Perspektiven in der Inhalationstherapie[1]

Zusammenfassung

Die inhalative Applikation von Medikamenten wird neue Anwendungsgebiete sowohl bei Lungenerkrankungen als auch in der systemischen Therapie gewinnen. Die Inhalation von Antibiotika ist bereits Standard in der Therapie der zystischen Fibrose. Bei Bronchiektasen, der schweren COPD mit bakterieller Kolonisation und bei invasiv beatmeten Patienten gibt es Hinweise auf die Wirksamkeit der Inhalation von Aminoglykosiden. Die Inhalation zur Substitution von alpha 1-Antitrypsin ist der i. v. Gabe beim Lungenemphysem bezüglich der intrapulmonalen Dosis überlegen. Auch wenn das inhalative Insulin wieder vom deutschen Markt genommen wurde, besteht weiter eine intensive Forschungstätigkeit auf dem Gebiet der Inhalation von Insulin und Heparin zur systemischen Therapie des Diabetes mellitus bzw. der Antikoagulation.

Abstract

Administration of drugs via the inhalation route will find new indications in the therapy for lung diseases. Furthermore, aerosolised drugs are of increasing interest for systemic treatment. The inhalation of antibiotics is already a well established therapy in cystic fibrosis. In bronchiectasis, severe COPD with bacterial airway colonisation and in mechanically ventilated patients, aerosolised aminoglycosides may provide benefit. Substitution of alpha1-antitrypsin in lung emphysema via inhalation seems to be superior to the intravenous administration. Inhaled insulin has currently been withdrawn from the market in spite of being approved by FDA and EMEA. However, intensive scientific research is still ongoing and many clinical studies are underway in the field of the inhalation of insulin, heparins and other systemic treatments.

1 Prof. Dr. Dieter Köhler zum 60. Geburtstag gewidmet.

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1 Prof. Dr. Dieter Köhler zum 60. Geburtstag gewidmet.