Aerosoltherapie bei obstruktiven Atemwegserkrankungen: Deposition, Applikationsarten, Inhalationstechniken, Inhalationshilfen

  • B. Niggemann
Conference paper
Part of the Advances in Internal Medicine and Pediatrics / Ergebnisse der Inneren Medizin und Kinderheilkunde book series (KINDERHEILK. NF, volume 59)


Inhalationstherapie bedeutet heute die Behandlung des Atemwegstraktes mit einem Aerosol. Unter einem Aerosol versteht man ein 2-Phasen-System, welches aus einem Gas einerseits und Partikeln andererseits besteht, wobei die Partikel entweder fest (Suspensionsaerosol) oder flüssig (Lösungsaerosol) sein können (Newman u. Pavia 1985; Swift 1985).

Key words

Aerosol Deposition Inhalationstherapie Vernebler Dosieraerosol Inhalationshilfe 


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  1. Ahmad D (1984) Effects of aerosol propellants on airways function. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Canada Ltd. pp 22–26Google Scholar
  2. American Thoracic Society (1980) Guidelines for the use of intermittent positive pressure breathing (IPPB). Resp Care 25: 365–370Google Scholar
  3. Andersen JB, Klausen NO (1982) A new mode of administration of nebulized bronchodilator in severe bronchospasm. Eur J Respir Dis (Suppl) 119: 97–100Google Scholar
  4. Asmundsson T, Johnson RF, Kilbum KH, Goodrich JK (1973) Efficiency of nebulizers for depositing saline in human lung. Am Rev Respir Dis 108: 506–512PubMedGoogle Scholar
  5. Auty RM, Brown K, Neale MG, Snashall PD (1987) Respiratory tract deposition of sodium cromoglycate is highly dependent upon technique of inhalation using the spinhaler. Br J Dis Chest 81: 371–380PubMedGoogle Scholar
  6. Barnes KL, Clifford R, Holgate ST, Murphy D, Comber P, Bell E (1987) Bacterial contamination of home nebulisers. Br Med J 295: 812Google Scholar
  7. Barnes PJ (1987) Pharmacology of the lower airways. In: Newman SP, Moren F, Crompton GK (eds) A new concept in inhalation therapy. Medioom pp 25–48Google Scholar
  8. Barron EN (1988) Proper technique for using inhalers in asthma. N Engl J Med 316 (15): 951–952Google Scholar
  9. Beasley CRW, O‘Donnell TV (1985) Pear shaped spacer nebuhaler compared with nebulised solution for terbutaline administration in acute severe asthma N Z Med J 98: 845–855Google Scholar
  10. Beasley CRW, Rafferty P, Holgate ST (1987a) Bronchoconstrictor properties of preservatives in ipratropium bromide ( Atrovent) nebuliser solution. Br Med J 294: 1197–1198Google Scholar
  11. Beasley CRW, Rafferty P, Holgate ST (1987b) (Correspondence) Paradoxical response to nebulised salbutamol in wheezy infants. Thorax 42: 702–703Google Scholar
  12. Beasley CRW, Rafferty P, Holgate ST (1988) Adverse reactions to the non-drug constituents of nebuliser solutions. Br J Clin Pharmacol 25: 283–287PubMedGoogle Scholar
  13. Becker AB, Simons FER, Benoit TC, Gillespie CA (1985) Terbutaline by metered-dose inhaler: conventional inhaler versus tube spacer for children with asthma. Ann Allergy 55: 724–728PubMedGoogle Scholar
  14. Bell KA, Ho AT (1981) Growth rate measurements of hygroscopic aerosols under conditions simulating the respiratory tract. J Aerosol Sci 12 (3): 247–254Google Scholar
  15. Berdel D, v Berg A (1986) Bronchospasmolytische Wirkung von Fenoterol and Ipratropiumbromid als Einzelsubstanz sowie in der fixen Kombination nach bukkaler Anwendung mittels Dosier-Aerosol bei Kindern. Atemw Lungenkrkh 12 (6): 262–265Google Scholar
  16. Berman DA, Noris R (1988) Inhaled bronchodilators in young pediatric asthmatic: a method of delivery. Am J Emerg Med 6 (2): 206PubMedGoogle Scholar
  17. Birk Madsen E, Bundgaard A, Hidinger KG (1982) Cumulative dose-response study comparing terbutaline pressurized aerosol administered via a pearshaped spacer and terbutaline in a nebulized solution. Eur J Clin Pharmacol 23: 27–30Google Scholar
  18. Blackhall MI, O‘Donnell SR (1987) A dose-response study of inhaled terbutaline administered via Nebuhaler or nebuliser to asthmatic children. Eur J Respir Dis 71: 96–101PubMedGoogle Scholar
  19. Bloomfield P, Crompton GK (1979) A tube spacer to improve inhalation of drugs from pressurized aerosols. Br Med J 12 /8: 1479Google Scholar
  20. Botman MJ, de Krieger RA (1987) Contamination of small-volume medication nebulizers and its association with oropharyngeal colonization. J Hosp Infect 10: 204–208PubMedGoogle Scholar
  21. Bouchikhi A, Becquemin MH, Bignon J, Roy M, Teillac A (1988) Particle size study of nine metered dose inhalers, and their deposition probabilities in the airways. Eur Respir J 1: 547–552PubMedGoogle Scholar
  22. Boye NP. Komstad S (1983) A comparison of fenoterol powder capsules and fenoterol metered dose spray in bronchial asthma. Eur J Respir Dis 64 (Suppl 130): 9–11Google Scholar
  23. Brain JD, Valberg PA (1979) Deposition of arerosol in the respiratory tract. Am Rev Respir Dis 120: 1325–1373PubMedGoogle Scholar
  24. Brain JD, Valberg PA, Sneddon S (1985) Mechanisms of aerosol deposition and clearance. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principle, diagnosis and therapy. Elsevier Sc (Biomed Divi), Amsterdam, 123–147Google Scholar
  25. Brennan PO (1983) (Correspondence) - Addiction to aerosol treatment. Br Med J 287:1877Google Scholar
  26. Brown A Jr, Schanker LS (1983) Absorption of aerolized drugs from the rat lung. Drug Metab Dispos 11 (4): 355–360PubMedGoogle Scholar
  27. Bryant DH, Pepys J (1976) Bronchial reactions to aerosol inhalant vehicles. Br Med J May 29: 1319–1320Google Scholar
  28. Burton AJ (1984) Asthma inhalation devices: what do we know? Br Med J 288: 1650–1651Google Scholar
  29. Byron PR, Davis SS; Bubb MD, Cooper P (1977) Pharmaceutical implications of particle growth at high relative humidities. Pestic Sci 8: 521–526Google Scholar
  30. Canny GJ, Levison H (1988) Aerosols–therapeutic use and delivery in childhood asthma. Ann Allergy 60: 11–19PubMedGoogle Scholar
  31. Chambers S, Dunbar J, Taylor B (1980) Inhaled powder compared with aerosol administration of fenoterol in asthmatic children. Br J Arch Dis Children, 55: 73–74Google Scholar
  32. Chung KF, Jeyasingh K, Snashall PD (1988) Influence of airway calibre on the intrapulmonary dose and distribution of inhaled aerosol in normal and asthmatic subjects. Eur Respir J 1: 890–895PubMedGoogle Scholar
  33. Cissik JH, Bode FR, Smith JA (1986) Double-blind crossover study of five bronchodilator medications and two delivery methods in stable asthma. Chest 90 (4): 489–493PubMedGoogle Scholar
  34. Clarke SW (1988) Inhaler therapy. Quar J Med (N S)67, 253: 355–368Google Scholar
  35. Clarke SW, Newman SP (1981) Differences between pressurized aerosol and stable dust particles. Chest 80 (6): 907–909PubMedGoogle Scholar
  36. Clarke SW, Pavia D, Newman SP (1982) Influence of different inhalation modes on the efficacy of pressurized aerosol bronchodilators. EurJ Respir Dis [Suppl 119] 63: 79–80Google Scholar
  37. Clay MM, Clarke SW (1987) Effect of nebulised aerosol size on lung deposition in patients with mild asthma. Thorax 42: 190–194PubMedGoogle Scholar
  38. Clay MM, Pavia D, Nemwan SP, Clarke SW (1982) Efficiency of jet nebulisers in the production of therapeutic aerosols. Thorax 37: 788–789Google Scholar
  39. Clay MM, Pavia D, Newman SP, Lennard-Jones T, Clarke SW (1983) Assessment of jet nebulisers for lung aerosol therapy. Lancet Sept 10: 592–594Google Scholar
  40. Coady TJ, Davies HJ, Barnes P (1976a) Evaluation of a breath actuated pressurized aerosol. Clin Allergy 6: 1–6PubMedGoogle Scholar
  41. Coady TJ, Stewart CJ, Davies HJ (1976b) Synchronization of bronchodilator release. Practitioner 217: 273–275PubMedGoogle Scholar
  42. Connolly CK (1975) Method of using pressurized aerosols. Br Med J July 5: 21Google Scholar
  43. Corr D, Dolovich M, McCormack D, Ruffin R, Obminski G, Newhouse M (1982) Design and characteri- stics of a breath actuated, particle size selective medical aerosol inhaler. J Aerosol Sci 13 (1): 1–7Google Scholar
  44. Crimi N, Palermo F, Cacopardo B, Vancheri C, Oliveti R, Palermo B, Mistretta A (1987) Bronchodilator effect of aerochamber and inspirease in comparison with metered dose inhaler. Eur J Respir Dis 71: 153–157PubMedGoogle Scholar
  45. Crompton GK (1971) Breath-activated Aerosol. Br Med J June 12: 652Google Scholar
  46. Crompton GK (1982a) Problems patients have using pressurized inhalers. Eur J Respir Dis [Suppl 119] 63: 101–104Google Scholar
  47. Crompton GK (1982b) Sputum viscosity and long-term ipratropium bromide nebuliser therapy. Lancet May 29:1243Google Scholar
  48. Crompton GK (1982c) Inhalation devices. Eur J Respir Dis 63: 489–492PubMedGoogle Scholar
  49. Crompton GK (1988) New inhalation devices. Eur Respir J 1: 679–680PubMedGoogle Scholar
  50. Cushley MJ, Lewis RA, Tattersfield AE (1983) Comparison of three techniques of inhalation on the airway response to terbutaline. Thorax 38: 908–913PubMedGoogle Scholar
  51. Dale BAS (1987) Bacterial contamination of home nebulisers. Br Med J 295: 1486Google Scholar
  52. Davies DS (1975) Pharmacokinetics of inhaled substances. Postgraduate Med J 51 [Suppl]: 69–75Google Scholar
  53. Davies DS (1982) Pharmacokinetic studies with inhaled drugs. Eur J Respir Dis [Suppl 119] 63: 67–72Google Scholar
  54. Davis SS (1978) Physico-chemical studies on aerosol solutions for drug delivery. I. Water-propylen glycol systems. Int J Pharm 1: 71–83Google Scholar
  55. Dirksen H, Groth S (1983) Fenoterol inhalation powder as an alternative to treatment with the metered dose inhaler. Eur J Respir Dis 64 [Suppl 1301: 48–53Google Scholar
  56. Dirksen H, Groth S, Mygind N (1983) The bronchodilating effect of fenoterol after intranasal administration. Eur J Respir Dis 64 [Suppl 1281: 116–118Google Scholar
  57. Dolovich M (1984) Lung deposition of aerosols: methods and assessments. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Canada Ltd, pp 27–37Google Scholar
  58. Dolovich M, Ruffin RE, Roberts R, Newhouse MT (198la) Optimal delivery of aerosols from metered dose inhalers. Chest 80 (6):911–915Google Scholar
  59. Dolovich M, Ryan G, Newhouse MT (1981b) Aerosol penetration into the lung–influence on airway responses. Chest 80 (6): 834–836PubMedGoogle Scholar
  60. Dolovich M, Ruffin RE, Corr D, Newhouse MT (1983) Clinical evaluation of a simple demand inhalation MDI aerosol delivery device. Chest 81 (1): 36–41Google Scholar
  61. Dolovich M, Vanzieleghem M, Hidinger KG (1988) Influence of inspiratory flow rate on the response to terbutaline sulphate inhaled via the turbuhaler. Am Rev Respir Dis 137 (4): 433Google Scholar
  62. Duncan D, Paterson IC, Harris D, Crompton GK (1977) Comparison of the bronchodilator effects of salbutamol inhaled as a dry powder and by conventional pressurised aerosol. Br J Clin Pharmacol 4: 669–671Google Scholar
  63. Durrani FK, Richards W, CHurch JA, Roberts MJ, Keens TG (1988) Evaluation of a new, shorter method of administration of drenergic aerosols in the treatment of asthma. Ann Allergy 61: 147–150PubMedGoogle Scholar
  64. Earis JE, Bernstein A (1978) Misuse of pressurised nebulisers. Br Med J June 10: 1554Google Scholar
  65. Editorial (1975) Fluorocarbon aerosol propellants. Lancet May 10: 1073Google Scholar
  66. Editorial (1978) Wet or dry inhalers? Lancet Jan 14: 79–80Google Scholar
  67. Editorial (1981) The proper use of aerosol bronchodilators. Lancet Jan 3: 23Google Scholar
  68. Editorial (1984) The nebuliser epidemic. Lancet Oct 6: 789Google Scholar
  69. Editorial (1988) Nebulizers and paradoxical bronchoconstriction. Lancet July 23: 202Google Scholar
  70. Eedy DJ, Barton K, Stanford CF (1988) Irritant contact facial dematitis due to nebulize therapy. Postgr Med J 64: 306–307Google Scholar
  71. Ellul-Micallef R, Moren F, Wetterlin K, Hidinger KC (1980) Use of a special inhaler attachment in astmatic children. Thorax 35: 620–623PubMedGoogle Scholar
  72. Emmett PC, Aitken RJ, Hannan WJ (1982) Measurements of the total and regional deposition of inhaled particles in the human respiratory tract. J Aerosol Sci 13 (6): 549–560Google Scholar
  73. Engel T, Reinig JH, Mailing HJ, Scharling B, Nihander K, Madsen F (1989) Clinical comparison of inhaled budenoside delivered either via presserized metered dose inhale or Tubuhah. Allergy 44: 220–225PubMedGoogle Scholar
  74. Epstein SW, Duncan CS (1984) The use of MDI‘s in clinical medicine. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Ltd. Canada, pp 59–62Google Scholar
  75. Epstein SW, Manning CPR, Ashley MJ, Corey PN (1979) Survey of the clinical use of pressurised aerosol inhalers. Can Med Assoc J 120: 813–816PubMedGoogle Scholar
  76. Epstein SW, Parsons JE, Corey PN, Worsley GH, Reilly PA (1983) A comparison of three means of pressurized aerosol inhaler use. Am Rev Respir Dis 128: 253–255PubMedGoogle Scholar
  77. Eschenbacher WL, Boushey HA, Sheppard D (1984) Alteration in osmolarity of inhaled aerosols cause bronchoconstriction and cough, but absence of a permanent anion causes cough alone. Am Rev Respir Dis 129: 211–215PubMedGoogle Scholar
  78. Exner M, Vogel F, Rost HD (1983) Mikroorganismen in Inhalationsgeräten der Heimtherapie. Dtsch Med Wochenschr 108: 12–17PubMedGoogle Scholar
  79. Fairchild CI, Stampfer JF (1987) Particle concentration in exhaled breath. Am Ind Hyg Assoc J 48 (11): 948–949PubMedGoogle Scholar
  80. Fairshter RD (1987) Evaluation of a metered-dose aerosol delivery system using partial flow-volume curves. Am Rev Respir Dis 135: 741–743PubMedGoogle Scholar
  81. Ferron GA (1977) The size of soluble aerosol particles as a function of the humidity of the air. Application to the human respiratory tract. J Aerosol Sci 8: 251–267Google Scholar
  82. Fern GA, Kerrebijn KF, Weber J (1976) Properties of aerosols produced with three nebulizers. Am Rev Respir Dis 114: 899–908Google Scholar
  83. Freelander M, Van Asperen PP (1984) Nebuhaler versus nebuliser in children with acute asthma. Br Med J 288: 1873–1874Google Scholar
  84. Fuglsang G, Pedersen S (1986) Comparison of nebuhaler and nebulizer treatment of acute severe asthma in children. Eur J Respir Dis 69: 109–113PubMedGoogle Scholar
  85. Fuller HD (1986) Comparison of two chamber devices in patients using a metered-dose inhaler with satisfactory technique. Can Med Assoc J 135: 625–629Google Scholar
  86. Gerrity TR, Garrard CS, Yeates DB (1981) Theoretic analysis of sites of aerosol deposition in the human lung. Chest 80 (6): 898–901PubMedGoogle Scholar
  87. Gervais A, Begin P (1987) Bronchodilatation with a metered-dose inhaler plus an extension using tidal breathing vs jet nebulization. Chest 92 (5): 822–824PubMedGoogle Scholar
  88. Gleeson JGA, Price JF (1988) Controlled trial of budenoside given by the nebuhaler in preeschool children with asthma. Br Med J 297: 163–166Google Scholar
  89. Godden DJ, Crompton GK (1981) An objective assessment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently. Br J Dis Chest 75: 165–168PubMedGoogle Scholar
  90. Gomm SA, Keaney NP, Hunt LP, Allen SC, Stretton TB (1983) Dose-response comparison of ipratropium bromide from a metered-dose inhaler and by jet nebulisation. Thorax 38: 297–301PubMedGoogle Scholar
  91. Gurwitz D, Levison H, Mindorff C, Reilly P, Worsley G (1983) Assessment of a new device ( Aerochamber) for use with aerosol drugs in asthmatic Children. Ann Allergy 50: 166–170PubMedGoogle Scholar
  92. Hampson NB, Mueller MP (1989) (Correspondence) Cooling of metered-dose inhalers decreases pressure output from canisters. New Engl J Med 320 (5):321Google Scholar
  93. Hausen T (1984) Inhalationsbehandlung bei chronischen Atemwegserkrankungen. Therapiewoche 34: 1309–1315Google Scholar
  94. Hausen T (1986) Worauf Sie bei der Verordnung achten müssen.–Umgang mit Dosier-Aerosolen and Inhaliergeäten bei obstruktiven Atemwegserkrankungen. Der Allgemeinarzt 8 (8): 1138–1150Google Scholar
  95. Henry RL, Milner AD, Davies JG (1983) Simple drug delivery system for use by young asthmatics. Br Med J 286: 2121Google Scholar
  96. Hetzel MR, Clark TJH (1977) Comparison of salbutamol Rotahaler with conventional pressurized aerosol. Clin Allergy 7: 563–568PubMedGoogle Scholar
  97. Heyder J (1981) Mechanisms of aerosol particle deposition. Chest 80 (6): 820–823PubMedGoogle Scholar
  98. Heyder J (1982) Particle transport onto human airway surfaces. Eur J Respir Dis [Suppl 119] 63: 29–55Google Scholar
  99. Hidinger KG, Perk J (1981) Clinical trial of a modified inhaler for pressurized aerosols. Eur J Clin Pharmacol 20: 109–111PubMedGoogle Scholar
  100. Higgs CMB, Jones P, Transer AR (1987) Bacterial contamination of home nebulisers. Br Med J 295: 1281–1282Google Scholar
  101. Hill LS (1988) The inhaled route of drug administration in the therapy of asthma. Br J Clin Prac 42 (8): 313–315Google Scholar
  102. Hiller C, Mazumder MK, Wilson JD, Bone RC (1978) Aerodynamic size distribution of metered-dose bronchodilator aerosols. Am Rev Respir Dis 118: 311–317PubMedGoogle Scholar
  103. Hiller C, Mazumder MK, Wilson JD, Renninger RG, Bone RC (1981) Physical properties of therapeutic aerosols. Chest 80 (6): 901–903PubMedGoogle Scholar
  104. Hodges IGC, Milner AD, Stokes GM (1981) Assessment of a new device for delivering aerosol drugs to asthmatic children. Arch Dis Child 56: 787–800PubMedGoogle Scholar
  105. Horsley MG, Bailie GR (1988) Rish factors for inaedequate use of pressurized aerosol inhalers. J Clin Pharm Ther 13: 139–143PubMedGoogle Scholar
  106. Houlsby WT, Bannister OM (1987) Teaching young asthmatics to use inhalers. The Practitioner 231: 362PubMedGoogle Scholar
  107. Itoh H, Ishii Y, Meda H, Todo G, Torizuka K, Smaldone GC (1981) Clinical observations of aerosols deposition in patients with airways obstruction. Chest 80 (6): 837–840PubMedGoogle Scholar
  108. Johansen B (1982) Closing remarks. Eur J Respir Dis [Suppl 119] 63: 123–125Google Scholar
  109. Johnsen CR, Weeke ER (1988) Turbuhaler: a new device for dry powder turbutaline inhalation. Allergy 43: 392–395PubMedGoogle Scholar
  110. Jenkins SC, Heaton RW, Fulton TJ, Moxham J (1987) Comparison of domiciliary nebulized salbutamol and salbutamol from a metered-dose inhaler in stable chronic airflow limitation. Chest 91 (6): 804–807PubMedGoogle Scholar
  111. Jones PD, Moritz V, Pierce RJ (1985) Microbial contamination of domiciliary nebuliser therapy equipment. Aust NZ J Med 15: 585–589Google Scholar
  112. Kim CS, Trujillo D, Sackner MA (1985) Size aspects of metered-dose inhaler aerosols. Am Rev Respir Dis 132: 137–142PubMedGoogle Scholar
  113. Kim CS, Eldridge MA, Sackner MA (1987) Oropharyngeal deposition and delivery aspects of metered-dose inhaler aerosols. Am Rev Respir Dis 135: 157–164PubMedGoogle Scholar
  114. Kitzman DW (1988) Inhalers and cold weather. North Carolina Med J 49 (2): 109Google Scholar
  115. Kjellman B (1982) Inhalation therapy in children Eur J Respir Dis [Suppl 119] 63: 115–119Google Scholar
  116. Kjellman NIM (1981) Letter to the editor. Allergy 36: 437–438PubMedGoogle Scholar
  117. Kjeflman NIM, Hidinger KG (1981) Improved efficacy of pressurized terbutaline aerosol in childhood asthma using a spacer. Opuscula Medica 26 (2): 47–48Google Scholar
  118. Klein G, Köhler D, Fleischer D, Zähringer T, Matthys H (1984) Gibt es Wirkungsunterschiede auf die bronchiale Obstruktion zwischen totaler und intrabronchialer Deposition von 200 ug Fenoterol? Verh Dtsch Ges Inn Med 90: 1096–1098Google Scholar
  119. Klein G, Köhler D, Matthys H (1988) Unterschiedliche Reaktion des Bronchialsystems auf zentrale oder periphere Inhalation eines Parasympathomimetikums. Atemw Lungenkrkht 14 (7): 313–316Google Scholar
  120. Köhler D (1988) Vor-und Nachteile verschiedener Inhalationsgeräte. Dtsch Ärztebl 31 (3):C-79 - C-81Google Scholar
  121. Köhler D, Simonides R, Rothfuss J, Vatsag E, Daikeler G, Matthys H (1983) Aerosolverteilungsmuster von 16 handelsüblichen Inhalationsgeräten. Prax Klin Pneumo137: 922–924Google Scholar
  122. Köhler D, Fleischer W, Schiimichen C, Matthys H (1985) Depositionsmuster von Dosieraerosol im menschlichen Organismus. Atemw Lungenkrkht 11 (7): 340–341Google Scholar
  123. Köhler D, Fleischer W, Matthys H (1986) Inhalationstherapie. Gedon & Reuss, MünchenGoogle Scholar
  124. Köhler D, Fleischer W, Matthys H (1988) New method for easy labeling of beta-2-agonists in the metered dose inhaler with technetium 99 m. Respiration 53: 65–73PubMedGoogle Scholar
  125. König P (1985) Spacer devices used with metered-dose inhalers–breakthrough or gimmick? Chest 88 (2): 276–284PubMedGoogle Scholar
  126. König P, Gayer D, Kantak A, Kreutz C, Douglass B, Hordvik NL (1988) A trial of metaproterenol by metered-dose inhaler and two spacers in preeschool asthmatics. Pediatr Pulmonol 5: 247–251PubMedGoogle Scholar
  127. Komstad S, Boye NP (1983) Patient errors and preference with regard to the use of a bronchodilating spray and fenoterol (Berotec) powder. EurJ Respir Dis 64 ISuppl 1301: 12–16Google Scholar
  128. Landensuo A, Muittari A (1986) Bronchodilator effects of a fenoterol metered dose inhaler and fenoterol powder in asthmatics with poor inhaler technique. Eur J Respir Dis 68: 225–332Google Scholar
  129. Latimer KM, Roberts R, Dolovich J, Hargreave FE (1982) Salbutamol: comparison of bronchodilating effect of inhaled powder and aerosol in asthmatic subjects. Can Med Assoc J 127: 857–859PubMedGoogle Scholar
  130. Laursen LC (1986) A new inhalation technique for improved effect of aerolized drugs in asthma. Allergy 41: 157–159PubMedGoogle Scholar
  131. Lawford P, McKenzie D (1981) Pressurized aerosol technique. Lancet May 2: 1003–1004Google Scholar
  132. Lawford P, McKenzie D (1983) Pressurized aerosol inhaler technique: How important are inhalation from residual volume, inspiratory flow rate and the time interval between puffs? Br J Chest 77: 276–281Google Scholar
  133. Lee HS (1983) Proper aerosol inhalation technique for delivery of asthma medications. Clin Pediatr 22 (6): 440–443Google Scholar
  134. Lee HS, Evans HE (1984) Aerosol bag for administration of bronchodilators to young asthmatic children. Pediatrics 73 (2): 230–232PubMedGoogle Scholar
  135. Lee HS, Evans HE (1987a) Evaluation of inhalation aids of metered dose inhalers in asthmatic children. Chest 91 (3): 366–369PubMedGoogle Scholar
  136. Lee HS, Evans HE (19876) Aerosol inhalation teaching device. J Pediatr 110: 249–252Google Scholar
  137. Levison H, Reilly PA, Worsley GH (1985) Spacing devices and metered-dose inhalers in childhood asthma. J Pediatr 107 (5) 662–668PubMedGoogle Scholar
  138. Lewis RA, Fleming JS (1985) Fractional deposition from a jet nebulizer: how it differs from a metered dose inhaler. Br J Chest 79: 361–367Google Scholar
  139. Lindemann H (1983) Die Inhalationsbehandlung in der kinderärztlichen Praxis. Pädiat Prax 28: 449–459Google Scholar
  140. Lindgren SB, Bake B, Larsson S (1987) Clinical consequences of inadequate inhalation technique in asthma therapy. Eur J Respir Dis 70: 93–98PubMedGoogle Scholar
  141. Lindgren SB, Formgren H, Moren F (1980) Improved aerosol therapy of asthma: effect of actuator tube size on drug availability. Eur J Respir Dis 61: 56–61Google Scholar
  142. Löllgen H, v. Nieding G, Krekeler H (1978) Zur bronchialerweitemden Wirkung ß-adrenerger Substanzen bei oraler, bukkaler und inhalativer Anwendung. Atemw Lungenkrkht 4 (6): 401–404Google Scholar
  143. Loren M, Chai H, Miklich D, Barwise G (1977) Comparison between simple nebulization and intermittent positive-pressure in asthmatic children with severe bronchospasm. Chest 72 (2): 145–147PubMedGoogle Scholar
  144. Lowry RH, Wood Am, Higenbottam TW (1988) Effects of pH and osmolarity on aerosol-induced cough in normal volunteers. Clin Sci 74: 373–376PubMedGoogle Scholar
  145. MacFarlane JT, Lane DJ (1980) Irregularities in the use of regular aerosol inhalers. Thorax 35: 477–478PubMedGoogle Scholar
  146. Maddem PJ, Oh TE, Elphick HR, Paterson JW (1978) Adverse reaction after aerosol inhalation. Med J Aust 1: 274–275Google Scholar
  147. Mallol J, Barmeto L, Girardi G, Toro O (1987) Bronchodilator effect of fenoterol and ipratropium bromide in infants with acute wheezing: Use of MDI with a spacer device. Pediatr Pulmonol 3: 352–356PubMedGoogle Scholar
  148. Marion RJ, Creer TL, Bums K (1983) Training asthmatic children to use their nebnlizPr correctly. J Asthma 20 (3): 183–188PubMedGoogle Scholar
  149. Matthys H, Köhler D (1985) Pulmonary deposition of aerosols by different mechanical devices. Respiration 48: 269–276PubMedGoogle Scholar
  150. Matthys H, Köhler D (1988) Aerosoltherapie. Prax Kim Pneumol 42: 314–319Google Scholar
  151. Matthys H, Eltschka R, App EM (1988) Deposition eines markierten B2-Sympathomimetikum-Aerosols. Atemw Lungenkrkht 14 (10): 485–488Google Scholar
  152. McCarthy TP (1988) (Correspondence) Nebulised budenoside in severe childhood asthma. Lancet February 18:379–380Google Scholar
  153. McLean AEM (1977) Chlorofluorocarbons–in the can, in man an in the atmosphere. Br J Clin Pharmacol 4: 663–666Google Scholar
  154. Milner AD (1986) (Correspondence) Nebulisers - uses and abuses. Arch Dis Child 61:1142–1148PubMedGoogle Scholar
  155. Mitchell DM, Solomon MA, Tolfree SEJ, Short M, Spiro SG (1987) Effect of particle size of bronchodilator aerosols on lung distribution and pulmonary function in patients with chronic asthma. Thorax 42: 457–461PubMedGoogle Scholar
  156. Molina MJ, Rowland FS (1974) Stratospheric sink for chlorofluoromethanes: chlorine atom catalysed destruction of ozone. Nature 249: 810–812Google Scholar
  157. Moren F (1978a) Drug deposition of pressurized inhalation aerosols. I. Influence of actuator tube design. Int J Phann 1: 205–212Google Scholar
  158. Moren F (1978b) Drug deposition of pressurized inhalation aerosols, II. Influence of vapour pressure and metered volume. Int J Pharm 1: 213–218Google Scholar
  159. Moren F (1982) Drug deposition of pressurized inhalation aerosols. Eur J Respir Dis [Suppl 119] 63: 51–55Google Scholar
  160. Moren F (1984) Formulation and design of metered dose inhalers. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Canada Ltd, pp 1–5Google Scholar
  161. Moren F (1985) Aerosol dosage forms and formulations. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, Diagnosis and therapy. Elsevier Sci (Biomed Div); Amsterdam 261–287Google Scholar
  162. Moren F, Andersson J (1980) Fraction of dose exhaled after administration of pressurized inhalation aerosols. Int J Pharm 6: 295–300Google Scholar
  163. Moren F, Andersson J, Stiksa G (1984) Mode of inhalation for trained and untrained asthmatics using a pressurized aerosol. Respiration 45: 56–60PubMedGoogle Scholar
  164. Morgan MDL, Singh BV, Frame MH, Williams SJ (1982) Terbutaline aerosol given through pear spacer in acute severe asthma Br Med J 285: 849–850Google Scholar
  165. Morrison-Smith J, Gwynn CM (1978) A clinical comparison of aerosol and powder administration of beclomethason dipropionate in asthma. Clin Allergy 8: 479–481Google Scholar
  166. Morrow PE, Yu CP (1985) Models of aerosol behavior in airways. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, diagnosis and therapy. Elsevier Sci (Biomed Div) Amsterdam, pp 149–191Google Scholar
  167. Newhouse MT (1984) Metered dose inhaler aerosol propellants. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Canada Ltd. pp 6–18Google Scholar
  168. Newhouse MT, Dolovich M (1986a) Control of asthma by aerosols. N Engl J Med 315 (14): 870–874PubMedGoogle Scholar
  169. Newhouse MT, Dolovich M (1986b) Spacer devices for asthma. J Pediatr 109 (5): 913PubMedGoogle Scholar
  170. Newhouse MT, Dolovich M (1986c) Aerosol therapy of asthma: Principles and applications. Respiration 50 [Suppl] 21: 123–130Google Scholar
  171. Newhouse MT, Dolovich M (1987a) Aerosol therapy: Nebulizer vs metered dose inhaler. Chest 91 (6): 799–800PubMedGoogle Scholar
  172. Newhouse MT, Dolovich M (1987b) Aerosol therapy of reversible airflow obstruction. Chest 91 (5) [Suppl]: 58S - 64SGoogle Scholar
  173. Newhouse MT, Ruffin RE (1978) Deposition and fate of aerosolized drugs. Chest 73 (6): 936–943PubMedGoogle Scholar
  174. Newman SP (1983) Deposition and effects of inhalation aerosols. AB DRACO, Lund SwedenGoogle Scholar
  175. Newman SP, Clarke SW (1985) Aerosols in therapy. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, diagnosis and therapy. Elsevier Sci Publ (Biomed Div), Amsterdam, pp 289–312Google Scholar
  176. Newman SP, Pavia D (1985) Aerosol deposition in man. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, diagnosis and therapy. Elsevier Sci (Biomed Div), Amsterdam, pp 193–217Google Scholar
  177. Newman SP, Pavia D, Clarke SW (1980) Simple instructions for using pressurised aerosol bronchodilators. J R Soc Med 73: 776–779PubMedGoogle Scholar
  178. Newman SP, Pavia D, Clarke SW (1981a) Improving the bronchial deposition of pressurized aerosols. Chest 80 (6): 909–911PubMedGoogle Scholar
  179. Newman SP, Pavia D, Clarke SW (198lb) How should a pressurized B-adrenergic bronchodilator be inhaled? Eur J Respir Dis 62: 3–21Google Scholar
  180. Newman SP, Moren F, Pavia D, Little F, Clarke SW (1981c) Deposition of pressurized suspension aerosols inhaled through extension Devices. Am Rev Respir Dis 124: 317–320PubMedGoogle Scholar
  181. Newman SP, Pavia D, Garland N, Clarke SW (1982) Effects of various inhalation modes on the deposition of radioactive pressurized aerosols. Eur J Respir Dis [Suppl 119] 63: 57–65Google Scholar
  182. Newman SP, Millar AB, Lennard-Jones TR, Moren F, Clarke SW (1984a) Improvement of pressurised aerosol deposition with Nebuhaler spacer device. Thorax 39: 935–941PubMedGoogle Scholar
  183. Newman SP, Millar AB, Lennard-Jones TR, Moren F, Clarke SW (1984b) Improved pressurised aerosol deposition pattern with the Nebuhaler spacer. Am Rev Respir Dis 129: 4Google Scholar
  184. Newman SP, Moren F, Trofast E, Woodman G, Clarke SW (1987a) Deposition patterns in man from turbuhaler: a preliminary report. In: Newman SP, Moren F, Crompton GK (eds) A new concept in inhalation therapy. Medicom, pp 104–114Google Scholar
  185. Newman SP, Pellow PGD, Clarke SW (1987b) In vitro comparison of deVilbiss jet and ultrasonic nebulizers. Chest 92 (6):991–994Google Scholar
  186. Newman SP, Johnson MA, Clarke SW (1988) (Correspondence) - Effect of particle size of bronchodilator aerosols on lung distribution and pulmonary function in patients with chronic asthma. Thorax 43: 159PubMedGoogle Scholar
  187. Newman SP, Moren F, Trofast E, Talaee N, Clarke SW (1989) Deposition and clinical efficacy or terbutaline sulphate from Turbuhaler, a new multi-dose powder inhaler. Eur Respir J 2: 247–252PubMedGoogle Scholar
  188. Nieminen MM, Holli H, Landensuo A, Muittari A, Karvonen J (1987) Aerosol deposition in automatic dosimeter nebulization. Eur J Respir Dis 71: 145–152PubMedGoogle Scholar
  189. Nilsson HT, Simonsson BG, Strom B (1975) The fate of 3H-terbutaline sulphate administered to man as an aerosol. Eur J Clin Pharmacol 10: 1–7Google Scholar
  190. Nolte D, Berger D, Förster E (1979) Wirken Treibgase von Dosier-Aerosolen bronchokonstriktorisch? Dtsch Med Wochenschr, 104: 172–174PubMedGoogle Scholar
  191. O‘Callaghan C, Milner AD (1986) Pradoxial deterioration in lung function after nebulised salbutamol in wheezy infants. Lancet Dec 20: 1424–1425Google Scholar
  192. O‘Callaghan C, Milner AD (1987) Paradoxical response to nebulised salbutamol in wheezy infants. Thorax 42: 702–703Google Scholar
  193. O‘Callaghan C, Milner AD (1988) Aerosol treatment abuse. Arch Dis Child, 63: 70PubMedGoogle Scholar
  194. Oherek J, Gayrard P, Grimaud C, Charpin J (1976) Patient error in use of bronchodilator metered aerosols. Br Med J 1: 76Google Scholar
  195. Paterson IC, Crompton GK (1976) Use of pressurised aerosols by asthmatic patients. Br Med J Jan 10: 76–77Google Scholar
  196. Pauwels R (1985) Pharmacokinetics of inhaled drugs. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, diagnosis and therapy. Elsevier Sci (Biomed Div), Amsterdam, pp 219–224Google Scholar
  197. Pauwels R, Lamont H, Hidinger K, Straetenvd M (1984) Influence of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler. Respiration 45: 61–66PubMedGoogle Scholar
  198. Pavia D, Thomson ML, Clarke SW, Shannon HS (1977) Effect of lung function and mode of inhalation om penetration of aerosol into the human lung. Thorax 32: 194–197PubMedGoogle Scholar
  199. Pavia D, Thomson ML, Clarke SW (1978) Enhanced clearance of secretions from the human lung after the administration of hypertonic saline aerosol. Am Rev Respir Dis 117: 199–203PubMedGoogle Scholar
  200. Pavia D, Lopez-Vidriero MT, Sutton PP, Clarke SW (1982) Long-term ipratropium bromide nebuliser therapy and lung mucociliary clearance. Lancet 2: 332–333PubMedGoogle Scholar
  201. Pavia D, Agnew JE, Lopez-Vidriero MT, Newman SP, Clarke SW (1984) The effect of metered dose aerosols on the viscoelastic properties and clearance of bronchial secretions. In: Epstein SW (ed) Metered dose inhalers. Astra Pharmaceuticals Canada Ltd, pp 38–48Google Scholar
  202. Pedersen S (1983) Aerosol treatment of bronchoconstriction in children, with or without a tube spacer. N Engl J Med 308 (22): 1328–1330PubMedGoogle Scholar
  203. Pedersen S (1985a) Treatment of acute bronchoconstriction in children with use of a tube spacer aerosol and a dry powder inhaler. Allergy 40: 300–304PubMedGoogle Scholar
  204. Pedersen S (1985b) Optimal use of tube spacer in asthmatic children. Clin Allergy 15: 473–478PubMedGoogle Scholar
  205. Pedersen S (1986a) How to use a rotahaler. Arch Dis Child 61: 11–14PubMedGoogle Scholar
  206. Pedersen S (1986b) The importance of a pause between the inhalation of two puffs of terbutaline from a pressurized aerosol with a tube spacer. J Allergy Clin Immunol 77 (3):505–509Google Scholar
  207. Pedersen S (1987) Inhaler use in children with asthma. Dan Med Bull 34 (5): 234–249PubMedGoogle Scholar
  208. Pedersen S, Prahl P (1987) Jet-nebulized beclomethasone dipropionate in the management of bronchial asthma. Allergy 42: 272–275PubMedGoogle Scholar
  209. Pedersen S, Steffensen G (1986a) Simplification of inhalation therapy in asthmatic children. Allergy 41: 296–301PubMedGoogle Scholar
  210. Pedersen S, Steffenson G (1986b) Fenoterol powder inhaler technique in children: influence of inspiratory flow rate and breath-holding. Eur J Respir Dis 68: 207–214PubMedGoogle Scholar
  211. Pedersen S, Frost L, Amfred T (1986) Errors in inhalation technique and efficinecy in inhaler use in asthmatic children. Allergy 41: 118–124PubMedGoogle Scholar
  212. Persson G, Gruvstad E, Stahl E (1988) A new miltiple dose powder inhaler, ( Turbuhaler), compared with a pressurized inhaler in a study of terbutaline in asthmatics. Eur Respir J 1: 681–684PubMedGoogle Scholar
  213. Pierce Ak, Sanford JP, Thomas GD, Leonard JS (1970) Long-term evaluation of decontamination of inhalation-therapy equipment and the occurence of necotizing pneumonia. N Engl J Med 282 (10): 528–531PubMedGoogle Scholar
  214. Pool JB, Greenough A, Gleeson JGA, Price IF (1988) Inhaled bronchodilator treatment via the nebuhaler in young asthmatic patients. Arch Dis Child, 63: 288–291PubMedGoogle Scholar
  215. Polli GP, Grim WM, Bacher FA, Yunker MH (1969) Influence of formulation on aerosol particle size. J Phann Sci 58 (4): 484–486Google Scholar
  216. Pover GM, Langdon CG, Jones SR, Fidler C (1988) Evaluation of a breath operated powder inhaler. J Int Med Res 16: 201–203PubMedGoogle Scholar
  217. Prahl P, Jensen T (1987) Decreased adreno-cortical suppression utilizing the nebuhaler for inhalation of steroid aerosols. Clin Allergy 17: 393–398PubMedGoogle Scholar
  218. Pratt HF (1982) Abuse of salbutamol inhalers in young people. Clin Allergy 12: 203–208PubMedGoogle Scholar
  219. Prendiville A, Green S, Silverman M (1987) Paradoxical response to nebulised salbutamol in wheezy infants, assessed by partial expiratory flow-volume curves. Thorax 42: 86–91PubMedGoogle Scholar
  220. Pritchard JN (1987) Particle growth in the airways and the influence of airflow. In: Newman SP, Moren F, Crompton GK (eds) A New Concept in Inhalation Therapy. Medicom, pp 3–24Google Scholar
  221. Rachelefsky GS, Rohr AS, Wo J, Gracey V, Spector SL, Siegel SC, Katz RM, Mickey MR (1986) Use of a tube spacer to improve the efficacy of a metered-dose inhaler in asthmatic children. Am J Dis Child 140: 1191–1193PubMedGoogle Scholar
  222. Rao S, Wilson DB, Brooks RC, Sproule BJ (1970) Acute effects of nebulization of N-acetylcystein on pulmonary mechanics and gas exchange. Am Rev Respir Dis 102: 17–22PubMedGoogle Scholar
  223. Rees PJ, an TM, Moren F (1982) The importance of particle size in response to inhaled bronchodilators. Eur J Respir Dis [Suppl 119[63: 73–78Google Scholar
  224. Reiser J, Warner JO (1986) Inhalation treatment for asthma. Arch Dis Child 61: 88–94PubMedGoogle Scholar
  225. Reiser J, Frame MH, Warner JO (1986) The potential value of a 750-ml spacer for the administration of inhaled corticosteroids to children. Pediatr Puhnonol 2: 237–243Google Scholar
  226. Richards R, Simpson SF, Renwick AG, Holgate ST (1988) Inhalation rate of sodium cromoglycate determines plasma phannakokinetics and protection against AMP-induced bronchoconstriction in asthma. Eur Respir J 1: 896–901PubMedGoogle Scholar
  227. Riley DJ, Weitz BW, Edelman NH (1976) The response of asthmatic subjects to isoproterenol inhaled at differing lung volumes. Am Rev Respir Dis 114: 509–515PubMedGoogle Scholar
  228. Riley DJ, Liu RT, Edelman NH (1979) Enhanced responses to aerolized bronchodilator therapy in asthma using respiratory maneauvers. Chest 76 (5): 501–507PubMedGoogle Scholar
  229. Rivlin J, Mindorff C, Levison H, Kazim F, Reilly P, Worsley G (1983) Effect of administration technique on bronchodilator response to fenoterol in a metered-dose inhaler. J Pediatr 102 (3): 470–472PubMedGoogle Scholar
  230. Rivlin J, Mindorff C, Reilly P, Levison H (1984) Pulmonary response to a bronchodilator delivered from three inhalation devices. J Pediatr 104 (3): 470–473PubMedGoogle Scholar
  231. Rodenstein D, Stanescu DC (1982) Mouth spraying versus inhalation of fenoterol aerosol in healthy subjects and asthmatic patients. Br J Dis Chest 76: 365–373PubMedGoogle Scholar
  232. Rothe T, Mansfeld H-J, Schmitz-Schumann M (1988) Dosieraerosole in der Behandlung des kindlichen Asthma bronchiale. Der Kinderarzt 19 (5): 679–684Google Scholar
  233. Ruffin RE, Montgomery JM, Newhouse MT (1978a) Site of beta-adrenergic receptors in the respiratory tract. Chest 74 (3): 256–260PubMedGoogle Scholar
  234. Ruffin RE, Obminsky G, Newhouse MT (1978b) Aerosol salbutamol administration by IPPB: lowest effective dose. Thorax 33: 689–693PubMedGoogle Scholar
  235. Ruffin RE, Dolovich MB, Wolff RK, Newhouse MT (1978c) The effects of preferential deposition of histamine in the human airway. Am Rev Respir Dis 117: 485–492PubMedGoogle Scholar
  236. Ruffin RE, Kenworthy MC, Newhouse MT (1978d) Response of asthmatic patients to fenoterol inhalation: A method of quantifying the airway bronchodilator dose. Clin Pharmacol Ther 23 (3): 338–345PubMedGoogle Scholar
  237. Russell G, Frame M (1986) Terbutaline by Nebuhaler in young children. The Practitioner 230: 1043–1046PubMedGoogle Scholar
  238. Russi E (1983) Aerosoltherapie. Schweiz Med Wochenschr 113 (35): 1234–1238PubMedGoogle Scholar
  239. Russi E (1985) Praktische Aspekte der Inhalationstherapie mit Aerosolen. Schweiz Rundschau Med (Praxis) 74 (9): 207–210Google Scholar
  240. Ryan G, Dolovich MB, Obminski G, Cockroft DW, Juniper E, Hargreave FE, Newhouse MT (1981) Standardization of inhalation provocation tests: influence of nebulizer output, particle size, and method of inhalation. J Allergy Clin Immunol 67 (2): 156–161PubMedGoogle Scholar
  241. Ryrfeldt A (1987) Pharmacokinetic aspects of drugs for inhalation. In: Newman SP, Moren F, Crompton GK (eds) A new concept in inhalation therapy. Medicom, pp 49–64Google Scholar
  242. Sackner MA, Epstein S, Wanner A (1976) Effect of beta-adrenergic agonists aerolized by freon propellant on tracheal mucous velocity and cardiac output. Chest 69 (5): 593–598PubMedGoogle Scholar
  243. Sackner MA, Brown LK, Kim CS (1981) Basis of an improved metered aerosol delivery system. Chest, 80 (6): 915–918PubMedGoogle Scholar
  244. Salorinne Y, Siren R (1983) Ventilation effects of fenoterol powder and freon-propelled aerosol in patients with asthma. Eur J Respir Dis 64 [Suppl 130]: 6–8Google Scholar
  245. Salzman GA, Pryszczynski DR (1988) Oropharyngeal candidiasis in patients treated with beclomethasone dipropionate delivered by metered-dose inhaler alone and with aerochamber. J Allergy Clin Immunol 81: 424–428PubMedGoogle Scholar
  246. Saunders KB (1965) Misuse of inhaled bronchodilator agents. Br Med J 1: 1037–1038PubMedGoogle Scholar
  247. Schanker LS (1978) Drug absorption from the lung. Biochem Pharmacol 27: 381–385PubMedGoogle Scholar
  248. Schön MH, Bruderer K (1988) Der Einfluß hyperosmolarer Mischlösungen von Natriumchlorid and ß2Sympathomimetika auf die Lungenfunktion von asthmatischen Kindern and Adoleszenten. Schweiz Med Wochenschr 118: 1377–1381Google Scholar
  249. Seifert CF, Hamilton SF (1988) Incorrect instructions for use of metered-dose inhalers. Am J Hosp Pharm 45: 75–76PubMedGoogle Scholar
  250. Sheppard D, Rizk NW, Boushey HA, Bethel RA (1983) Mechanism of cough and bronchoconstriction induced by destilled water aerosol. Am Rev Respir Dis 127: 691–694PubMedGoogle Scholar
  251. Shim C (1987) Inhalation aids of metered dose inhalers. Chest 91 (3): 315–316PubMedGoogle Scholar
  252. Shim C, Williams MH (1980) The adequacy of inhalation of aerosol from canister nebulizers. Am J Med 69: 891–894PubMedGoogle Scholar
  253. Shore SC, Weinberg EG, Dun MH (1976) Buccal administration of fenoterol aerosol in young children with asthma. S Mr Med J 50: 1362–1364Google Scholar
  254. Simonsson BG (1982) Anatomical and pathophysiological considerations in aerosol therapy. Eur J Respir Dis [Suppl 119] 63: 7–14Google Scholar
  255. Smith G, Hiller C, Mazumder M, Bone R (1980) Aerodynamic size distribution of cromolyn sodium at ambient and airway humidity. Am Rev Respir Dis 121: 513–517PubMedGoogle Scholar
  256. Speizer FE, Wegman DH, Ramirez A (1975) Palpitation rates associated with fluorocarbon exposure in a hospital setting. N Engi J Med March 20: 624–626Google Scholar
  257. Stauder J, Hidinger K-G (1983) Terbutaline aerosol from a metered dose inhaler with a 750-ml spacer or as a nebulized solution. Respiration 44: 237–240PubMedGoogle Scholar
  258. Steventon RD; Wilson RSE (1981) Facemask or mouthpiece for delivery of nebulized bronchodilator aerosols? Br J Dis Chest 75: 88–90PubMedGoogle Scholar
  259. Stiftung Warentest (1983) Test Inhaliergeräte. Viel Dampf–selten Wirkung. Test 18 (6): 32–37Google Scholar
  260. Stiksa G (1982) Indications for continuous aerosol therapy. Eur J Respir Dis [Suppl 119] 63: 89–96Google Scholar
  261. Svedmyr N, Löfdahl CG, Svedmyr K (1982) The effect of powder aerosol compared to pressurized aerosol. Eur J Respir Dis [Suppl 119] 63: 81–88Google Scholar
  262. Swift DL (1985) Aerosol characterization and generation. In: Moren F, Newhouse MT, Dolovich MB (eds) Aerosols in medicine. Principles, diagnosis and therapy. Elsevier Sci (Biomed Div), Amsterdam, pp 53–76Google Scholar
  263. Teo J, Kwang LW, Yip WCL (1988) An inexpensive spacer for use with metered-dose bronchodilators in young asthmatic children. Pediatr Pulmonol 5: 244–246PubMedGoogle Scholar
  264. Thiessen B, Pedersen OF (1980) Effect of freon inhalation on maximal expiratory flows and heart rhythm after treatment with salbutamol and ipratropium bromide. Eur J Respir Dis 61: 156–161PubMedGoogle Scholar
  265. Thomas SHL, Langford JA, George RDG, Geddes DM (1988) Improving the efficiency of drug administration with jet nebulizers. Lancet Jan 16: 126Google Scholar
  266. Thompson PJ, Dhillon P, Cole P (1983) Addication to aerosol treatment: the asthmatic altemative to glue sniffing. Br Med J 287: 1515–1516Google Scholar
  267. Toogood JH (1986) (Correspondence) - Are spacers of any use in the treatment of asthma? Pediatr Pulmonol 2 (4):250–251PubMedGoogle Scholar
  268. Toogood JH, Baskerville J, Jennings B, Lefcoe NM, Johansson S (1984) Use of spacers to facilitate inhaled conicosteroid treatment of asthma. Am Rev Respir Dis 129: 723–729PubMedGoogle Scholar
  269. Ulmer WT, Islam MS, Zimmermann I, Bulgalho De Almeida AA (1982) Aggression and Abwehr am Beispiel der Lunge. Gemischte Abwehr: Die Atemwegsobstruktion. Verh Dtsch Ges Inn Med 88: 245–252Google Scholar
  270. Unzeitig JC, Richards W, Church JA (1983) Administration of metered-dose inhalers: comparison of openand closed-mouth techniques in childhood asthmatics. Ann Allergy 51 (6): 571–573PubMedGoogle Scholar
  271. Vildgren MT, Paronen TP, Kärkkäinen A, Karjalainen P (1987) Effect of extension devices on the drug deposition from inhalation aerosols. Int J Pharm 39: 107–112Google Scholar
  272. Walker SR, Evans ME, Richards AJ, Paterson JW (1972) The clinical pharmacology of oral and inhaled salbutamol. Clin Pharmacol Ther 13 (6): 861–867PubMedGoogle Scholar
  273. Warachit B (1988) Nosocomial pneumonia caused by contaminated Nebulizer. I Med Assoc Thai 71: 33–34Google Scholar
  274. Weber RW, Petty WE, Nelson HS (1979) Aerosolized terbutaline in asthmatics–comparison of dosage strength, schedule, and method of administration. J Allergy Clin Immunol 63 (2): 116–121PubMedGoogle Scholar
  275. Weeke ER (1982) Reported clinical experiences with inhaled terbutaline aerosol via spacer devices. Eur J Respir Dis [Suppl 119] 63: 105–109Google Scholar
  276. Weinberg EG, Klein M (1988) Abuse of home nebulisers in asthma. S Afr J Med 74: 136–137Google Scholar
  277. Wetterlin K (1988) Turbuhaler.A new powder inhaler for administration of drugs to the airways. Phamtaceutical Res 5 (8): 506–506Google Scholar
  278. Wickramasinghe H, Liebeschuetz HJ (1983) (Correspondence) - Addiction to aerosol treatment. Br Med J 287: 1877Google Scholar
  279. Yarbrough J, Mansfield LE, Ting S (1985) Metered dose inhaler induced bronchospasm in asthmatic patients. Ann Allergy 55: 25–27PubMedGoogle Scholar
  280. Yu CP, Nicolaides P, Soong TT (1979) Effect of random airway sizes on aerosol deposition. Am Ind Hyg Assoc J 40: 999–1005PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • B. Niggemann
    • 1
  1. 1.KinderklinikUniversitäts-Krankenhaus EppendorfHamburg-EppendorfGermany

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