エアロチャンバー・プラス^®を用いた薬剤師の指導で気管支喘息の吸入薬治療が可能となった永久気管孔の1症例

抄録

Inhaled medications are crucial in the pharmacological treatment of bronchial asthma and COPD, and proper inhalation instruction and adherence are essential in improving treatment outcomes. However, inhalation therapy in patients with permanent tracheostomy is technically challenging due to the upper airway’s anatomical bypassing. In this report, we describe a case in which inhalation therapy using the AeroChamber Plus^® and guidance from a pharmacist was successful in a patient with a permanent tracheostomy, resulting in improved asthma control. The patient is a male in his 70s who underwent total laryngectomy for laryngeal cancer, resulting in permanent tracheostomy. Asthma developed, and the patient was prescribed Flutiform^®. Because oral inhalation was not possible, the pharmacist provided inhalation instruction. The inhalation instruction used an AeroChamber Plus^® with a mask positioned upside down to prevent air leakage, making inhalation through the permanent tracheostomy feasible. Because oral inhalation was not possible, gargling was unnecessary, and wiping the surrounding area of the tracheostomy was recommended as a measure for side effects. The patient showed improvement in respiratory distress, and asthma symptoms remained stable after discharge. The regular follow-up visits were continued. This case suggests that inhaled medications can be used effectively even in patients with a permanent tracheostomy, allowing for long-term asthma management with adjustments to inhalation techniques. Proper use of inhaled medications helps prevent exacerbation of asthma and maintains the patient’s quality of life.