Arzu Ari, PhD, PT, RRT, CPFT Dean Hess, PhD, RRT, FAARC Timothy R. Myers, BS, RRT-NPS Joseph L. Rau, PhD, RRT, FAARC Sam Giordanoxecutive Director of AARC (American Asiation for Respirat Care, AARC) Respironics Inc. () ) 15 (Chia-Chen Chu) 26 ( ) 36 (Yueh-Hua Yuan) 7 ( ) ( Tzu-Ching Ni) 4 1. 2. 3. 4. 5. 6. 7.
2007 6 Respironics Dean R Hess, PhD, RRT, FAARTimothy R Myers, BS, RRT-NPS Joseph L Rau, PhD, RRT, FAARC 48 4 Sam P. Giordano () () Sam P. Giordano 2008/1/29 (ICRC Governor for Taiwan) 1
2009128(International Council for Respiratory Care, ICRC) Arzu Ari Respironics Dean R Hess, PhD, RRT, FAARTimothy R Myers, BS, RRT-NPS Joseph L Rau, PhD, RRT, FAARC Ari48 4 Sam P. Giordano () () Sam P. Giordano Sam O. Giordano 2
朱家成編審與喬治亞州州立大學Arzu Ari博士合 影於2009年12月8日世界呼吸照護聯盟會議 朱家成 參予第一版翻譯及編審人員 2010/4/29 (2011/03/01修稿完成 ) 現任 中國醫藥大學附設醫院呼吸治療科技術主任 中國醫藥大學呼吸治療學系講師 世界呼吸照護聯盟執行委員會台灣區代表 (ICRC Governor for Taiwan) 美國呼吸照護會呼吸照護雜誌(Respiratory Care)中文網播審查員 亞太呼吸網誌主編 台灣呼吸治療學會榮譽會員 中華民國呼吸治療師公會全國聯合會第二屆理事 台中市呼吸治療師公會第三屆理事長 曾任 中華民國呼吸照護學會第一屆常務理事 第二屆秘書長 第三屆國際事務理事 中華民國呼吸照護學會第四 五屆理事長 六屆國際事務理事 第七 八屆理事長 台灣呼吸治療學會第八屆理事長 第九屆國際事務理事 台中市呼吸治療師公會第一屆常務理事 中華民國呼吸治療師公會全國聯合會第一屆理事 台北榮民總醫院呼吸治療科技師 fish 2/24/11 10:08 PM Deleted: fish 2/24/11 10:08 PM : Left 3
? (pmdi) (dry powder inhaler) (nebulizer) fish 2/24/11 10:08 PM Deleted: 4
Sam Giordano, MBA, RRT, FAARC (American Association for Respiratory Care, AARC) / CRCECRCER /CRCE 24(www.AARC.org). CRCE// http://www.aarc.org/go/adu / / 5
: fish 2/24/11 10:17 PM : Font:Bold 1. 2. (nebulizer) (pressurized metered-dose inhalers;pmdis) (dry powder inhalers;dpis) 3. 4. 5. 6. (jet nebulizer) (mesh nebulizer) (ultrasonic nebulizer) 7. 8. 9. (metered-dose inhalers) 10. 11HFACFC 12.pMDI 13.(priming) 14. (hlding chamber) (spacer)( ) 15.holding chamberspacer 16. 17. 18.DPI 19.DPI 20.holding chamber/spacer 21.pMDIsDPIs 22. 23. 24. 25. 26. 27. 28. fish 2/23/11 9:32 PM Deleted: fish 2/23/11 9:33 PM Deleted: 6
? fish 2/23/11 8:49 PM Deleted: 7
fish 2/23/11 9:33 PM Deleted: 8
CDC CDER CDRH CF CHC DPI FDA FPF GSD HFA IC MMAD MMD pmdi SPAG SVN VHC (Centers for Disease Control and Prevention) (Center for Drug Evaluation and Research) (Center for Devices and Radiological Health) (cystic fibrosis) (chlorofluorocarbon) (dry-powder inhaler) (U.S. Food and Drug Administration) (fine-particle fraction) (Geometric Standard Deviation) (hydrofluoroalkane) (Infection Control) (mass median aerodynamic diameter) (mass median diameter) (pressurized meter-dose inhaler) (small particle aerosol generator) (small-volume nebulizer) (valved holding chamber) 9
(pmdi)(pmdidpi) 1 (aerosol)(svn)(pmdi)(dpi) (aerosol deposition) (aerosol generator) (aerosol output (aerosol therapy) (chlorofluorocarboncfc)pmdis (freon) ( (diffusion) (emmited dose) (fine-particle fraction;fpf)1-5 (heterodisperse) (hydrofluoroalkane;hfapmdi CFCs 10
(cascade impactor) (monodisperse) (nebulizer) (plume)pmdi (pressurized metered-dose inhaler; pmdi) pmdi (respirable mass) (residual volumeor dead volume) (spacer)pmdi (valved holding chamber) fish 2/24/11 10:11 PM Deleted: 10-15 2 11
(From Reference 2, with permission) (small volume nebulizer; SVN) (pressurized metered-dose inhaler; pmdi) (dry powde inhaler;dpi) (SVN) (pmdi hlding chambers (DPI)? 1-50 3-7 fish 2/24/11 10:31 PM : Font:Times New Roman, 10.5 pt fish 2/23/11 9:35 PM Deleted: fish 2/23/11 9:35 PM Deleted: 12
fish 2/23/11 9:40 PM Deleted: fish 2/23/11 9:40 PM : Indent: Left 3.75 ch pmd SVDP (Modified, with permission, from Reference 1 and Reference 7) (Modified, with permission, from Reference 1) 8 fish 2/23/11 9:40 PM Deleted: fish 2/24/11 10:32 PM : Font:10.5 pt fish 2/23/11 9:41 PM Deleted: pmd SVDP (Modified, with permission, from Reference 1 and Reference 7) fish 2/23/11 9:35 PM Deleted: fish 2/23/11 9:36 PM Deleted: fish 2/24/11 10:32 PM : Font:10.5 pt, Italic fish 2/24/11 10:32 PM : Font:(Default) Times New Roman, 10.5 pt, Not Bold fish 2/23/11 9:41 PM Deleted: fish 2/23/11 9:37 PM Deleted: 13
) 9 10 11 2- (agonists)fev 1 fish 2/23/11 9:38 PM : Font:12 pt fish 2/23/11 9:38 PM Deleted: 2. (Modified, with permission, from Reference 1) () () MDI fish 2/24/11 10:32 PM : Font:(Default) Times New Roman, 10.5 pt, Not Bold fish 2/24/11 10:32 PM : Font:10.5 pt, Not Bold 14
(From Reference 6, with permission) fish 2/24/11 10:33 PM : Font:Times New Roman, 10.5 pt fish 2/24/11 10:33 PM : Font:10.5 pt 16-18 13,16,18,19 fish 2/23/11 9:58 PM : Font:Times New Roman fish 2/23/11 9:58 PM : Font:Times New Roman fish 2/23/11 9:59 PM Deleted: fish 2/23/11 9:59 PM Deleted: 15
26 27-29 30-32 fish 2/23/11 9:59 PM : Indent: Left: 0", First line: 0 ch fish 2/23/11 9:59 PM Deleted: 16
17
18
19
4. 5-25 (FDA) (Center for Devices and Radiological Health; CDRH) FDA (Center for Drug Evaluation and Research;CDER) 20
(SVN)6-12% (5) 5. ( Modified, with permission, from Reference 1) (acetylcysteine) Budesonide (Pulmicort Respules ) Tobramycin (TOBI ) Pari LC Dornase alfa (Pulmozyme ) Hudson T Up-draft II, Marquest Acorn II, Pari LC, Durable Sidestream, Pari Baby TM Pentamadine(NebuPent) Marquest Respirgard II Ribavirin (Virazole ) Small Particle Aerosol Generator Iloprost(Ventavis ) ProDose I-neb 6. 50-100 100-250 /horn nebulizer 200-1,200 750-2,000 7. (1-7 1-3 21 ) (1-3) 4-15 (1-3) 10-12 fish 2/24/11 10:33 PM : Font:10.5 pt fish 2/24/11 10:33 PM : Font:10.5 pt, Italic fish 2/24/11 10:33 PM : Font:10.5 pt fish 2/23/11 9:54 PM Deleted: Pari Baby Pentamadine(NebuPent) fish 2/23/11 9:54 PM Deleted: Marquest Respirgard II fish 2/23/11 9:51 PM Deleted: Acorn II, fish 2/23/11 9:54 PM Deleted: Small Particle Aerosol Generator fish 2/23/11 9:53 PM : Justified fish 2/23/11 9:55 PM Deleted: fish 2/23/11 9:56 PM Deleted:
8.(Modified, with permission, form Reference 1) fish 2/24/11 10:33 PM : Font:10.5 pt fish 2/24/11 10:33 PM : Font:10.5 pt, Italic 22
1,33,34 28 L/min 50psi 6-8L /min13psi 2mL 4-5mL 1,34 0.52.0 ml (heliox)50% fish 2/23/11 9:58 PM : Font:Times New Roman 23
35,36 (reservoir tube) (breath-enhanced fish 2/24/11 10:34 PM Deleted: (From reference 1, with permission) A. (4-A) 36,37 10%-20% t 38 5 Misty-Neb TM (Cardinal Health, McGaw Park,IL fish 2/24/11 10:35 PM Deleted: fish 2/24/11 10:33 PM Deleted: fish 2/24/11 10:34 PM Deleted: fish 2/24/11 10:33 PM : Font:Times New Roman, 10.5 pt, Italic 24
fish 2/24/11 10:34 PM Deleted: (From Reference 1, with permission) fish 2/24/11 10:38 PM Deleted: fish 2/24/11 10:34 PM : Font:Times New Roman, 10.5 pt, Italic fish 2/23/11 10:00 PM : Font:(Default) Times New Roman, 12 pt From Reference 37, with permission fish 2/24/11 10:38 PM Deleted: fish 2/24/11 10:35 PM : Font:10.5 pt fish 2/24/11 10:35 PM : Font:Times New Roman, 10.5 pt, Italic fish 2/24/11 10:35 PM : Font:10.5 pt 25
From reference 37, with permission 37 fish 2/24/11 10:36 PM : Font:10.5 pt fish 2/24/11 10:38 PM Deleted: fish 2/24/11 10:36 PM : Font:Times New Roman, 10.5 pt, Italic fish 2/24/11 10:36 PM : Font:10.5 pt fish 2/23/11 10:01 PM : Font:Times New Roman fish 2/24/11 10:20 PM Deleted: From Reference 7, with permission AeroEclipse (Monagham Medical Corporation, Plattsburgh,NY) 9 fish 2/24/11 10:36 PM : Font:Times New Roman, 10.5 pt, Italic fish 2/24/11 10:36 PM : Font:10.5 pt fish 2/24/11 10:38 PM Deleted: fish 2/24/11 10:36 PM : Font:10.5 pt fish 2/24/11 10:20 PM Deleted: 26
fish 2/24/11 10:20 PM Deleted: fish 2/24/11 10:20 PM Deleted: (From Reference 37, with permission) methacholine Prodose AAD Respironics) (Philips (transducer) (standing waves)(10) budesonide MicroAir Ultrasonic Model(Omron Healthcare, Bannockburn, IL)MABISMist TM II(Mabis Healthcare, Waukegan, IL) fish 2/24/11 10:37 PM : Font:10.5 pt fish 2/24/11 10:37 PM : Font:10.5 pt, Italic fish 2/24/11 10:37 PM : Font:10.5 pt 27
(From Reference 1, with permission) fish 2/24/11 10:37 PM : Font:10.5 pt fish 2/24/11 10:37 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:37 PM : Font:10.5 pt 11. AAD (Philips Respironics) NE-U22(Omron Healthcare) 3 (adaptive aerosol deliveryaad) (12)AAD 0.251.40.1 AAD50-80% 28
12. Philips (From Reference 1, with permission) Pentamidine pentamidine pentamidine fish 2/24/11 10:37 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:37 PM : Font:10.5 pt 39 fish 2/23/11 10:06 PM : Font:(Default) Times New Roman 29
Y- (From Reference 1, with permission.) 1. 1. () 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. fish 2/24/11 10:37 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/23/11 10:10 PM : Indent: Left: 0", Numbered + Level: 1 + Numbering Style: 1, 2, 3,... + Start at: 1 + Alignment: Left + Aligned at: 0.25" + Tab after: 0.5" + Indent at: 0.5", Tabs: 0.25", List tab + Not at 0.5" fish 2/23/11 10:10 PM Deleted: fish 2/23/11 10:10 PM Deleted: 30
1. () 31
(+/-20)12~24 (14) fish 2/23/11 10:11 PM Deleted: fish 2/23/11 10:11 PM Deleted: fish 2/23/11 10:12 PM Deleted: 32
14. 33
pmdi1995dr. Geroge Maison pmdis pmdi pmdis9 pmdis 9. pmdi (Modified, with permission, from Reference 1) (propellant) fish 2/24/11 10:39 PM : Font:10.5 pt pmdis pmdis: pmdispmdispmdis 10pMDI 10. pmdi (From Reference 1 with permission) (metering valve) (actuator) (dose counter) (dose counter) (elastomeric valve) () pmdis pmdi 34 fish 2/24/11 10:39 PM : Font:10.5 pt fish 2/23/11 10:12 PM Deleted:
pmdi pmdi (propellant) (excipient) (15) 42 pmdi1~2% (propellant)/ (excipient)pmdi80% (surfactant) (CFC) pmdis 25~100µL50µg5mg fish 2/23/11 10:15 PM Deleted: 15. (Modified with permission from Reference 42) pmdi - - pmdiscfcs HFAsCFCs CFCsHFAsCFCs pmdiscfcshfascfcs (surfactant) HFAs(surfactant)(alcohol) 16.HFA pmdiscfc pmdis HFA pmdis (16) CFC pmdis(16) pmdi HFA pmdiscfc pmdis pmdi HFAspMDI CFCs(priming)(temperature effect)(tail-off)cfc HFA pmdis (11)HFA pmdicfc pmdi fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:10.5 pt 35
16. HFA pmdi() CFC pmdi() (From New York Times, with permission) 11. CFC HFA pmdi (From Reference1, with permission) CFC HFA HFA (-20) (3) CFC fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:10.5 pt fish 2/24/11 10:39 PM : Indent: First line: 2.5 ch fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:10.5 pt pmdi Autohaler (Graceway Pharmaceuticals, Bristol, TN) pmdipmdi pmdiautohaler Autohaler 30L/minpMDI pmdispmdi pmdi 43,44 pmdis 43 Autohaler CFC17.Autohaler 36
17. Autohaler (From Reference 2, with permission) fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:10.5 pt pmdi: pmdi(18) MD Turbo (Respirics, Raleigh, NC) and the SmartMist (Aradigm, Hayward, CA)pMDI pmdismd Turbo pmdis MD Turbo pmdissmartmist SmartMist SmartMist 18.pMDIs fish 2/24/11 10:25 PM Deleted: 37
pmdis pmdis(14)pmdis-2 (-2 agonists)(anticholinergics-2 pmdis pmdis100µmpmdis 10~20pMDIs µpmdi pmdis pmdi 45 pmdis 12 pmdiscfc pmdis 10HFA pmdis-20~ 20 44 pmdi 46 <1mm 46 pmdi 47 (terbutaline)(budesonide) 48 1,7,13 p p p pmdi12pmdis fish 2/23/11 10:20 PM Deleted: <sp> 38
12. pmdis (Modified, with permission, from Reference 1) Albuterol Sulfate HFA Pirbuterol Levalbuterol HCl Ipratropium Bromide HFA Ipratropium Bromide/ Albuterol Sulfate Combination Beclomethasone Propionate HFA Ciclesonide Fluticasone Propionate Triamcinolone Acetonide Budesonide combined with Formoterol ProAir HFA Proventil HFA Ventolin HFA Maxair Autohaler Xopenex HFA Atrovent HFA Combivent HFA QVAR Alvesco Flovent HFA Azmacort Symbicort HFA 14 2 3 3 24 10 10 7 3 7 3 4 4 2 4 2 3 2 3 4 1 2 2 fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:39 PM : Font:10.5 pt Fluticasone combined with Salmeterol Advair HFA 4 4 2 Cromolyn Sodium Intal HFA 1 39
pmdi fish 2/23/11 10:23 PM Deleted: s fish 2/23/11 10:23 PM : Font:, Bold fish 2/23/11 10:23 PM : Indent: Left: 0.33" fish 2/23/11 10:24 PM Deleted: fish 2/23/11 10:24 PM Deleted: fish 2/23/11 10:24 PM Deleted: fish 2/23/11 10:24 PM : Indent: Left: 0.33" 1. p 2. pmdi 3. pmdi 4. 5. 6. 2 7. ()p 8. pmdi 9. 1010 10. 11. 2-10 13. pmdi 40 fish 2/23/11 10:25 PM Deleted: fish 2/23/11 10:25 PM Deleted: s fish 2/23/11 10:25 PM Deleted: s fish 2/23/11 10:25 PM Deleted: fish 2/23/11 10:25 PM Deleted: fish 2/23/11 10:25 PM Deleted: s fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:24 PM Deleted:
2. pmdi 3. pmdi 4. 5. 6. pmdi 7. 8. pmdi 9. 1010 10. 11. 2-10 13. pmdi pmdi(autohaler ) Autohaler p Autohaler Autohaler (test fire slide) Autohaler (priming spray) Autohaler 3~4 Autohaler pmdi 10 41 fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:26 PM Deleted: s fish 2/23/11 10:26 PM Deleted: fish 2/23/11 10:27 PM Deleted: MDIs fish 2/23/11 10:27 PM Deleted: MDIs fish 2/23/11 10:27 PM Deleted: s
pmdis(autohaler ) Autohaler 20. p 2. 3. 4. p p p p fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:29 PM Deleted: fish 2/23/11 10:28 PM Deleted: fish 2/23/11 10:29 PM Deleted: fish 2/23/11 10:29 PM Deleted: fish 2/23/11 10:29 PM Deleted: 42
55-57 57,59,60 61 The Ventolin HFA (GlaxoSmithKline, Research Triangle Park, NC) and Flovent HFA (GlaxoSmithKline)(19) Ventolin HFAFlovent HFA 62-64 18, 65 65 fish 2/23/11 10:31 PM Deleted: fish 2/23/11 10:31 PM Deleted: fish 2/23/11 10:31 PM Deleted: fish 2/23/11 10:31 PM : Font color: Black 43
(200825 fish 2/23/11 10:31 PM Deleted: fish 2/23/11 10:31 PM Deleted: fish 2/23/11 10:32 PM Deleted: 44
pmdis. (VHCs) pmdisvhcsspacers( ) (Modified, with permission, from Reference 1) 24pMDI pmdi pmdi spacers pmdi pmdi pmdipmdi fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:40 PM : Font:10.5 pt fish 2/23/11 10:33 PM Deleted: s fish 2/23/11 10:32 PM Deleted: s fish 2/23/11 10:33 PM Deleted: s fish 2/23/11 10:32 PM Deleted: s fish 2/23/11 10:33 PM Deleted: s fish 2/23/11 10:33 PM Deleted: s fish 2/23/11 10:32 PM Deleted: s 45
(VHCs)Spacer Azmacort, Abbott Laboratories, North Chicago, IL (VHC) 46
3. pmdispacer /VHC fish 2/23/11 10:35 PM Deleted: pmdi spacer/ 1. pmdi 2. pmdi 3. pmdi 4. 5. 6. 7. : apmdi bpmdi c1010 d e f () gpmdi h i 9. 1530 10. 11. 12. spacer/pmdis: spacer/pmdis 47
1. pmdispacer/ 2. pmdi 3. pmdispacer/ pmdi(chamber) fish 2/23/11 10:36 PM Deleted: 48
14. 14.(Modified, with permission, from Reference 1) fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt fish 2/24/11 10:40 PM : Font:(Default) Times New Roman, 10.5 pt DPI sdpisdpis DPIs(22)DPIDPIs DPI (blister strips)dpi DPIs (Single-dose DPIs) 49
Aerolizer (Schering-Plough, Kenilworth, NJ)HandiHaler (Boehringer Ingleheim) (22)Aerolizer Formoterol HandiHaler tiotropium bromideaerolizer HandiHaler DPIs (Multiple Unit-dose DPIs) Diskhaler (GlaxoSmithKline)DPIs zanamivir Diskhaler 60 (Multiple-dose DPIs) DPIs DPIsTwisthaler (Schering-Plough)Flexhaler (AstraZeneca, Wilmington, DE)Diskus (GlaxoSmithKline)Twisthaler DPImometasone FuroateFlexhaler budesonidediskus salmeterolfluticasone salmeterolfluticasone Twisthaler Flexhale DPI (deagglomeration) Flexhaler Twisthaler Diskus 60 Diskus Twisthaler Diskus fish 2/23/11 10:37 PM : Font:(Default) Times New Roman, 12 pt, Superscript fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:37 PM : Font:14 pt, Superscript fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:37 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: r fish 2/23/11 10:39 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: fish 2/23/11 10:38 PM Deleted: 22DPI( fish 2/23/11 10:39 PM Deleted: fish 2/23/11 10:39 PM Deleted: 50
)DPI()DPI( 22. () DPI DPI HandiHaler Diskus DPI/ fish 2/23/11 10:39 PM Deleted: fish 2/23/11 10:40 PM Deleted: DPIs DPI DPI DPIs 51
Twisthaler Twisthaler DPI pmdidpis fish 2/23/11 10:40 PM Deleted: fish 2/23/11 10:40 PM Deleted: DPIs 4. (Single-dose DPIs) Aerolizer : 1. 2. 3. (foil blister) 4. 5. 6. both buttons 7. 8. 9. buttons 10. 11. 12. 10 13. 14. 15. 16. 17. HandiHaler : 1 Handihale 2. 3. 4. 5. fish 2/23/11 10:40 PM Deleted: fish 2/23/11 10:40 PM Deleted: fish 2/23/11 10:40 PM Deleted: 52
6. Handihaler 7. 8. Handihaler 9. 10 11. 12. 10 13. Handihaler 14. Handihaler 15. Handihaler 16. Handihaler 17. (Multiple Unit-dose DPI) Diskhaler 1 2. 3. 4. 5. 6. 7. Diskhaler 8. 9. 10 Diskhaler 10 11. 12. 412 13. (Multiple-dose DPIs) Diskus 1. 2. 3. 4. fish 2/23/11 10:41 PM Deleted: Handihaler fish 2/23/11 10:41 PM Deleted: Handihaler fish 2/23/11 10:41 PM Deleted: fish 2/23/11 10:41 PM Deleted: Handihaler fish 2/23/11 10:41 PM Deleted: Handihaler fish 2/23/11 10:41 PM Deleted: Handihaler fish 2/23/11 10:41 PM Deleted: fish 2/23/11 10:42 PM Deleted: fish 2/23/11 10:42 PM Deleted: fish 2/23/11 10:42 PM Deleted: 53
5. 6. 10 7. 8. 9. Twisthaler : 1 2. 3. 4. 1 5. () 6. -- 7. 8. 9. 10 10 11. 12. Twisthaler 13. 14. Flexhaler 1 2. Flexhaler () 3. 4. 5. 6. 7. 8. 9. 10 11. 12. 13. fish 2/23/11 10:42 PM Deleted: fish 2/23/11 10:42 PM Deleted: fish 2/23/11 10:42 PM Deleted: fish 2/23/11 10:42 PM Deleted: 54
DPIDPI 1 2. DPI 3. DPI 4. 5. DPI 6. 7. DPI DPIDPI DPI DPI DPI DPI 55
DPIAerolizer HandiHaler 66 fish 2/23/11 10:43 PM Deleted: fish 2/23/11 10:43 PM Deleted: Diskhaler DPI4 8 67 DPI fish 2/23/11 10:43 PM Deleted: DPIs 66 DPI DPI Flexhaler Twisthaler Diskus 60120 30 60 0 01 Twisthaler 01 5 10 [0] 须 5 [0] fish 2/23/11 10:43 PM Deleted: fish 2/23/11 10:44 PM Deleted: fish 2/23/11 10:44 PM Deleted: 48DPIs 56
8 13, 68-74 / 8, 13, 18, 68, 73, 75-77 45 75, 75-80 pmdis (40-60) 75, 81 DPIs 82-84 8, 18,77 8, 18, 85 67, 77 57
67,86,87 88-90 367 77 / / 58
68-71,91 68, 76, 91 pmdis 91-95 pmdisvhcs 93, 94 DPIs60-90 DPIs 71, 96 fish 2/23/11 10:45 PM Deleted: pmdis 15 68-70, 96-99 pmdisvhcs 5 69, 70, 96 3pMDIs (holding chamber) 69,93,94 5 69, 70, 96 100 3 69 /56 68, 69, 97 4 71, 96 pmdidpi fish 2/23/11 10:46 PM Deleted: fish 2/23/11 10:44 PM Deleted: s 59
15. (SVN with mask) (SVN with mouthpiece) / (pmdi with holding chamber/spacer and mask / (pmdi with holding chamber/spacer (Dry-powder inhaler) (Metered-dose inhaler) (Breath-actuated MDI Autohaler ) (Breath-actuatednebulizers) 3 3 < fish 2/23/11 10:46 PM Deleted: s fish 2/23/11 10:47 PM Table fish 2/23/11 10:48 PM Deleted: s fish 2/23/11 10:47 PM Deleted: fish 2/23/11 10:47 PM : Indent: First line: 0 ch fish 2/23/11 10:47 PM Deleted: fish 2/23/11 10:48 PM Deleted: p fish 2/23/11 10:48 PM Deleted: s fish 2/23/11 10:48 PM Deleted: 60
92, 98, 101, 102 69, 70, 102, 103 104 69%75% 105 fish 2/23/11 10:49 PM Deleted: -? 100, 106 100, 107, 108 0.550 109-113 着? 93, 109, 114, 115 116,117 61
(CF) 20-22 23,24 118 (CI) 20-22,25,119 (IC) 24,119,120 23,24,121,122 123 85%(CF) 124 125 24 83 fish 2/23/11 10:50 PM Deleted: (Pressurized Metered-dose Inhaler:)pMDIs 126,127 16 16. pmdi Autohaler pmdi Autohaler Autohaler pmdi Autohaler fish 2/23/11 10:50 PM Deleted: 62
(Metered-dose Inhalers Accessory Devices)pMDI 17.pMDI 17. pmdi 2-4 4 (Dry-powder Inhaler)DPIs DPI DPI (Nebulizers) 128 18. 63
18. 1. 1:503 2. 70%(isopropyl alcohol)5 3. 3(hydrogen peroxide) 30 4. 1:31 CF (Disinfection) 1. 5 2. 1:503 3. 70%(isopropyl alcohol)5 4. 3(hydrogen peroxide)30 5. 1:31CF fish 2/23/11 10:52 PM : Bullets and Numbering fish 2/23/11 10:52 PM : Bullets and Numbering fish 2/23/11 10:52 PM Deleted: 18. fish 2/23/11 10:52 PM Deleted:... [1]... [2] (quaternary ammonium compound) 1.25%(quaternary ammonium compound) 10(quaternary ammonium compound) 129 64
(Final Rinse) 128 5 (Drying and Maintenance) 130 131,132 CDC 133 (IC)24 134,135 (Inhaled Drugs) 136-139 (unitdose) 133 (Infection Transmission) 140,141 30,142 (Compliance to IC Management System) (Infection Surveillance) (Occupational Health and Safety of Respiratory Therapists) 65
(Health Assessment and Immunization:) (Hand Hygiene) 31,141,143-145 31,141-145 (Protective Equipment) 30 (Ventilation System) 31610 31 69 99.9% 32 (Filtered Nebulizers) 66
(Patient Adherence) (adherence) (adherence) (compliance) β-- 78%pMDI48% 146 19 125 19. (1125) () 67
pmdi (spacer)dpispmdi 147,148 (nebulizer) fish 2/23/11 10:53 PM Deleted: holding chamber 20 125,147,148 20. (aerosol generator) (1126) pmdi / pmdi pmdi pmdi pmdi pmdi () (boot) pmdi pmdi (Ideomotor dyspraxia) /(Valved Holding Chambers/Spacers) // pmdi/ / fish 2/23/11 10:54 PM Deleted: fish 2/23/11 10:56 PM Deleted: fish 2/23/11 10:56 PM Deleted: fish 2/23/11 10:56 PM Deleted: fish 2/23/11 10:56 PM Deleted: 68
(Dry-powder Inhalers) (residual volume) (multi-dose) (N e b u l i z e r s) pmdipmdi (20)pMDI pmdi pmdi 72%pMDI 90 pmdi 120 puff200 puff pmdi (31-32) /(holding chamber/spacer) /20 pmdi/ pmdipmdi / /pmdi 10-20 puff/ 33,149 / fish 2/23/11 10:56 PM Deleted: fish 2/23/11 10:57 PM Deleted: fish 2/23/11 10:57 PM Deleted: / fish 2/23/11 10:57 PM Deleted: fish 2/23/11 10:57 PM Deleted: fish 2/23/11 10:57 PM Deleted: fish 2/23/11 10:57 PM Deleted: fish 2/23/11 10:57 PM Deleted: 69
DPIs (20) pmdisdpis 34 DPIs DPIs 147 (20) (.,DPIs) 1. 2. (checklist) 3. () 4. 5. 6. 7. 70
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