Asthma is a chronic inflammatory disorder of the airways. It is caused by infiltration of eosinophils, mast cells, and CD4+ -T-lymphocytes which leads to variable
airway obstruction. The core
element of
therapy is to control
inflammation, which is best possible with inhaled
steroids, the so-called controller drugs. Cromones are only second line therapeutic agents because they are not powerful enough for optimal
inflammation control. Reliever drugs like beta2-agonists or
anticholinergic agents serve as a symptomatic medication because they only lead to bronchial dilatation. The
inflammation in
COPD is caused by neutrophils, macrophages and CD8+ -T-lymphocytes. This kind of
inflammation causes an irreversible
airway obstruction accompanied by destruction of the lung parenchyma. By the majority, only symptomatic medication is effective for
COPD, like
anticholinergic agents and beta2-agonists. About 10-20% of patients with
COPD are showing improvement when treated with inhaled
steroids. However, the best treatment result is only guaranteed by optimal application of the medication. The most important barrier is an insufficient coordination between manual use of the inhaling system and inhalation. Various attempts are made to solve this problem, thus leading to a huge variety of application systems. However this also leads to
confusion of patients and doctors because it is difficult to choose the optimal system and to use it in the most efficient way. This article provides an overview of the different application systems and compiles important details to facilitate the optimal application of
inhalation therapy by the patient.