INH

ALA

LEBIH

JAU

H

Dr Salim S Thalib

INH

ALA

SI

OBAT MEL. SAL. NAPAS

BENTUK AEROSOL

TUJUAN TERAPI

LOKAL DAN SISTEMIK

DEFINISI

INH

ALA

SI

MANFAAT

DOSIS RENDAH

EFEK SAMPING MINIMAL

ONSET CEPAT

INH

ALA

SI

INH

ALA

SI

TINGGI

RENDAH

INH

ALA

SI

LAMA

MINIMAL

KHASIAT OBAT

EFEK SISTEMIK

PENYERAPAN ORAL

PLASMA PROTEIN

INH

ALA

SI

DEPOSISI AEROSOL

IMPACTION

PADA PARU

SEDIMANTATIONDIFFUSION

INH

ALA

SI

IMPACTION

INH

ALA

SI

IMPACTION SEDIMANTATION

INH

ALA

SI

DIFFUSION

INH

ALA

SI

DEPOSISI AEROSOLPADA PARU

NASOPHARENGEAL

IMPACTION

TRACHEOBRONCHIAL

IMPACTION

(CENTRAL)

SEDIMANTATION

PULMONARY

SEDIMANTATIONDIFFUSION

(PERIPHERAL)

INH

ALA

SI

UKURAN AEROSOL

MEDIAN DIAMETER-MICROMETERMASS MEDIAN DIAMETER-

MICROMETER

DEP

OS

ITIO

NFR

AC

TIO

N

INH

ALA

SI

KECEPATAN AEROSOL

TEND TO GET

TEND TO SLOWER FLOW

DEPOSITED IN UPPER AIRWAY

MINIMIZED UPPER AIRWAY

ENHANCHES DISTAL DELIVERY

HIGH VELOCITY

LOW VELOCITY

DEPOSITION

DEPOSITION

DEPOSITION

INH

ALA

SI

TIPE PERNAPASAN

BREATH HOLD AT END INSPIRATION

INCREASED CENTRALRAPID INHALATION

SLOW INHALATION

INCREASED PERIPHERAL

INH

ALA

SI ABSORPTION

ABSORPTION

TIPE PERNAPASAN

LOW SYSTEMIC

IMPACTIONVASCULER BED

HIGH SYSTEMIC

HUMIDIFICATIONNASAL BREATHING

MOUTH BREATHING

INH

ALA

SI

PENETRASI OBAT

SMALL AIRWAY MORE DEPOSITION

NARROWING AIRWAY :

VARIASI NORMAL JALAN NAPAS

PENYAKIT DASAR PARU

KED

ALA

M P

AR

U

BRONCHOSPAM, FIBROTIC, SECRETMORE DEPOSITION IN CENTRAL

Martonen TK , Pharm Respir 1995, 12: 96

IN CENTRAL

INH

ALA

SI

PENETRASI OBATK

EDA

LAM

PA

RU

ADULT CHILD CHILD WITHINFLAMED AIRWAY

INH

ALA

SI

FACTORS AFFECTING DELIVERY

OF AEROSOLIZED TO THE LUNG

FAC

TO

RS

AFFEC

TIN

G D

ELIVER

Y

INH

ALA

SI

HASIL TERAPI MELALUI

EFEK TOPIKAL

PROSES

ABSORBSIGABUNGAN

INH

ALA

SI

H.derendorf, Eur J 2006 ; 28 1042-1050

On site activation in the lung. low oropharyngeal exposure. Negligible oral bioavallability. protein binding and rapid

clearance

Decrease local and

systemic side effects

small particle High receptor binding activity. long pulmonary residence

time.Lipid conjugation.

Increase or prolong the anti

inflammatory effects

PHARMACOKINETIC PHARMACODYNAMIC

EFEK SAMPING INH

ALA

SI APAKAH ADA

TERAPI

INH

ALA

SI

POTENTIAL LOCAL

INH

ALA

SIc

POTENTIAL SYSTEMIC

SKIN BRUISING

INH

ALA

SI

PERANAN TERAPI

INHALASI PENYAKIT PARU

PER

AN

AN

TER

AP

I INH

ALA

SI P

AD

A P

ENYA

KIT

PA

RU

PCP

P

INH

ALA

SI

METERED DOSE PRESSURIZED

INHALERS

DDRY POWDERINHALERS

NNEBULIZERJET & ULTRA SONIC

PMETERED DOSE INHALERS

PRESSURIZED

INH

ALA

SI

PMETERED DOSE INHALERS

INH

ALA

SI

PRESSURIZED

PMETERED DOSE INHALERS

INH

ALA

SI

PRESSURIZED

PROPELLANTS

FORMULATION ACTUATOR

CONTAINER

METERING VALVE

PMETERED DOSE INHALERS CONTAINER

PRESSURIZED

PMETERED DOSE INHALERS PROPELLANTS

PRESSURIZED

PMETERED DOSE INHALERS ACTUATOR

PRESSURIZED

PMETERED DOSE INHALERS How to use

PRESSURIZED

PMETERED DOSE INHALERS

ADVANTAGES DISADVANTAGES

PRESSURIZED

PMETERED DOSE INHALERS

SPACER DEVICES

PRESSURIZED

PMETERED DOSE INHALERS

SPACER DEVICES

PRESSURIZED

INH

ALA

SI

PMETERED DOSE INHALERS

SPACER DEVICES

PRESSURIZED

EFFECT OF DIAMETER AND SPACER LENGTHON AVAILABILITY OF DRUG

INH

ALA

SI

WHY USE A WITH AN INHALER

INHALER ALONE, INHALER WITH SPACER,

MEDICINE ENDS UP IN MORE MEDICINE ISTHE MOUTH,

THROAT,STOMACH AND DELIVERED TO THE

DEVICES

PMETERED DOSE INHALERS

SPACER DEVICES

3 CATEGORIES :

SIMPLE TUBE HOLDING CHAMBER

RESERVE - FLOW

PRESSURIZED

PMETERED DOSE INHALERS

SIMPLE TUBE

SIMPLE TUBE EXTENTION

PRESSURIZED

TO ACTUATOR

SPACER

MOUTHPIECE

PMETERED DOSE INHALERS

VALVE HOLDING PRESSURIZED

CHAMBER

PMETERED DOSE INHALERS

VALVE HOLDING PRESSURIZED

CHAMBER

PMETERED DOSE INHALERS How to use

PRESSURIZED WITH SPACER

P- MDI WITH SPACER

RESERVE FLOWDEVICES

PMETERED DOSE INHALERS

PRESSURIZED

INH

ALA

SI

INHALERS FOR CHILDREN

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

PORTABLE INSPIRATORY FLOW-DRIVEN DEVICES THAT DELIVER POWDER FORMULATIONS OFINHALED DRUG TO LUNG

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

PRINCIPLES OF DRY POWDER INHALER DESIGN

INH

ALA

SI

DRY POWDER INHALERS

TU

RB

O H

ALE

R

INH

ALA

SI

DRY POWDER INHALERS

PERBANDINGAN DEPOSISI OBAT

P-MDI 15 % DPI 32 % Thorsson et al, 1998

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

DRY POWDER INHALERS

INH

ALA

SI

NEBULIZER

INH

ALA

SI

NEBULIZER

INH

ALA

SI

JET -NEBULIZER

INH

ALA

SI

JET -NEBULIZER

INH

ALA

SI

ULTRA SONIC -NEBULIZER

INH

ALA

SI

ULTRA SONIC -NEBULIZER

INH

ALA

SI

MIST INHALER

CHARACTERISTIC OF THE

AEROSOL GENERATORS

•KARAKTERISTIK INH

ALA

SI ID

EAL

OBAT

BIAYA TERAPI YANG EKONOMIS

DEPOSISI OROPHARYNX RENDAH

DEPOSISI PARU TINGGI

NYAMAN, KOORDINASI MINIMAL

INH

ALA

KE ALI LEBIH

JAU

H

Dr Salim S Thalib