution phase of the inflammatory process. They are contraindicated: in acute pneumonia, severe edema, hypertrophy or polyposis of the mucous membranes, purulent inflammation, hypertension, coronary disease hearts.

Warm-moist inhalations. Aerosols of solutions of salts and alkalis, which have mucolytic and bronchiolytic effects, heated to 38-42°C are used. They are carried out to liquefy and evacuate mucus, suppress persistent cough, and improve the drainage function of the bronchi. After it is carried out, the patient must cough in a drainage position (in which the paths for the outflow of sputum are below the place of its accumulation), do breathing exercises or vibration massage of the back and chest. Contraindications for warm-moist inhalations are similar to steam inhalations.

Wet inhalations. Medicinal substances are administered into the respiratory tract without preheating. Due to the low load on the respiratory tract, such inhalations can be performed by patients in the early postoperative period, for anesthesia of the nasopharyngeal mucosa. They can be prescribed to patients for whom steam and warm-moist inhalations are contraindicated.

Oil inhalations. When they are carried out, heated aerosols are injected into the tracheo-bronchial tract various oils, which have trophic, reparative-regenerative and bronchoprotective effects. In this regard, they are used for acute inflammation and severe atrophy of the mucous membranes of the respiratory tract. When combined with warm-moist inhalations, it is necessary to first remove sputum to prevent the formation of oil-mucus plugs in the small bronchi.

To obtain aerosols in medical practice use the following methods:

- pneumatic (using compressed air that disperses the medicine);
- ultrasonic (mechanical vibrations of ultrasonic frequency cause liquid cavitation and the formation of small particles);
- propellant (dispersion of particles of a medicinal substance using the sublimation of propellants);
- steam (steam, when moving, captures medicinal substances dissolved in the tank).

To produce aerosols, devices that disperse liquid in the air are more often used - aerosol generators of closed (individual) and open (group) types. The first of them include portable inhalers: Breeze, IP-2, Dissonic, Monsoon, IN-6, IN-7, IP-1, PAI, as well as stationary universal inhalers “Arsa”, Aerosol, “Vulcan-1”, “ Fog-1", Paros, PulmoAide, USI and others. Electroaerosols are obtained using the devices “Electroaerosol-1” and “TEI-1”. Aerosols for external use are obtained using open-type inhalers “Albedo”, Vapazon, Vaporisator, and to obtain electric aerosols the devices GEK-1 (chamber electric aerosol generator) and GEG-2 (group electric aerosol generator) are used. They are placed in special rooms - inhalators, with an area of at least 12 m2. The inhalation room requires supply and exhaust ventilation with a 4-fold air exchange.

Methodology. Inhalations are carried out no earlier than 1.5 hours after eating in a calm state of the patient, without difficulty breathing. For diseases of the nasopharynx, during inhalation the patient inhales and exhales evenly. For diseases of the larynx, trachea and bronchi, the patient should do deep breath, hold your breath and exhale through your nose. To increase the penetrating ability of aerosols, drugs that improve bronchial patency (bronchodilators) should be taken before inhalation. After inhalation, rest for 10-15 minutes is necessary. Eating, talking and smoking are not recommended for an hour.

During group inhalations, patients are placed at a distance of 75-120 cm from the aerosol generator. Inhalation of electric aerosols is carried out through a respiratory mask.

External aerosol therapy is performed by spraying aerosols on the surface of the skin, surgical field, wounds and burns. The aerosol generator nozzle is installed at a distance of 10-20 cm from the irrigated surface. After the procedure, a sterile bandage moistened with a solution of the sprayed substance is applied to the treatment area. In addition to aeroion therapy, aerosol therapy is combined with electrotherapy and heat therapy.

Dosing of aerosol therapy procedures is carried out according to the degree of particle dispersion (which is determined by the pressure, air flow and sprayed solutions in inhalers), inhalation depth, drug concentration and duration of the procedure.

The duration of daily procedures is 5-15 minutes. The course of treatment is 10-20 procedures. If necessary, a repeat course of aerosol therapy is carried out after 10-20 days.