Terapi Inhalasi pada Asma Anak

Bambang Supriyatno, Heda Melinda D Nataprawira

Sari


Pemberian obat pada asma dapat berbagai macamn cara yaitu parenteral, per oral, atau
perinhalasi. Pemberian per inhalasi adalah pernberian obat secara langsung ke dalam
saluran nafas melalui penghisapan. Pernberian obat secara inhalasi mempunyai beberapa
keuntungan yaitu obat bekerja langsung pada saluran nafas, onset kerjanya cepat, dosis
obat yang digunakan kecil, serta efek samping yang minimal karena konsentrasi obat di
dalam darah sedikit atau rendah. Pemberian aerosol yang ideal adalah dengan alat yang
sederhana, mudah dibawa, tidak mahal, secara selektif mencapai saluran nafas bawah,
hanya sedikit yang tertinggal di saluran nafas atas serta dapat digunakan oleh anak,
orang cacat atau orang tua. Namun keadaan ideal tersebut tidak dapat sepenuhnya tercapai
dengan adanya beberapa keuntungan dan kerugian masing-masing jenis alat terapi
inhalasi. Terapi inhalasi dapat diberikan dengan inhaler dosis terukur (metered dose
inhaler=MDI), MDI dengan bantuan spacer, nebulizer, intermitten positive pressure
breathing, rotahaler, atau diskhaler. Jenis terapi inhalasi di atas mempunyai keuntungan
dan kerugian masing-masing. Keberhasilan terapi inhalasi ditentukan oleh indikasi, cara
pemilihan obat, jenis obat, dan cara pemberiannya. Pada asma anak, baik tatalaksana
serangan (Pereda, reliever) maupun tatalaksana jangka panjang (pengendali, controller)
sangat dianjurkan penggunaan secara inhalasi. Penggunaan terapi inhalasi merupakan
pilihan tepat pada asma karena banyak manfaat yang didapat seperti onset kerjanya
cepat, dosis obat kecil, efek samping minimal, dan langsung mencapai target. Namun
demikian, terapi inhalasi ini mempunyai beberapa kendala yaitu tehnik dan cara
pemberian yang kurang tepat sehingga masih banyak yang tidak menggunakannya.
Dengan mengetahui hal di atas diharapkan pengobatan asma mencapai kemajuan yang
cukup berarti.


Kata Kunci


terapi inhalasi; asma anak

Teks Lengkap:

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Referensi


Lenfant C, Khaltaev N. Global initiative for asthma.

NHLBI/WHO Workshop Report 1995

Warner JO, Naspitz CK. Third International Pediatric

Consensus Statement on the Management of Childhood

Asthma. Pediatr Pulmonol 1998; 25:1-17.

Huchon, G. Metered dose inhalers past and present: Advantages

and limitations. Eur Respir Rev 1997; 7:26-8.

Matthys H. CFCs and their effect on the ozone layer:

the Montreal Protocol and consequences for physicians.

Eur Respir Rev 1997; 7:29-31.

June D. Achieving the change: challenges and successes

in the formulation of CFC-free MDIs. Eur Respir Rev

; 7:32-4.

Newman SP. New aerosol delivery system. Dalam: Barnes

PJ, Grunstein MM, Leff AR, Woolcock AJ, Asthma.

Philadelphia: Lippincott-Raven, 1997. h. 1805-15.

Reiser J dan Warner JO. Inhalation treatment for asthma.

Arch Dis Child 1986; 61:88-94.

Barry PW, Fouroux B, Pederson S, O’Callaghan C.

Nebulizers in childhood. Eur Respir Rev 2000; 10: 527-

Dolovich MB, Everard ML. Delivery of aerosols to children:

devices and inhalation techniques. Dalam: Naspitz

C, Szefler SJ, Tinkelman D, Warner JO. Textbook of

pediatric asthma. An International Perspective. London:

Martin Dunitz Ltd 2001. h. 327-46.

Malmstrom K, Sorva R, Silvasti M. Application and efficacy

of the multidose powder inhaler, easyhaler, in children

with asthma. Pediatr Allergy Immunol 1999; 10:66-70.

Kanner RE, Kanter LJ, Dwork P. A comparison of drug

delivery from a metered-dose inhaler plus an inspiratory

flow control device with a metered-dose inhaler plus a

spacer device. J Allergy Clin Immunol 1997; 99:853-4.

Bertrand P, Aranibar H, Castro E, Sanchez I. Efficacy of nebulized

epinephrine versus salbutamol in hospitalized infants

with bronchiolitis. Pediatr Pulmonol 2001; 31:284-8.

Freenhandler M, Asperen PPV. Nebuhaler versus nebulizer

in children with acute asthma. Br Med J 1984; 288:

-4.

Leach C. Safety assessment of the HFA propellant and

the new inhaler. Eur Respir Rev 1997; 7:35-6.

Bleecker E. Clinical reality: the safety and efficacy of the

world’s first CFC-free MDI. Eur Respir Rev 1997; 7:37-9.

Kamps AWA, van Ewijk B, Roorda RJ, Brand PLP. Poor

inhalation technique, even after inhalation instructions, in

children with asthma. Pediatr Pulmonol 2000; 29:39-42.

Fok TF, Lam K, Cheung Ng P, dkk. Aerosol delivery to

non-ventilated infants by metered-dose inhaler: should a

valved spacer be used? Pediatr Pulmonol 1997; 24:204-12.

Pederson S. Aerosol treatment of bronchoconstriction

in children, with or without a tube spacer. N Engl J Med

; 308:1328-30.

Barry PW. In vitro comparison of the amount of

salbutamol available for inhalation from different formulations

used with different spacer devices. Eur Respir

J 1997; 10:1345-8.

Rubilar L, Castro-Rudriguez JA, Girardi G. Randomized

trial of salbutamol via metered-dose inhaler with spacer

versus nebulizer for acute wheezing in children less than 2

years of age. Pediatr Pulmonol 2000; 29:264-9.

Nikander K, Turpeinem M, Wolmer P. Evaluation of

pulsed and breath-syncrinized nebulization of budesonide

as a means of reducing nebulizer wastage of drug. Pediatr

Pulmonol 2000; 29:120-6.

Ahonen A, Leinonen M, Pesonen MR. Patient satisfaction

with easyhaler compared with other inhalation system

in the treatment of asthma: A meta- analysis. Current

Theraupetic Research 2000; 61:61-73.

UKK Pulmonologi IDAI. Konsensus Nasional Penanganan

Asma pada Anak. Jakarta, 2000

Schuch S, Johnson DW, Callahan S, Canny G, Levison

H. Efficacy of frequent nebulized ipratropium bromide

added to frequent high-dose albuterol therapy in severe

childhood asthma. J Pediatr 1995; 126:639-45.

Nuhoglu Y, Bahceeiler, Barlan IB, Basaran MM. The

effectiveness of high-dose inhaled budesonide therapy

in the treatment of acute asthma exacerbations in children.

Ann Allergy Asthma Immunol 2001; 86:318-22.

Rabe KF, Vermeire PA, Soriane JB, Maier WC. Clinical

management of asthma in 1999: the Asthma insights

and reality in Europe (AIRE) study. Eur Respir J 2000;

:802-7.

Condemi JJ, Chervinsky P, Goldstein MF, dkk. Fluticasone

propionate powder administration through diskhaler versus

triamsolone acetonide aerosol administered through

metered-dose inhaler in patients with persistent asthma. J

Allergy Clin Immunol 1997; 100: 468-74.

Allen HDW, Thong IG, Clifton-Bligh P, Holmes S, Nery

L, Wilson KB. Effects of high-dose inhaled corticosteroids

on bone metabolism in prepubertal children with

asthma. Pediatr Pulmonol 2000; 29:188-93.

Kemp JP, Skoner DP, Szefler SJ, Walton-Bowen K, Rivera

MC, Smith JA. Once-daily budesonide inhalation suspension

for the treatment of persistent asthma in infants

and young children. Ann Allergy Asthma Immunol

; 83:231-9.

Szefler SJ. A review of budesonide inhalation suspension

in the treatment of pediatric asthma. Pharmacotherapy

; 21:195-206.




DOI: http://dx.doi.org/10.14238/sp4.2.2002.67-73

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