tamiflu v other two, page-12

CPG
good question and I have the answer.
In two parts, and I have posted it previously, but maybe a couple of years ago.

Briefly:


Ventolin is an aerosol, press the button and its puffs, simple easy.



Asthma is either a chronic or eposidic condition.
The asthma spray are the most efficient means of giving
A Instant relief (Relievers)
B Longer relief (controllers & preventers)

Yes, some of the inhaled asthma medications are not aerosols. They require the patient to use their breath to draw the medication from the inhaler into their lungs and like Relenza are a bit more difficult to use.



Asthma patients can be trained to use an inhaler which provides almost instant relief using the "relieving' medications ( salbutamol et al)
There is a technique to using them... not too difficult but needs to be done correctly to gain the max. benefit.
Asthma patients use them regularly and get quite efficient at it.
Although I am constantly amazed at the poor technique of some asthma sufferers in using their aerosols.
(Over the years I have trained many asthmatics on how to correctly use both aerosols and non aerosol inhalers)

It becomes a routine practised action.

The reason for aerosols over oral preparations:

It delivers the active ingredient directly to the site where it is needed, the bronchioles, quickly and efficiently and it does not circulate to any great extent around the rest of the body so has minimal effects on heart rate raised BP etc.
It acts pretty well immediately.
As it is only delivered to the site of action, much lower doses are needed than if it was distributed thoughout the body and delivered to the brochioles via the bloodstream as would be the case with an oral or injected dose.

An example:

Salbutamol (Ventolin ) tablets 4mg were available( not sure if they still are) but didn't work as quickly and did have cardiac effects and raised BP. This compares with a single metered dose of Ventolin spray of 100 microgram
Tablets 4000microgram /dose V Spay 100 microgram/dose.
normally 2 puffs of spay administered = 200 mcg
Therefore
This is 1/20th the dose of the tablet form for a faster better result with fewer side effects.



So to summarise
Aerosols for asthma.... the delivery system of choice which can be used simply efficiently and regularly and with relative safety.

No real alternatives.

Asthma a chronic disease suffered by 100s of millions of people worldwide, so Aerosols for asthma= a huge mkt ...and GSK Ventolin is the mkt leader.

That is why an aerosol is their leading product



Now lets look at a typical flu sufferer and dose form/ dosage administration

Relenza not quite as simple as taking an oral dose, in this case a Tamiflu capsule.

The Flu sufferer feel lousy, just want to go home to bed, This is hardly the time to be introducing them to and explaining some new fangled unfamiliar inhaler gadget when the can swallow a capsule as an alternative which does the same job..

Simpler for the patient, simpler for the medical profession.

................................

Thats been the case up until now, but if Tamiflu resistance has/is developing, this is about to change.

Hope that answers your question.

Cheers,

Bendigo