metricas
covid
Buscar en
Medicina Clínica
Toda la web
Inicio Medicina Clínica Terapia inhalada en el asma
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Revisión
Terapia inhalada en el asma
Inhaled therapy in asthma
Vicente Plaza Moral
Autor para correspondencia
vplaza@santpau.cat

Autor para correspondencia.
, Jordi Giner Donaire
Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
Leído
115
Veces
se ha leído el artículo
23
Total PDF
92
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S0025775315005862"
  "issn" => "00257753"
  "doi" => "10.1016/j.medcli.2015.09.021"
  "estado" => "S300"
  "fechaPublicacion" => "2016-04-01"
  "aid" => "3422"
  "copyright" => "Elsevier España, S.L.U.. Todos los derechos reservados"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "rev"
  "cita" => "Med Clin. 2016;146:316-23"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 113
    "formatos" => array:2 [
      "HTML" => 91
      "PDF" => 22
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2387020616302583"
      "issn" => "23870206"
      "doi" => "10.1016/j.medcle.2016.05.038"
      "estado" => "S300"
      "fechaPublicacion" => "2016-04-01"
      "aid" => "3422"
      "copyright" => "Elsevier España, S.L.U."
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "rev"
      "cita" => "Med Clin. 2016;146:316-23"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 1
        "PDF" => 1
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
        "titulo" => "Inhaled therapy in asthma"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "316"
            "paginaFinal" => "323"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Terapia inhalada en el asma"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Fig&#46; 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 2410
                "Ancho" => 3145
                "Tamanyo" => 699157
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Diagnostic evaluation and treatment of adult asthma exacerbations&#46; <span class="elsevierStyleItalic">Source</span>&#58; Taken from the Spanish Guide for Asthma Management &#40;GEMA&#41; 4&#46;0<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a> and Rodrigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">41</span></a></p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Vicente Plaza Moral, Jordi Giner Donaire"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Vicente"
                "apellidos" => "Plaza Moral"
              ]
              1 => array:2 [
                "nombre" => "Jordi"
                "apellidos" => "Giner Donaire"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0025775315005862"
          "doi" => "10.1016/j.medcli.2015.09.021"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315005862?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616302583?idApp=UINPBA00004N"
      "url" => "/23870206/0000014600000007/v1_201607151011/S2387020616302583/v1_201607151011/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S002577531500634X"
    "issn" => "00257753"
    "doi" => "10.1016/j.medcli.2015.11.012"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "3452"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Clin. 2016;146:324-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 208
      "formatos" => array:2 [
        "HTML" => 147
        "PDF" => 61
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Diagn&#243;stico y tratamiento</span>"
      "titulo" => "Nuevas terapias en el c&#225;ncer de tiroides"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "324"
          "paginaFinal" => "329"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "New therapies in thyroid cancer"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2817
              "Ancho" => 1641
              "Tamanyo" => 267472
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se define al paciente refractario a RAI como aquel que cumple alguna de las siguientes situaciones&#58; A&#41; Lesiones metast&#225;sicas que no capta RAI en el tratamiento inicial&#46; B&#41; El RAI se concentra en algunas lesiones&#44; pero no en otras&#46; C&#41; Las lesiones pierden la capacidad para concentrar RAI despu&#233;s de una evidencia previa de enfermedad yodo&#225;vida&#46; D&#41; Lesiones que progresan en el &#250;ltimo a&#241;o a pesar de concentrar RAI&#46; RAI&#58; yodo radioactivo&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro L&#243;pez Mond&#233;jar, Juan Carlos Galofr&#233;"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "L&#243;pez Mond&#233;jar"
            ]
            1 => array:2 [
              "nombre" => "Juan Carlos"
              "apellidos" => "Galofr&#233;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2387020616302935"
        "doi" => "10.1016/j.medcle.2016.06.014"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616302935?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531500634X?idApp=UINPBA00004N"
    "url" => "/00257753/0000014600000007/v1_201603150321/S002577531500634X/v1_201603150321/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S002577531500648X"
    "issn" => "00257753"
    "doi" => "10.1016/j.medcli.2015.11.022"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "3464"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Clin. 2016;146:311-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 23
      "formatos" => array:2 [
        "HTML" => 14
        "PDF" => 9
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Nota cl&#237;nica</span>"
      "titulo" => "Expansi&#243;n del triplete citosina-guanina-guanina&#58; 3 casos de s&#237;ndrome OMIM en una misma familia"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "311"
          "paginaFinal" => "315"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Triplet expansion cytosine-guanine-guanine&#58; Three cases of OMIM syndrome in the same family"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2300
              "Ancho" => 3000
              "Tamanyo" => 248322
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#193;rbol geneal&#243;gico con los casos estudiados&#58; familiares de primer&#44; segundo y tercer grado a partir del caso &#237;ndice&#47;probando&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSmallCaps">IV</span>&#58;6&#44; IV&#58;3 y IV&#58;2&#58; SXF&#59; III&#58;1&#44; III&#58;2&#59; III&#58;3&#58; FXPOI&#59; II&#58;1&#58; FXTAS&#59; IV&#58;4&#58; mosaico premutado&#47;mutado completo asintom&#225;tico&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jes&#250;s Gonz&#225;lez-P&#233;rez, Silvia Izquierdo-&#193;lvarez, Cristina Fuertes-Rodrigo, Lorena Monge-Galindo, Jos&#233; Luis Pe&#241;a-Segura, Francisco Javier L&#243;pez-Pis&#243;n"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Jes&#250;s"
              "apellidos" => "Gonz&#225;lez-P&#233;rez"
            ]
            1 => array:2 [
              "nombre" => "Silvia"
              "apellidos" => "Izquierdo-&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Fuertes-Rodrigo"
            ]
            3 => array:2 [
              "nombre" => "Lorena"
              "apellidos" => "Monge-Galindo"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233; Luis"
              "apellidos" => "Pe&#241;a-Segura"
            ]
            5 => array:2 [
              "nombre" => "Francisco Javier"
              "apellidos" => "L&#243;pez-Pis&#243;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2387020616302625"
        "doi" => "10.1016/j.medcle.2016.05.042"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616302625?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531500648X?idApp=UINPBA00004N"
    "url" => "/00257753/0000014600000007/v1_201603150321/S002577531500648X/v1_201603150321/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
    "titulo" => "Terapia inhalada en el asma"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "316"
        "paginaFinal" => "323"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Vicente Plaza Moral, Jordi Giner Donaire"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Vicente"
            "apellidos" => "Plaza Moral"
            "email" => array:1 [
              0 => "vplaza&#64;santpau&#46;cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Jordi"
            "apellidos" => "Giner Donaire"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital de la Santa Creu i Sant Pau&#44; Institut d&#8217;Investigaci&#243; Biom&#233;dica Sant Pau &#40;IIB Sant Pau&#41;&#44; Departament de Medicina&#44; Universitat Aut&#242;noma de Barcelona&#44; Barcelona&#44; Espa&#241;a"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Inhaled therapy in asthma"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1480
            "Ancho" => 2711
            "Tamanyo" => 227778
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Esquema de ayuda para la elecci&#243;n del inhalador&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">C&#225;mara inh&#58; c&#225;mara de inhalaci&#243;n&#59; DPI&#58; <span class="elsevierStyleItalic">dry powder inhaler</span> &#40;&#171;inhalador de polvo&#187;&#41;&#59; pMDI&#58; <span class="elsevierStyleItalic">pressurized metered-dose inhaler</span> &#40;&#171;cartucho presurizado de dosis medida&#187;&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#42; El profesional sanitario implicar&#225; al paciente&#44; seg&#250;n sus preferencias&#44; en la elecci&#243;n final del dispositivo&#44; entre los recomendados en dicho grupo&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Fuente&#58; basada en parte en Broeders et al&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">48</span></a>&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">El principal inconveniente de la v&#237;a inhalada para la administraci&#243;n de f&#225;rmacos estriba en la dificultad que la mayor&#237;a de los pacientes tienen para utilizarlos correctamente<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46; Un uso inapropiado de estos contribuye a un control deficiente tanto del asma<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">4</span></a> como de la EPOC<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">5</span></a>&#46; Por tanto&#44; los pacientes deben ser adiestrados en su correcto uso&#46; Sin embargo&#44; m&#250;ltiples estudios recientes han mostrado que el nivel de conocimiento de los profesionales sanitarios sobre los aspectos te&#243;ricos y pr&#225;cticos de la terapia inhalada es insuficiente<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; Con el &#225;nimo de paliar dichas carencias recientemente se editaron 2 documentos que el lector de la presente revisi&#243;n deber&#237;a consultar para una mayor informaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Por otro lado&#44; y teniendo en consideraci&#243;n la aplicaci&#243;n de dicha terapia inhalada en el tratamiento del asma&#44; que resume este documento&#44; recientemente 2 importantes gu&#237;as de pr&#225;ctica cl&#237;nica para el asma&#44; una internacional &#40;GINA&#44; 2015&#41;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">10</span></a> y otra nacional &#40;GEMA 4&#46;0&#44; editada tambi&#233;n en 2015&#41;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a>&#44; han actualizado sus enunciados con novedades relevantes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conceptos y fundamentos te&#243;ricos de los aerosoles</span><p id="par0010" class="elsevierStylePara elsevierViewall">Un &#171;aerosol&#187; es la suspensi&#243;n de part&#237;culas microsc&#243;picas de material s&#243;lido o l&#237;quido en el aire u otro gas<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46; El tama&#241;o de las part&#237;culas del aerosol se mide mediante el <span class="elsevierStyleItalic">di&#225;metro de la mediana de la masa aerodin&#225;mica</span> &#40;DMMA&#41;&#44; que es el di&#225;metro en el que la mitad de la masa de las part&#237;culas de un aerosol tiene un tama&#241;o mayor&#44; y la otra mitad&#44; menor&#46; La <span class="elsevierStyleItalic">masa respirable</span> de un aerosol es la cantidad de part&#237;culas con un di&#225;metro inferior a 5<span class="elsevierStyleHsp" style=""></span>&#956;m<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46; Las part&#237;culas de menor tama&#241;o &#40;0&#44;5-2<span class="elsevierStyleHsp" style=""></span>&#956;m&#41; llegan a los bronquiolos terminales y la regi&#243;n alveolar&#44; las de 2-5<span class="elsevierStyleHsp" style=""></span>&#956;m se depositan en las peque&#241;as v&#237;as a&#233;reas&#44; las que tienen entre 5-10<span class="elsevierStyleHsp" style=""></span>&#956;m&#44; en las grandes v&#237;as a&#233;reas&#44; y las de tama&#241;o superior a 10<span class="elsevierStyleHsp" style=""></span>&#956;m&#44; en el &#225;rea orofar&#237;ngea<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46; El dep&#243;sito de un f&#225;rmaco depende de diversos factores<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">12&#8211;14</span></a>&#44; entre los que destaca el papel del tama&#241;o de la part&#237;cula&#46; Seg&#250;n este&#44; el aerosol se deposita por diferentes mecanismos&#58; impactaci&#243;n o choque&#44; sedimentaci&#243;n y difusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">12&#44;13</span></a>&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Dispositivos</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Cartuchos presurizados de dosis medida</span><p id="par0015" class="elsevierStylePara elsevierViewall">Son conocidos por el acr&#243;nimo pMDI&#44; del ingl&#233;s <span class="elsevierStyleItalic">pressurized metered-dose inhaler</span>&#46; En su interior el f&#225;rmaco est&#225; disuelto o en suspensi&#243;n en el propelente &#40;gas vehiculizador&#41;&#44; que al contactar con la presi&#243;n atmosf&#233;rica se transforma en gas &#40;aerosol&#41;&#46; Las principales ventajas de estos dispositivos son su portabilidad&#44; la precisi&#243;n de las dosis y el bajo coste&#59; y las desventajas&#44; la dificultad para realizar una maniobra de inhalaci&#243;n correcta &#40;especialmente la coordinaci&#243;n entre la inspiraci&#243;n y la pulsaci&#243;n&#41; y el elevado impacto orofar&#237;ngeo del f&#225;rmaco<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">8&#44;9&#44;15</span></a>&#46; Tipos &#40;en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se resumen sus dep&#243;sitos y DMMA&#41;&#58;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cartuchos presurizados de dosis medida convencionales&#46;</span> Constan de una peque&#241;a bombona o cartucho presurizado a 5<span class="elsevierStyleHsp" style=""></span>atm&#44; de unos 10<span class="elsevierStyleHsp" style=""></span>ml&#44; que contiene las part&#237;culas de f&#225;rmaco en suspensi&#243;n junto al propelente&#59; una v&#225;lvula dosificadora&#44; que libera la dosis en ella depositada&#59; y una carcasa de pl&#225;stico externa&#44; en la que se introduce el cartucho y sobre el que descansa la v&#225;lvula de salida del aerosol&#46; Los antiguos propelentes clorofluorocarbonos han sido sustituidos en la actualidad por los hidrofluoroalcanos<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cartuchos presurizados de dosis medida de part&#237;culas extrafinas</span> &#40;Modulite<span class="elsevierStyleSup">&#174;</span>&#41;&#46; Se trata de un pMDI que contiene el f&#225;rmaco en soluci&#243;n &#40;por lo que no precisan agitarse&#41;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">13</span></a>&#46; El orificio de salida de la v&#225;lvula es de un tama&#241;o menor que el de los pMDI convencionales&#44; lo cual proporciona un aerosol con part&#237;culas m&#225;s finas &#40;&#171;extrafinas&#187;&#41;&#44; que se depositan en las peque&#241;as v&#237;as a&#233;reas distales&#44; suministrando un elevado dep&#243;sito intrapulmonar<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cartuchos presurizados de dosis medida de autodisparo</span> &#40;Autohaler<span class="elsevierStyleSup">&#174;</span> y Easybreath<span class="elsevierStyleSup">&#174;</span>&#41;&#46; De dise&#241;o similar al pMDI convencional&#44; pero se disparan autom&#225;ticamente con la inspiraci&#243;n del paciente&#46; No precisan coordinar la pulsaci&#243;n y la inspiraci&#243;n<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Inhalador de niebla fina</span> &#40;Respimat<span class="elsevierStyleSup">&#174;</span>&#41;&#46; A medio camino entre un pMDI y un nebulizador de bolsillo&#46; La soluci&#243;n atraviesa un filtro con 1&#46;000 orificios &#40;Uniblock<span class="elsevierStyleSup">&#174;</span>&#41;&#44; que divide y reconduce el aerosol al exterior en 2 columnas enfrentadas&#44; que al colisionar genera una fina nube de aerosol<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">20</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">C&#225;maras de inhalaci&#243;n o espaciadores</span><p id="par0040" class="elsevierStylePara elsevierViewall">Aparato que se ajusta a los pMDI&#59; al separar la boca de la salida del aerosol del pMDI&#44; disminuye el impacto orofar&#237;ngeo de las part&#237;culas grandes<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; Las principales ventajas es que hace innecesaria la coordinaci&#243;n entre la inspiraci&#243;n-pulsaci&#243;n y reduce los efectos secundarios locales&#59; y entre los inconvenientes&#44; su escasa portabilidad&#46; Existe una gran variedad de c&#225;maras disponibles&#44; entre otras&#44; con v&#225;lvula unidireccional&#44; colapsables o hinchables<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Dispositivos de polvo inhalado</span><p id="par0045" class="elsevierStylePara elsevierViewall">Son conocidos como DPI&#44; del ingl&#233;s <span class="elsevierStyleItalic">dry powder inhaler</span>&#46; Tienen en com&#250;n que son peque&#241;os&#44; port&#225;tiles&#44; no contienen gases propelentes y se liberan con la inspiraci&#243;n&#46; El f&#225;rmaco en polvo se encuentra en el dispositivo&#44; ya sea aglomerado o&#44; m&#225;s frecuentemente&#44; en combinaci&#243;n con part&#237;culas transportadoras &#40;habitualmente lactosa&#41;&#46; La presi&#243;n inspiratoria y la turbulencia del flujo generada ocasionan la liberaci&#243;n de las part&#237;culas &#40;aglomeradas o combinadas con un transportador&#41;&#46; Entre sus ventajas destaca que no precisan coordinaci&#243;n entre inhalaci&#243;n y pulsaci&#243;n&#44; la sencilla t&#233;cnica de inhalaci&#243;n de los nuevos sistemas multidosis &#40;habitualmente de solo 3 o 4 pasos&#41; y su portabilidad&#59; y entre sus inconvenientes&#44; que precisan de una inspiraci&#243;n voluntaria y con flujos m&#225;s altos que con los cartuchos presurizados de dosis medida<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">8&#44;9&#44;15</span></a>&#46; Se pueden agrupar en 2 tipos o sistemas &#40;en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se resumen sus dep&#243;sitos y DMMA&#41;&#58;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Sistemas unidosis</span> &#40;por orden alfab&#233;tico&#58; Aerolizer<span class="elsevierStyleSup">&#174;</span>&#44; Breezhaler<span class="elsevierStyleSup">&#174;</span>&#44; Handihaler<span class="elsevierStyleSup">&#174;</span>&#44; Inhalator Ingelheim<span class="elsevierStyleSup">&#174;</span>&#44; Spinhaler<span class="elsevierStyleSup">&#174;</span>&#41;&#46; Dispositivos de una sola dosis&#46; El medicamento se encuentra en el interior de una c&#225;psula de gelatina dura que se introduce manualmente en el dep&#243;sito del dispositivo<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Su principal inconveniente es que precisa de muchos pasos para su inhalaci&#243;n&#44; lo cual puede ser fuente de errores en su manejo&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Sistemas multidosis</span> &#40;por orden alfab&#233;tico&#58; Accuhaler<span class="elsevierStyleSup">&#174;</span>&#44; Aerolizer<span class="elsevierStyleSup">&#174;</span>&#44; Easyhaler<span class="elsevierStyleSup">&#174;</span>&#44; Ellipta<span class="elsevierStyleSup">&#174;</span>&#44; Genuair<span class="elsevierStyleSup">&#174;</span>&#44; Handihaler<span class="elsevierStyleSup">&#174;</span>&#44; Nexthaler<span class="elsevierStyleSup">&#174;</span>&#44; Spiromax<span class="elsevierStyleSup">&#174;</span>&#44; Turbuhaler<span class="elsevierStyleSup">&#174;</span> y Twisthaler<span class="elsevierStyleSup">&#174;</span>&#41;&#46; El f&#225;rmaco&#44; en polvo&#44; se encuentra en un reservorio del que se retira mediante un sistema dosificador&#44; o bien est&#225; precargado en alv&#233;olos&#46; Los m&#225;s modernos disponen de algunas mejoras tecnol&#243;gicas&#44; entre otras&#44; detectan si el paciente inhal&#243; la dosis &#40;Nexthaler<span class="elsevierStyleSup">&#174;</span>&#41;&#44; se bloquean tras la &#250;ltima dosis administrada &#40;Genuair<span class="elsevierStyleSup">&#174;</span>&#41;&#44; la carga se realiza con solo abrir el dispositivo &#40;Spiromax<span class="elsevierStyleSup">&#174;</span>&#44; Nexthaler<span class="elsevierStyleSup">&#174;</span>&#44; Ellipta<span class="elsevierStyleSup">&#174;</span>&#44; Twisthaler<span class="elsevierStyleSup">&#174;</span>&#41; o al accionar un pulsador &#40;Easyhaler<span class="elsevierStyleSup">&#174;</span>&#44; Genuair<span class="elsevierStyleSup">&#174;</span>&#41;&#44; tienen retroinformaci&#243;n <span class="elsevierStyleItalic">&#40;feedback&#41;</span> visual y auditiva tras la inhalaci&#243;n &#40;Nexthaler<span class="elsevierStyleSup">&#174;</span> y Genuair<span class="elsevierStyleSup">&#174;</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">15</span></a>&#46; Pueden ser los preferidos por algunos pacientes<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">23</span></a> &#40;ver el apartado &#171;Educaci&#243;n y adiestramiento de las t&#233;cnicas de inhalaci&#243;n&#187; de esta revisi&#243;n&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Nebulizadores</span><p id="par0060" class="elsevierStylePara elsevierViewall">Los nebulizadores generan una corriente de part&#237;culas de aerosol a partir de una soluci&#243;n en fase l&#237;quida&#46; El aerosol se forma por la atomizaci&#243;n de un l&#237;quido tras aplicarle determinada energ&#237;a &#40;gaseosa&#44; el&#233;ctrica&#44; etc&#46;&#41;<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">15&#44;24</span></a>&#46; Su principal ventaja reside en que no requieren la colaboraci&#243;n del enfermo y permiten administrar diferentes f&#225;rmacos y combinaciones&#44; de ah&#237; que han tenido un profuso uso en la medicina de urgencias&#46; Entre sus inconvenientes&#44; que precisan tiempos prolongados de tratamiento y constituyen una fuente potencial de contaminaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">9&#44;13</span></a>&#46; Tipos&#58; <span class="elsevierStyleItalic">neum&#225;ticos</span> o <span class="elsevierStyleItalic">jet</span>&#44; el aerosol se genera al proyectar un gas a alta presi&#243;n sobre la soluci&#243;n&#59; <span class="elsevierStyleItalic">ultras&#243;nicos</span>&#44; mediante un cristal piezoel&#233;ctrico que convierte la energ&#237;a el&#233;ctrica en ondas ultras&#243;nicas de alta frecuencia &#40;superiores a 1<span class="elsevierStyleHsp" style=""></span>MHz&#41;&#59; y de <span class="elsevierStyleItalic">malla fija o vibrante</span>&#44; en los que la salida del aerosol se realiza a trav&#233;s de una malla con orificios de grosor predeterminado<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">25</span></a>&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Tratamiento inhalado del asma del adulto</span><p id="par0065" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los f&#225;rmacos a emplear utilizan la v&#237;a inhalatoria&#44; quedando en la actualidad circunscritas tanto la v&#237;a oral &#40;administraci&#243;n de glucocorticoides en la exacerbaci&#243;n&#41; como la subcut&#225;nea &#40;omalizumab en el asma al&#233;rgica grave no controlada&#44; salbutamol en la exacerbaci&#243;n con riesgo vital&#41; a indicaciones muy espec&#237;ficas&#44; y pr&#225;cticamente relegada la v&#237;a intravenosa&#46;</p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Tratamiento de mantenimiento</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los f&#225;rmacos empleados en el tratamiento de mantenimiento del asma se aglutinan en 2 grandes grupos&#58; medicamentos de control y medicamentos de alivio &#40;o &#171;de rescate&#187;&#41;&#46; Los de control&#44; que deben administrarse a diario durante per&#237;odos prolongados&#44; incluyen glucocorticoides inhalados &#40;GCI&#41; o sist&#233;micos&#44; antagonistas de los receptores de los leucotrienos &#40;ARLT&#41;&#44; <span class="elsevierStyleItalic">long-acting &#946;</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">agonists</span> &#40;LABA&#44; &#171;agonistas &#946;<span class="elsevierStyleInf">2</span>adren&#233;rgicos de acci&#243;n larga&#187;&#41;&#44; tiotropio y anticuerpos monoclonales anti-IgE &#40;omalizumab&#41;&#46; Las cromonas y la teofilina de liberaci&#243;n retardada han ca&#237;do en desuso por su menor eficacia&#46; Los medicamentos de alivio se utilizan a demanda para tratar o prevenir la broncoconstricci&#243;n de forma r&#225;pida&#44; y entre ellos se encuentran los <span class="elsevierStyleItalic">short-acting &#946;</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">agonists</span> &#40;SABA&#44; &#171;agonistas &#946;<span class="elsevierStyleInf">2</span>adren&#233;rgicos de acci&#243;n corta&#187;&#41; inhalados &#40;salbutamol o terbutalina&#41; y los anticolin&#233;rgicos inhalados de acci&#243;n corta &#40;bromuro de ipratropio&#41;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El tratamiento se ajusta en cada visita&#44; con el objeto de que el paciente est&#233; siempre controlado&#46; Tras comprobar que el enfermo entiende y sigue las conductas de evitaci&#243;n de desencadenantes espec&#237;ficos &#40;al&#233;rgenos&#41; y no espec&#237;ficos &#40;tabaquismo&#41;&#44; su correcta adhesi&#243;n al tratamiento y la t&#233;cnica de inhalaci&#243;n apropiada de los inhaladores que est&#225; utilizando&#44; se incrementar&#225; el tratamiento farmacol&#243;gico de mantenimiento si su asma no estuviese bien controlada&#44; o&#44; por el contrario&#44; se descender&#225; si hubiera estado bien controlada por lo menos en los 3 meses previos a la visita<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los tratamientos inhalados de elecci&#243;n recomendados en la &#250;ltima edici&#243;n de la Gu&#237;a Espa&#241;ola para el Manejo del Asma &#40;GEMA 4&#46;0&#41;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a> se distribuyen en los 6 escalones que muestra la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; y los f&#225;rmacos e inhaladores comercializados en nuestro &#225;mbito &#40;en julio de 2015&#41; se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Brevemente&#58;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 1&#46;</span> SABA inhalados &#40;salbutamol o terbutalina&#41; a demanda ante s&#237;ntomas aislados de asma&#46; Los SABA inhalados administrados unos 10-15 min antes del ejercicio f&#237;sico son los medicamentos de elecci&#243;n para prevenir la broncoconstricci&#243;n inducida por ejercicio<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 2&#46;</span> GCI &#40;beclometasona&#44; budes&#243;nida&#44; ciclesonida&#44; fluticasona o mometasona&#41; a dosis bajas y administrado diariamente&#46; La dosis habitual oscila entre 200 y 400<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;d&#237;a de budesonida o equivalente<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">28</span></a>&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran las dosis equipotentes de los GCI recomendados<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">10&#44;11</span></a>&#46; Los GCI constituyen el tratamiento de mantenimiento para el asma persistente m&#225;s efectivo tanto para controlar los s&#237;ntomas diarios como para prevenir exacerbaciones<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">29&#44;30</span></a>&#46; En este escal&#243;n de asma leve la adici&#243;n de un LABA a un GCI no aporta un beneficio relevante<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">31</span></a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 3&#46;</span> GCI a dosis bajas &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; junto con un LABA &#40;salmeterol o formoterol o vilanterol&#41; inhalados<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">32&#44;33</span></a>&#44; que preferiblemente se administran en un solo dispositivo&#46; Las combinaciones comercializadas en Espa&#241;a &#40;en 2015&#41; son&#58; fluticasona propionato con salmeterol&#44; budes&#243;nida con formoterol&#44; beclometasona con formoterol&#44; fluticasona propionato con formoterol&#44; y fluticasona furoato con vilanterol&#46; Los LABA nunca deben utilizarse en monoterapia&#46; Formoterol es un LABA pero de inicio r&#225;pido&#44; que combinado a dosis bajas de un GCI &#40;budes&#243;nida o beclometasona&#41; en un solo inhalador puede utilizarse tanto como tratamiento de mantenimiento como de alivio &#40;estrategia conocida como MART&#44; del ingl&#233;s <span class="elsevierStyleItalic">maintenance and rescue therapy</span>&#41; en pacientes con asma persistente moderada o grave &#40;escalones 3 a 6&#41;<a class="elsevierStyleCrossRefs" href="#bib0465"><span class="elsevierStyleSup">34&#44;35</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 4&#46;</span> GCI a dosis medias &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; junto con un LABA<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">32&#44;36</span></a>&#44; administrados en un solo inhalador&#46; Como alternativa puede considerarse la combinaci&#243;n de un GCI a dosis medias&#44; junto con un ARLT&#59; no obstante&#44; la adici&#243;n de un LABA a un GCI proporciona mejores resultados<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">37</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 5&#46;</span> GCI a dosis altas &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; junto con un LABA<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">32&#44;36</span></a>&#44; administrados en un solo inhalador&#46; En pacientes insuficientemente controlados con la anterior combinaci&#243;n y que tengan una obstrucci&#243;n cr&#243;nica del flujo a&#233;reo se puede considerar la adici&#243;n de tiotropio inhalado<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">38&#44;39</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Escal&#243;n 6&#46;</span> No se recomiendan otros tratamientos inhalados espec&#237;ficos para los pacientes no controlados con los f&#225;rmacos recomendados en el escal&#243;n anterior&#46; En este supuesto se emplear&#225;n otras alternativas terap&#233;uticas&#44; como omalizumab subcut&#225;neo&#44; teofilina oral&#44; termoplastia endobronquial y glucocorticoides parenterales<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">10&#44;11&#44;40</span></a>&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Tratamiento de la exacerbaci&#243;n</span><p id="par0115" class="elsevierStylePara elsevierViewall">Seg&#250;n la gravedad de la exacerbaci&#243;n asm&#225;tica establecida de forma objetiva mediante pruebas de funci&#243;n pulmonar que determinen el grado de obstrucci&#243;n &#40;espirometr&#237;a o flujo espiratorio m&#225;ximo&#41;&#44; las exacerbaciones se clasifican en leves&#44; moderadas-graves o muy graves con riesgo vital y parada cardiorrespiratoria inminente<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">11&#44;41</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; La v&#237;a inhalada es la de elecci&#243;n para administrar el tratamiento en los 2 primeros supuestos&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Leve&#46;</span> Los SABA &#40;salbutamol o terbutalina&#41; &#40;ver dosis en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#41; son los f&#225;rmacos de primera elecci&#243;n&#44; administrados preferiblemente con c&#225;mara de inhalaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">42</span></a>&#46; Se a&#241;adir&#225;n glucocorticoides sist&#233;micos &#40;por v&#237;a oral&#44; preferiblemente&#41; si&#58; no se consigue una reversi&#243;n de la obstrucci&#243;n bronquial con SABA inhalados&#59; el paciente ya estaba tomando glucocorticoides orales&#59; se han probado otras opciones terap&#233;uticas sin respuesta cl&#237;nica favorable&#59; o existen antecedentes de exacerbaciones graves<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">11&#44;43</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Moderada-grave&#46;</span> La administraci&#243;n de salbutamol y bromuro de ipratropio &#40;dosis en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#41;&#44; que se pueden combinar en la misma nebulizaci&#243;n&#44; se asocia a un incremento de la funci&#243;n pulmonar y a un descenso de las hospitalizaciones<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">44</span></a>&#46; Los glucocorticoides sist&#233;micos&#44; administrados precozmente &#40;en la primera hora&#41; y preferiblemente por v&#237;a oral &#40;dosis en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#41;&#44; aceleran la resoluci&#243;n de la crisis y evitan las recidivas<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">45</span></a>&#46; El uso precoz y solo durante las 2 primeras horas de dosis elevadas de GCI &#40;dosis en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#41; reduce los ingresos hospitalarios<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">45</span></a>&#46; El sulfato de magnesio&#44; inhalado u oral&#44; en casos muy graves y sin respuesta al tratamiento anterior&#44; reduce la necesidad de hospitalizaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">46</span></a>&#46; El heliox &#40;mezcla de ox&#237;geno y helio&#41; puede utilizarse para administrar medicaci&#243;n nebulizada<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">47</span></a>&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Aspectos pr&#225;cticos</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Prescripci&#243;n del inhalador y preferencias de los pacientes</span><p id="par0130" class="elsevierStylePara elsevierViewall">Diversos elementos pueden ser decisivos en la elecci&#243;n de un inhalador en el momento de la prescripci&#243;n&#46; En la <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a> se propone una aproximaci&#243;n racional&#44; que combina algunos de ellos&#44; para ayudar en la toma de la decisi&#243;n<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">48</span></a>&#46; Sin embargo&#44; la adhesi&#243;n al tratamiento y el control del asma es mayor cuando la prescripci&#243;n del inhalador se establece de forma compartida entre el paciente y su m&#233;dico<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">49</span></a>&#46; Diversos estudios han mostrado que los dispositivos con t&#233;cnicas de inhalaci&#243;n f&#225;ciles&#44; con pocos pasos&#44; son los preferidos por los enfermos<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">50&#8211;52</span></a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Educaci&#243;n y adiestramiento de las t&#233;cnicas de inhalaci&#243;n</span><p id="par0135" class="elsevierStylePara elsevierViewall">El principal inconveniente de los inhaladores es que se debe ense&#241;ar a los pacientes a utilizarlos<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">3&#44;53</span></a>&#44; por lo que constituye uno de los elementos esenciales de los programas de educaci&#243;n de asma<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">10&#44;11</span></a>&#44; que adem&#225;s debe ser supervisada peri&#243;dicamente<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">54</span></a>&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> se expone un propuesta<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">55</span></a> con los pasos a seguir en la visita inicial y en las de seguimiento&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Adhesi&#243;n a los inhaladores</span><p id="par0140" class="elsevierStylePara elsevierViewall">Una baja adhesi&#243;n a los inhaladores se asocia a un peor control del asma<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">56</span></a>&#44; por lo que incrementar el cumplimiento terap&#233;utico es un aspecto clave&#46; Ello pasa por&#44; en primer lugar&#44; establecer el nivel de adhesi&#243;n&#44; y en segundo&#44; iniciar una acci&#243;n terap&#233;utica espec&#237;fica&#46; La simple anamnesis la sobrestima&#44; por lo que se recomienda emplear la informaci&#243;n obtenida tras la retirada de los f&#225;rmacos en la farmacia &#40;habitualmente en bases de datos electr&#243;nicos&#41; y&#47;o cuestionarios estandarizados cumplimentados por el propio paciente<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">10&#44;11</span></a>&#46; Recientemente se ha desarrollado un nuevo cuestionario espec&#237;ficamente dise&#241;ado para evaluar la adhesi&#243;n de los pacientes con asma o con EPOC a los inhaladores&#44; el Test de Adhesi&#243;n a los Inhaladores &#40;TAI&#41;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">57</span></a>&#46; Este permite identificar al paciente con baja adherencia&#44; establecer su intensidad &#40;buena&#44; intermedia o mala&#41; y orientar el tipo o patr&#243;n de incumplimiento &#40;err&#225;tico&#44; deliberado o inconsciente&#41;&#46; La adhesi&#243;n terap&#233;utica mejora al establecer pautas f&#225;ciles&#44; incorporar la opini&#243;n del paciente en la prescripci&#243;n del inhalador&#44; administrar un programa de educaci&#243;n y utilizar acciones espec&#237;ficas para los patrones de incumplimiento&#44; por ejemplo&#44; entrevista motivacional en el incumplidor &#171;deliberado&#187;<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">58</span></a> y recordatorios electr&#243;nicos o telemedicina en el &#171;err&#225;tico&#187;<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">59</span></a>&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusiones</span><p id="par0145" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0150" class="elsevierStylePara elsevierViewall">La v&#237;a inhalada es la de elecci&#243;n para el tratamiento del asma&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0155" class="elsevierStylePara elsevierViewall">El tratamiento de mantenimiento del asma persistente leve &#40;escal&#243;n 2&#41; es un GCI a dosis bajas&#59; el del asma persistente moderada &#40;escalones 3 y 4&#41;&#44; la combinaci&#243;n de un GCI a dosis bajas o medias con un LABA inhalados&#59; y el del asma persistente grave &#40;escalones 5 y 6&#41;&#44; un GCI a dosis altas en combinaci&#243;n con un LABA&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0160" class="elsevierStylePara elsevierViewall">En las crisis asm&#225;ticas se recomienda el tratamiento con SABA inhalados&#46; En las m&#225;s graves se a&#241;adir&#225; bromuro de ipratropio inhalado&#44; GCI y glucocorticoides parenterales &#40;orales&#44; preferiblemente&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Debe adiestrarse a los pacientes en la t&#233;cnica de inhalaci&#243;n&#46; Sus preferencias se deben considerar en la elecci&#243;n del inhalador&#46; Se debe establecer la adhesi&#243;n a los inhaladores &#40;entre otros&#44; mediante el cuestionario TAI&#41; e iniciar una acci&#243;n terap&#233;utica espec&#237;fica&#46;</p></li></ul></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres614978"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec628656"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres614977"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec628655"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conceptos y fundamentos te&#243;ricos de los aerosoles"
        ]
        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Dispositivos"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Cartuchos presurizados de dosis medida"
            ]
            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "C&#225;maras de inhalaci&#243;n o espaciadores"
            ]
            2 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Dispositivos de polvo inhalado"
            ]
            3 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Nebulizadores"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Tratamiento inhalado del asma del adulto"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Tratamiento de mantenimiento"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Tratamiento de la exacerbaci&#243;n"
            ]
          ]
        ]
        8 => array:3 [
          "identificador" => "sec0055"
          "titulo" => "Aspectos pr&#225;cticos"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Prescripci&#243;n del inhalador y preferencias de los pacientes"
            ]
            1 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Educaci&#243;n y adiestramiento de las t&#233;cnicas de inhalaci&#243;n"
            ]
            2 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Adhesi&#243;n a los inhaladores"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conclusiones"
        ]
        10 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conflicto de intereses"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-09-03"
    "fechaAceptado" => "2015-09-30"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec628656"
          "palabras" => array:2 [
            0 => "Asma"
            1 => "F&#225;rmacos aerosolizados"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec628655"
          "palabras" => array:2 [
            0 => "Asthma"
            1 => "Aerosolized drugs"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La administraci&#243;n de f&#225;rmacos aerosolizados mediante la v&#237;a inhalada&#44; dadas sus ventajas&#44; constituye la v&#237;a de administraci&#243;n de elecci&#243;n para el tratamiento del asma y de la EPOC&#46; El desarrollo tecnol&#243;gico experimentado en las &#250;ltimas d&#233;cadas ha propiciado la aparici&#243;n de m&#250;ltiples inhaladores y f&#225;rmacos aerosolizables&#46; Tal variedad obliga al facultativo que los debe prescribir a conocerlos en profundidad&#46; La presente revisi&#243;n tiene como principal objetivo resumir el estado actual del conocimiento sobre inhaladores y f&#225;rmacos inhalados habitualmente empleados en el tratamiento de mantenimiento y de la exacerbaci&#243;n del asma&#46; El texto aborda desde aspectos te&#243;ricos &#40;fundamentos&#44; dispositivos y f&#225;rmacos disponibles&#41;&#44; a otros m&#225;s pr&#225;cticos y de relevancia en la asistencia cl&#237;nica diaria del asma &#40;pautas terap&#233;uticas&#44; educaci&#243;n y adhesi&#243;n a los inhaladores&#41;&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Because of its advantages&#44; inhaled administration of aerosolized drugs is the administration route of choice for the treatment of asthma and COPD&#46; Numerous technological advances in the devices used in inhaled therapy in recent decades have boosted the appearance of multiple inhalers and aerosolized drugs&#46; However&#44; this variety also requires that the prescribing physician is aware of their characteristics&#46; The main objective of the present review is to summarize the current state of knowledge on inhalers and inhaled drugs commonly used in the treatment of asthma&#46; The review ranges from theoretical aspects &#40;fundamentals and available devices and drugs&#41; to practical and relevant aspects for asthma care in the clinical setting &#40;therapeutic strategies&#44; education&#44; and adherence to inhalers&#41;&#46;</p></span>"
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2035
            "Ancho" => 3198
            "Tamanyo" => 463745
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Escalones terap&#233;uticos del tratamiento de mantenimiento del asma del adulto&#46;</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">ARLT&#58; antagonistas de los receptores de los leucotrienos&#59; GCI&#58; glucocorticoide inhalado&#59; LABA&#58; <span class="elsevierStyleItalic">long-acting &#946;<span class="elsevierStyleInf">2</span> agonists</span> &#40;&#171;agonista &#946;<span class="elsevierStyleInf">2</span> adren&#233;rgico de acci&#243;n larga&#187;&#41;&#46;</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Fuente&#58; tomada de Gu&#237;a Espa&#241;ola para el Manejo del Asma &#40;GEMA&#41; 4&#46;0<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a>&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2491
            "Ancho" => 3143
            "Tamanyo" => 719553
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Evaluaci&#243;n diagn&#243;stica y tratamiento de la exacerbaci&#243;n asm&#225;tica del adulto&#46;</p> <p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fuente&#58; tomada de la Gu&#237;a Espa&#241;ola para el Manejo del Asma &#40;GEMA&#41; 4&#46;0<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a>&#46;y Rodrigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">41</span></a>&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1480
            "Ancho" => 2711
            "Tamanyo" => 227778
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Esquema de ayuda para la elecci&#243;n del inhalador&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">C&#225;mara inh&#58; c&#225;mara de inhalaci&#243;n&#59; DPI&#58; <span class="elsevierStyleItalic">dry powder inhaler</span> &#40;&#171;inhalador de polvo&#187;&#41;&#59; pMDI&#58; <span class="elsevierStyleItalic">pressurized metered-dose inhaler</span> &#40;&#171;cartucho presurizado de dosis medida&#187;&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#42; El profesional sanitario implicar&#225; al paciente&#44; seg&#250;n sus preferencias&#44; en la elecci&#243;n final del dispositivo&#44; entre los recomendados en dicho grupo&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Fuente&#58; basada en parte en Broeders et al&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">48</span></a>&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Fuente&#58; actualizaci&#243;n del Consenso SEPAR-ALAT sobre terapia inhalada<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46;"
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">DMMA&#58; di&#225;metro de la mediana de la masa aerodin&#225;mica&#59; DPI&#58; <span class="elsevierStyleItalic">dry powder inhaler</span> &#40;&#171;inhalador de polvo&#187;&#41;&#59; pMDI&#58; <span class="elsevierStyleItalic">pressurized metered-dose inhaler</span> &#40;&#171;inhalador presurizado de dosis medida&#187;&#41;&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La comparaci&#243;n de los valores mostrados entre los diferentes dispositivos debe ser tomada con cautela&#44; dados los diferentes m&#233;todos y f&#225;rmacos empleados en su determinaci&#243;n&#44; y en los estudios en humanos&#44; por haberse realizado en diversas condiciones cl&#237;nicas &#40;sanos y enfermos con diferentes procesos y niveles de gravedad&#41;&#44; flujos inspiratorios y edades&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col">Dep&#243;sito pulmonar <span class="elsevierStyleSmallCaps">&#40;&#37;&#41;</span></th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col">Dep&#243;sito orofar&#237;ngeo <span class="elsevierStyleSmallCaps">&#40;&#37;&#41;</span></th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleSmallCaps">DMMA &#40;</span>&#956;m&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">In vivo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">In vitro</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">In vivo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">In vitro</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">pMDI</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pMDI convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;8-34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#44;9-82&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4-8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pMDI convencional<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>c&#225;mara inhalaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;2-68&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2-3&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>pMDI autodisparo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Modulite<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31-34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33-58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1-2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alvesco<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respimat<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40-53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;3-39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">DPI &#40;por orden alfab&#233;tico&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Accuhaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12-37&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15-30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aerolizer<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13-28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#44;7-28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;9-7&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Breezhaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Easyhaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;5-31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Genuair<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;1-34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;7-61&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Handihaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18-22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;3-22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inhalator Ingelheim<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nexthaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;4-1&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Spinhaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Spiromax<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;92-2&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Turbuhaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;2-38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53-71&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;3 69&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7-5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Twisthaler<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36-37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2-2&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1006908.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Dep&#243;sitos y di&#225;metro de la mediana de la masa aerodin&#225;mica de los aerosoles proporcionados por los inhaladores</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Fuente&#58; tomada de la Gu&#237;a Espa&#241;ola para el Manejo del Asma &#40;GEMA&#41; 4&#46;0<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">11</span></a>&#46;"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dosis baja &#40;&#956;g&#47;d&#237;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dosis media &#40;&#956;g&#47;d&#237;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dosis alta &#40;&#956;g&#47;d&#237;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beclometasona dipropionato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200-500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">501-1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;001-2&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Beclometasona extrafina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100-200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">201-400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;<span class="elsevierStyleHsp" style=""></span>400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Budes&#243;nida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200-400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">401-800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">801-1&#46;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ciclesonida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80-160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161-320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">321-1&#46;280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fluticasona propionato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100-250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251-500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">501-1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fluticasona furoato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mometasona furoato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100-200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">201-400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">401-800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1006909.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Dosis equipotentes de los glucocorticoides inhalados ordenados por orden alfab&#233;tico</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Fuente&#58; actualizaci&#243;n del Consenso SEPAR-ALAT sobre terapia inhalada<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">9</span></a>&#46;"
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">DPI&#58; <span class="elsevierStyleItalic">dry powder inhaler</span> &#40;&#171;inhalador de polvo&#187;&#41;&#59; GCI&#58; glucocorticoide inhalado&#59; INF&#58; inhalador de niebla fina&#59; LABA&#58; <span class="elsevierStyleItalic">long-acting &#946;</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">agonists</span> &#40;&#171;agonista &#946;<span class="elsevierStyleInf">2</span> adren&#233;rgico de acci&#243;n larga&#187;&#41;&#59; LAMA&#58; <span class="elsevierStyleItalic">long-acting muscarinic antagonists</span> &#40;&#171;antimuscar&#237;nico de acci&#243;n larga&#187;&#59; pMDI&#58; <span class="elsevierStyleItalic">pressurized metered-dose inhaler</span> &#40;&#171;inhalador presurizado de dosis medida&#187;&#41;&#59; SABA&#58; <span class="elsevierStyleItalic">short-acting &#946;</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">agonists</span> &#40;&#171;agonista &#946;<span class="elsevierStyleInf">2</span> adren&#233;rgico de acci&#243;n corta&#187;&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#956;g&#47;n&#46;<span class="elsevierStyleSup">o</span> dosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">SABA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Salbutamol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ventolin<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Salbutamol Aldo-Uni&#243;n<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Salbutamol Sandoz<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ventilastin &#40;DPI&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ventoaldo<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Terbutalina</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Terbasmin<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">500&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">LABA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Foradil<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Oxis<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5&#47;60&#59; 9&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Broncoral<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#47;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Broncoral<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Neblik<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Formoterol Stada<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Formoterol Aldo-Uni&#243;n<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Salmeterol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Serevent<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Betamican<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inaspir<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Beglan<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Indacaterol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ombrez<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Oslif<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hirobriz<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Olodaterol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Striverdi<span class="elsevierStyleSup">&#174;</span> &#40;INF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Glucocorticoide inhalado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Budesonida</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pulmicort<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">400&#47;120&#59; 200&#47;100&#59; 100&#47;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pulmictan<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#47;120&#59; 100&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Olfex Bucal<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#47;200&#59; 50&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Budesonida Aldo-Uni&#243;n<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#47;100&#59; 200&#47;200&#59; 50&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ribujet<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Budesonida Easyhaler<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#47;200&#59; 200&#47;200&#59; 400&#47;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Miflonide<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#59; 400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Novopulm<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#47;200&#59; 400&#47;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fluticasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Flixotide<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;120&#59; 50&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inalacor<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;120&#59; 50&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Trialona<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;120&#59; 50&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Flusonal<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;120&#59; 50&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Beclometasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Beclo-asma<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;200&#59; 50&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Becotide<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Becloforte<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Mometasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Asmanex<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">400&#47;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ciclesonida</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Alvesco<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#47;120&#59; 160&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Glucocorticoide</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">LABA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">budesonida</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Symbicort<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;5&#47;120&#59; 160<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;5&#47;120&#59; 320<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>9&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Rilast<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;5&#47;120&#59; 160<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;5&#47;120&#59; 320<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>9&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Bufomix<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;57120&#59; 320<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>9&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Duoresp<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4&#44;57120&#59; 320<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>9&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Salmeterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">fluticasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Seretide<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>125&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>250&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Brisair<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>125&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>250&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Plusvent<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>125&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>250&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anasma<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>125&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>250&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inaladuo<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>125&#47;120&#59; 25<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>250&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">beclometasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Foster<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Formodual<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#44; DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>6&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">fluticasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Flutiform<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5&#47;120&#59; 125<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>5&#47;120&#59; 250<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>10&#47;1205&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Vilanterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">fluticasona furoato</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Relvar<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>22&#47;30&#59; 184<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>22&#47;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Glucocorticoide inhalado</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">SABA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Salbutamol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">beclometasona</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Butosol<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>50&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Anticolin&#233;rgicos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Ipratropio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Atrovent<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Atroaldo<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#47;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tiotropio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Spiriva<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Spiriva<span class="elsevierStyleSup">&#174;</span> &#40;INF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;5&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Bromuro aclidinio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Eklira<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">322&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Bretaris<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">322&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Bromuro glicopirronio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Seebri<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Enurev<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tovanor<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Umeclidinio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Incruse<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#47;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Cromonas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Nedocromil s&#243;dico</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tilad<span class="elsevierStyleSup">&#174;</span> &#40;pMDI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<span class="elsevierStyleHsp" style=""></span>mg&#47;112&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Glucocorticoide inhalado</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">SAMA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">ipratropio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Berodual<span class="elsevierStyleSup">&#174;</span> HFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#43;20&#47;120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">LABA</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">LAMA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Indacaterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">glicopirronio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ultibro<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#47;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ulunar<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#47;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Xoterna<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#47;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Vilanterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">umeclidinio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anoro<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&#47;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Formoterol</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#43;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">aclidinio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Duaklir Genuair<span class="elsevierStyleSup">&#174;</span> &#40;DPI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>340&#47;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1006910.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">F&#225;rmacos inhalados para el tratamiento del asma o de la enfermedad pulmonar obstructiva cr&#243;nica comercializados en Espa&#241;a en 2015</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Fuente&#58; Horne<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">56</span></a>&#46;"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Visita inicial</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Realizar la sesi&#243;n personalmente o delegarla en otro profesional sanitario con entrenamiento espec&#237;fico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Explicar verbalmente la maniobra de inhalaci&#243;n y las razones de cada uno de los pasos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Demostrar pr&#225;cticamente la maniobra&#44; describiendo cada paso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetir la demostraci&#243;n sin explicaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetir de nuevo la demostraci&#243;n con comentarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pedir al paciente que haga una demostraci&#243;n de la maniobra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Explicar los defectos observados en la t&#233;cnica del paciente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetir la demostraci&#243;n y pedir al enfermo que repita la maniobra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Citar al paciente para un futuro nuevo control de la t&#233;cnica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Visita de seguimiento</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Realizar la sesi&#243;n personalmente o delegarla en un profesional sanitario con entrenamiento espec&#237;fico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pedir al paciente que haga una demostraci&#243;n de la maniobra &#40;sin explicaciones&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Explicar los defectos observados en la t&#233;cnica del enfermo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Demostrar pr&#225;cticamente la maniobra&#44; describiendo cada paso&#44; poniendo especial &#233;nfasis en los defectos observados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetir la demostraci&#243;n sin explicaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetir de nuevo la demostraci&#243;n con comentarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Citar al paciente para un futuro nuevo control de la t&#233;cnica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1006911.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Pasos recomendados para la educaci&#243;n-instrucci&#243;n del paciente en la correcta t&#233;cnica de inhalaci&#243;n del dispositivo&#44; en la visita inicial y en las de seguimiento</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:59 [
            0 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use and misuse of metered-dose inhalers by patients with chronic lung disease&#46; A controlled&#44; randomized trial of two instruction methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; De Blaquiere"
                            1 => "D&#46;B&#46; Christensen"
                            2 => "W&#46;B&#46; Carter"
                            3 => "T&#46;R&#46; Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/140.4.910"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1989"
                        "volumen" => "140"
                        "paginaInicial" => "910"
                        "paginaFinal" => "916"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2679269"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of handling of inhaler devices in real life&#58; An observational study in 3811 patients in primary care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Molimard"
                            1 => "C&#46; Raherison"
                            2 => "S&#46; Lignot"
                            3 => "F&#46; Depont"
                            4 => "A&#46; Abouelfath"
                            5 => "N&#46; Moore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/089426803769017613"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Aerosol Med"
                        "fecha" => "2003"
                        "volumen" => "16"
                        "paginaInicial" => "249"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14572322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical personnel and patient skill in the use of metered dose inhalers&#58; A multicentric study&#46; CESEA Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Plaza"
                            1 => "J&#46; Sanchis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "1998"
                        "volumen" => "65"
                        "paginaInicial" => "195"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9670301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Giraud"
                            1 => "N&#46; Roche"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "246"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11866004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhaler mishandling is very common in patients with chronic airflow obstruction and long-term home nebuliser use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;S&#46; Melani"
                            1 => "P&#46; Canessa"
                            2 => "I&#46; Coloretti"
                            3 => "G&#46; DeAngelis"
                            4 => "R&#46; DeTullio"
                            5 => "M&#46; del Donno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2011.11.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2012"
                        "volumen" => "106"
                        "paginaInicial" => "668"
                        "paginaFinal" => "676"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22277996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physicians&#8217; knowledge of inhaler devices and inhalation techniques remains poor in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Plaza"
                            1 => "J&#46; Sanchis"
                            2 => "P&#46; Roura"
                            3 => "J&#46; Molina"
                            4 => "M&#46; Calle"
                            5 => "S&#46; Quirce"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jamp.2011.0895"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Aerosol Med Pulm Drug Deliv"
                        "fecha" => "2012"
                        "volumen" => "25"
                        "paginaInicial" => "16"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22047451"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442214701140"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Knowledge and attitudes of nurses in Spain about inhaled therapy&#58; Results of a National Survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Giner"
                            1 => "P&#46; Roura"
                            2 => "C&#46; Hern&#225;ndez"
                            3 => "M&#46; Torrej&#243;n"
                            4 => "M&#46; Peir&#243;"
                            5 => "M&#46;J&#46; Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "J Aerosol Med Pulm Drug Deliv"
                        "fecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What the pulmonary specialist should know about the new inhalation therapies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;L&#46; Laube"
                            1 => "H&#46;M&#46; Janssens"
                            2 => "F&#46;H&#46;C&#46; de Jongh"
                            3 => "S&#46;G&#46; Devadason"
                            4 => "R&#46; Dhand"
                            5 => "P&#46; Diot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00166410"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "1308"
                        "paginaFinal" => "1331"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21310878"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consenso SEPAR-ALAT sobre terapia inhalada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Giner"
                            1 => "V&#46; Plaza"
                            2 => "A&#46; Lopez-Vi&#241;a"
                            3 => "G&#46;J&#46; Rodrigo"
                            4 => "H&#46; Neffen"
                            5 => "P&#46; Casan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2013"
                        "volumen" => "49"
                        "numero" => "Supl 1"
                        "paginaInicial" => "2"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23967487"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Initiative for Asthma &#40;GINA&#41;&#46; Global strategy for asthma management and prevention&#46; 2015&#46; &#91;consultado 26 Nov 2015&#93;&#46; Disponible en&#58; www&#46;ginasthma&#46;com"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Gu&#237;a Espa&#241;ola para el Manejo del Asma &#40;GEMA&#41; 4&#46;0&#46; Arch Bronconeumol&#46; 2015&#59; 51&#40;Supl 1&#41;&#58;1-68&#46; Disponible en&#58; www&#46;gemasma&#46;com"
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aerosol deposition considerations in inhalation therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;P&#46; Newman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1985"
                        "volumen" => "88"
                        "numero" => "2 Suppl"
                        "paginaInicial" => "152S"
                        "paginaFinal" => "160S"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3893925"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aerosol drug delivery&#58; Developments in device design and clinical use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;B&#46; Dolovich"
                            1 => "R&#46; Dhand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(10)60926-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2011"
                        "volumen" => "377"
                        "paginaInicial" => "1032"
                        "paginaFinal" => "1045"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21036392"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caracter&#237;sticas f&#237;sicas y dep&#243;sito pulmonar de las part&#237;culas inhaladas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Olagu&#237;bel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Dispositivos para la inhalaci&#243;n de f&#225;rmacos&#46; Lo esencial"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sistemas de inhalaci&#243;n&#46; Caracter&#237;sticas y manejo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46; Bustamante"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Dispositivos para la inhalaci&#243;n de f&#225;rmacos&#46; Lo esencial"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Withdrawal of albuterol inhalers containing chlorofluorocarbon propellants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Hendeles"
                            1 => "G&#46;L&#46; Colice"
                            2 => "R&#46;J&#46; Meyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMra050380"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2007"
                        "volumen" => "356"
                        "paginaInicial" => "1344"
                        "paginaFinal" => "1351"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17392304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung penetration and patient adherence considerations in the management of asthma&#58; Role of extra-fine formulations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Scichilone"
                            1 => "M&#46; Spatafora"
                            2 => "S&#46; Battaglia"
                            3 => "R&#46; Arrigo"
                            4 => "A&#46; Benfante"
                            5 => "V&#46; Bellia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/JAA.S14743"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma Allergy"
                        "fecha" => "2013"
                        "volumen" => "6"
                        "paginaInicial" => "11"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23378776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new method to evaluate plume characteristics of hydrofluoroalkane and chlorofluorocarbon metered dose inhalers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;J&#46; Gabrio"
                            1 => "S&#46;W&#46; Stein"
                            2 => "D&#46;J&#46; Velasquez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Pharm"
                        "fecha" => "1999"
                        "volumen" => "186"
                        "paginaInicial" => "3"
                        "paginaFinal" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10469919"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;P&#46; Newman"
                            1 => "A&#46;W&#46; Weisz"
                            2 => "N&#46; Talaee"
                            3 => "S&#46;W&#46; Clarke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1991"
                        "volumen" => "46"
                        "paginaInicial" => "712"
                        "paginaFinal" => "716"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1750017"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimizing the in vitro performance of Respimat"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Zierenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Aerosol Med"
                        "fecha" => "1999"
                        "volumen" => "12"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S19"
                        "paginaFinal" => "S24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10623337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metered dose inhalers and spacer devices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Terzano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Rev Med Pharmacol Sci"
                        "fecha" => "1999"
                        "volumen" => "3"
                        "paginaInicial" => "159"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11073122"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of the spray velocities from a pressurized metered-dose inhaler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;M&#46; Crosland"
                            1 => "M&#46;R&#46; Johnson"
                            2 => "E&#46;A&#46; Matida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jamp.2008.0687"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Aerosol Med Pulm Drug Deliv"
                        "fecha" => "2009"
                        "volumen" => "22"
                        "paginaInicial" => "85"
                        "paginaFinal" => "97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18956946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient preference in the choice of dry powder inhalers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Giner"
                            1 => "M&#46; Torrej&#243;n"
                            2 => "A&#46; Ramos"
                            3 => "P&#46; Casan"
                            4 => "C&#46; Granel"
                            5 => "V&#46; Plaza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2004"
                        "volumen" => "40"
                        "paginaInicial" => "106"
                        "paginaFinal" => "109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14998473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Device selection and outcomes of aerosol therapy&#58; Evidence-based guidelines&#58; American College of Chest Physicians&#47;American College of Asthma&#44; Allergy&#44; and Immunology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;B&#46; Dolovich"
                            1 => "R&#46;C&#46; Ahrens"
                            2 => "D&#46;R&#46; Hess"
                            3 => "P&#46; Anderson"
                            4 => "R&#46; Dhand"
                            5 => "J&#46;L&#46; Rau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.127.1.335"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "127"
                        "paginaInicial" => "335"
                        "paginaFinal" => "371"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15654001"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative analysis of methods to measure aerosols generated by a vibrating mesh nebulizer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Waldrep"
                            1 => "A&#46; Berlinski"
                            2 => "R&#46; Dhand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jam.2007.0538"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Aerosol Med"
                        "fecha" => "2007"
                        "volumen" => "20"
                        "paginaInicial" => "310"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17894537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0425"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma control can be maintained when fluticasone propionate&#47;salmeterol in a single inhaler is stepped down"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;D&#46; Bateman"
                            1 => "L&#46; Jacques"
                            2 => "C&#46; Goldfrad"
                            3 => "T&#46; Atienza"
                            4 => "T&#46; Mihaescu"
                            5 => "M&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2005.11.036"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2006"
                        "volumen" => "117"
                        "paginaInicial" => "563"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16522454"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0430"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exercise-induced asthma&#58; Diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;A&#46; Tan"
                            1 => "S&#46;L&#46; Spector"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)61948-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2002"
                        "volumen" => "89"
                        "paginaInicial" => "226"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12269641"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0435"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence-based pharmacologic treatment for mild asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;S&#46; Koh"
                            1 => "L&#46;B&#46; Irving"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1742-1241.2007.01410.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Clin Pract"
                        "fecha" => "2007"
                        "volumen" => "61"
                        "paginaInicial" => "1375"
                        "paginaFinal" => "1379"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17590220"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0440"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhaled corticosteroids&#58; Impact on asthma morbidity and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Suissa"
                            1 => "P&#46; Ernst"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mai.2001.115653"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2001"
                        "volumen" => "107"
                        "paginaInicial" => "937"
                        "paginaFinal" => "944"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11398069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0445"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early intervention with budesonide in mild persistent asthma&#58; A randomised&#44; double-blind trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Pauwels"
                            1 => "S&#46; Pedersen"
                            2 => "W&#46;W&#46; Busse"
                            3 => "W&#46;C&#46; Tan"
                            4 => "Y&#46;Z&#46; Chen"
                            5 => "S&#46;V&#46; Ohlsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(03)12891-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2003"
                        "volumen" => "361"
                        "paginaInicial" => "1071"
                        "paginaFinal" => "1076"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12672309"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0450"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low dose inhaled budesonide and formoterol in mild persistent asthma&#58; The OPTIMA randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;M&#46; O&#8217;Byrne"
                            1 => "P&#46;J&#46; Barnes"
                            2 => "R&#46; Rodriguez-Roisin"
                            3 => "E&#46; Runnerstrom"
                            4 => "T&#46; Sandstrom"
                            5 => "K&#46; Svensson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.8.2104102"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "1392"
                        "paginaFinal" => "1397"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11704584"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0455"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of inhaled formoterol and budesonide on exacerbations of asthma"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Formoterol and Corticosteroids Establishing Therapy &#40;FACET&#41; International Study Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Pauwels"
                            1 => "C&#46;G&#46; L&#246;fdahl"
                            2 => "D&#46;S&#46; Postma"
                            3 => "A&#46;E&#46; Tattersfield"
                            4 => "P&#46; O&#8217;Byrne"
                            5 => "P&#46;J&#46; Barnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199711133372001"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1997"
                        "volumen" => "337"
                        "paginaInicial" => "1405"
                        "paginaFinal" => "1411"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9358137"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0460"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Woolcock"
                            1 => "B&#46; Lundback"
                            2 => "N&#46; Ringdal"
                            3 => "L&#46;A&#46; Jacques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.153.5.8630590"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1996"
                        "volumen" => "153"
                        "paginaInicial" => "1481"
                        "paginaFinal" => "1488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8630590"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0465"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Kew KM&#44; Karner C&#44; Mindus SM&#44; Ferrara G&#46; Cochrane Database Syst Rev&#46; 2013&#59;12&#58;CD009019&#46;"
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0470"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Budesonide&#47;formoterol combination therapy as both maintenance and reliever medication in asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;M&#46; O&#8217;Byrne"
                            1 => "H&#46; Bisgaard"
                            2 => "P&#46;P&#46; Godard"
                            3 => "M&#46; Pistolesi"
                            4 => "M&#46; Palmqvist"
                            5 => "Y&#46; Zhu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200407-884OC"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2005"
                        "volumen" => "171"
                        "paginaInicial" => "129"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15502112"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442207701278"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0475"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can guideline-defined asthma control be achieved&#63; The Gaining Optimal Asthma ControL study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;D&#46; Bateman"
                            1 => "H&#46;A&#46; Boushey"
                            2 => "J&#46; Bousquet"
                            3 => "W&#46;W&#46; Busse"
                            4 => "T&#46;J&#46;H&#46; Clark"
                            5 => "R&#46;A&#46; Pauwels"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200401-033OC"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2004"
                        "volumen" => "170"
                        "paginaInicial" => "836"
                        "paginaFinal" => "844"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15256389"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442204009639"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0480"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Montelukast as add-on therapy to inhaled corticosteroids in the treatment of mild to moderate asthma&#58; A systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Joos"
                            1 => "A&#46; Miksch"
                            2 => "J&#46; Szecsenyi"
                            3 => "B&#46; Wieseler"
                            4 => "U&#46; Grouven"
                            5 => "T&#46; Kaiser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2007.081596"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2008"
                        "volumen" => "63"
                        "paginaInicial" => "453"
                        "paginaFinal" => "462"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18443162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0485"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tiotropium in asthma poorly controlled with standard combination therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;A&#46; Kerstjens"
                            1 => "M&#46; Engel"
                            2 => "R&#46; Dahl"
                            3 => "P&#46; Paggiaro"
                            4 => "E&#46; Beck"
                            5 => "M&#46; Vandewalker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1208606"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "367"
                        "paginaInicial" => "1198"
                        "paginaFinal" => "1207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22938706"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0490"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is the role of tiotropium in asthma&#63;&#58; A systematic review with meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;J&#46; Rodrigo"
                            1 => "J&#46;A&#46; Castro-Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.14-1698"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2015"
                        "volumen" => "147"
                        "paginaInicial" => "388"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25322075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0495"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International ERS&#47;ATS guidelines on definition&#44; evaluation and treatment of severe asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;F&#46; Chung"
                            1 => "S&#46;E&#46; Wenzel"
                            2 => "J&#46;L&#46; Brozek"
                            3 => "A&#46; Bush"
                            4 => "M&#46; Castro"
                            5 => "P&#46;J&#46; Sterk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00202013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2014"
                        "volumen" => "43"
                        "paginaInicial" => "343"
                        "paginaFinal" => "373"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24337046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0500"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;ALERTA 2 guidelines&#46; Latin America and Spain&#58; Recommendations for the prevention and treatment of asmatic exacerbations&#46; Spanish Pulmonology and Thoracic Surgery Society &#40;SEPAR&#41;&#46; Asthma Department of the Latinamerican Thoracic Association &#40;ALAT&#41;&#93; Spanish"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "SEPAR&#59; ALAT"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Rodrigo"
                            1 => "V&#46; Plaza Moral"
                            2 => "S&#46;B&#46; Forns"
                            3 => "J&#46;A&#46; Castro-Rodr&#237;guez"
                            4 => "A&#46; de Diego Dami&#225;"
                            5 => "S&#46;L&#46; Cort&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0300-2896(10)70060-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2010"
                        "volumen" => "46"
                        "numero" => "Suppl 7"
                        "paginaInicial" => "2"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21334549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0505"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Holding chambers &#40;spacers&#41; versus nebulisers for beta-agonist treatment of acute asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;J&#46; Cates"
                            1 => "E&#46;J&#46; Welsh"
                            2 => "B&#46;H&#46; Rowe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD000052.pub3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2013"
                        "volumen" => "9"
                        "paginaInicial" => "CD000052"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24037768"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0510"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Corticosteroids for preventing relapse following acute exacerbations of asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;H&#46; Rowe"
                            1 => "C&#46;H&#46; Spooner"
                            2 => "F&#46;M&#46; Ducharme"
                            3 => "J&#46;A&#46; Bretzlaff"
                            4 => "G&#46;W&#46; Bota"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD000195.pub2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "CD000195"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17636617"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0515"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anticholinergics in the treatment of children and adults with acute asthma&#58; A systematic review with meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;J&#46; Rodrigo"
                            1 => "J&#46;A&#46; Castro-Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2005.040444"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2005"
                        "volumen" => "60"
                        "paginaInicial" => "740"
                        "paginaFinal" => "746"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0520"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early use of inhaled corticosteroids in the emergency department treatment of acute asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;L&#46; Edmonds"
                            1 => "S&#46;J&#46; Milan"
                            2 => "C&#46;A&#46; Camargo"
                            3 => "C&#46;V&#46; Pollack"
                            4 => "B&#46;H&#46; Rowe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD002308.pub2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "CD002308"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23235589"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0525"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of inhaled magnesium sulfate in the coadjuvant management of severe asthma crisis in an emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;C&#46; Gallegos-Sol&#243;rzano"
                            1 => "R&#46; P&#233;rez-Padilla"
                            2 => "R&#46;J&#46; Hern&#225;ndez-Zenteno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.pupt.2010.04.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pulm Pharmacol Ther"
                        "fecha" => "2010"
                        "volumen" => "23"
                        "paginaInicial" => "432"
                        "paginaFinal" => "437"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20416389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0530"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heliox-driven &#946;2-agonists nebulization for children and adults with acute asthma&#58; A systematic review with meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;J&#46; Rodrigo"
                            1 => "J&#46;A&#46; Castro-Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.anai.2013.09.024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2014"
                        "volumen" => "112"
                        "paginaInicial" => "29"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24331390"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0535"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The ADMIT series--Issues in inhalation therapy&#46; 2&#46; Improving technique and clinical effectiveness"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ADMIT Working Group"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;E&#46; Broeders"
                            1 => "J&#46; Sanchis"
                            2 => "M&#46;L&#46; Levy"
                            3 => "G&#46;K&#46; Crompton"
                            4 => "P&#46;R&#46; Dekhuijzen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4104/pcrj.2009.00025"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prim Care Respir J"
                        "fecha" => "2009"
                        "volumen" => "18"
                        "paginaInicial" => "76"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19475324"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0540"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Shared treatment decision making improves adherence and outcomes in poorly controlled asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;R&#46; Wilson"
                            1 => "P&#46; Strub"
                            2 => "A&#46;S&#46; Buist"
                            3 => "S&#46;B&#46; Knowles"
                            4 => "P&#46;W&#46; Lavori"
                            5 => "J&#46; Lapidus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200906-0907OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2010"
                        "volumen" => "181"
                        "paginaInicial" => "566"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20019345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0545"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparing usability of NEXThaler&#40;<span class="elsevierStyleSup">&#174;</span>&#41; with other inhaled corticosteroid&#47;long-acting &#946;2-agonist fixed combination dry powder inhalers in asthma patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Voshaar"
                            1 => "M&#46; Spinola"
                            2 => "P&#46; Linnane"
                            3 => "A&#46; Campanini"
                            4 => "D&#46; Lock"
                            5 => "A&#46; Lafratta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jamp.2013.1086"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Aerosol Med Pulm Drug Deliv"
                        "fecha" => "2014"
                        "volumen" => "27"
                        "paginaInicial" => "363"
                        "paginaFinal" => "370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24299501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0550"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preference&#44; satisfaction and errors with two dry powder inhalers in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Van der Palen"
                            1 => "T&#46; Ginko"
                            2 => "A&#46; Kroker"
                            3 => "P&#46; van der Valk"
                            4 => "M&#46; Goosens"
                            5 => "L&#46; Padull&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1517/17425247.2013.808186"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Opin Drug Deliv"
                        "fecha" => "2013"
                        "volumen" => "10"
                        "paginaInicial" => "1023"
                        "paginaFinal" => "1031"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23745954"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0555"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ease of use of the ELLIPTA dry powder inhaler&#58; Data from three randomised controlled trials in patients with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Svedsater"
                            1 => "L&#46; Jacques"
                            2 => "C&#46; Goldfrad"
                            3 => "E&#46;R&#46; Bleecker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/npjpcrm.2014.19"
                      "Revista" => array:5 [
                        "tituloSerie" => "NPJ Prim Care Respir Med"
                        "fecha" => "2014"
                        "volumen" => "24"
                        "paginaInicial" => "14019"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24966061"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0560"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter prospective study of respiratory patient education and instruction in the use of inhalers &#40;EDEN study&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Giner"
                            1 => "V&#46; Maci&#225;n"
                            2 => "C&#46; Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2002"
                        "volumen" => "38"
                        "paginaInicial" => "300"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12199928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0565"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhaler competence in asthma&#58; Common errors&#44; barriers to use and recommended solutions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Price"
                            1 => "S&#46; Bosnic-Anticevich"
                            2 => "A&#46; Briggs"
                            3 => "H&#46; Chrystyn"
                            4 => "C&#46; Rand"
                            5 => "G&#46; Scheuch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2012.09.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2013"
                        "volumen" => "107"
                        "paginaInicial" => "37"
                        "paginaFinal" => "46"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23098685"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0570"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inhaler devices - From theory to practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Sanchis"
                            1 => "C&#46; Corrigan"
                            2 => "M&#46;L&#46; Levy"
                            3 => "J&#46;L&#46; Viejo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2012.12.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2013"
                        "volumen" => "107"
                        "paginaInicial" => "495"
                        "paginaFinal" => "502"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23290591"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0575"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Compliance&#44; adherence&#44; and concordance&#58; Implications for asthma treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Horne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.130.1_suppl.65S"
                      "Revista" => array:7 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "130"
                        "numero" => "1 Suppl"
                        "paginaInicial" => "65S"
                        "paginaFinal" => "72S"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16840369"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0580"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of the &#8216;Test of the Adherence to Inhalers&#8217; &#40;TAI&#41; for asthma and COPD patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Plaza"
                            1 => "C&#46; Fern&#225;ndez-Rodr&#237;guez"
                            2 => "C&#46; Melero"
                            3 => "B&#46;G&#46; Cos&#237;o"
                            4 => "L&#46;M&#46; Entrenas"
                            5 => "L&#46; P&#233;rez de Llano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "J Aerosol Med Pulm Drug Deliv&#46;"
                        "fecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0585"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of a multi-level intervention to improve non-adherence in difficult to control asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Gamble"
                            1 => "M&#46; Stevenson"
                            2 => "L&#46;G&#46; Heaney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2011.03.019"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2011"
                        "volumen" => "105"
                        "paginaInicial" => "1308"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21511454"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0590"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a web-based asthma self-management system&#58; A randomised controlled pilot trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Wiecha"
                            1 => "W&#46;G&#46; Adams"
                            2 => "D&#46; Rybin"
                            3 => "M&#46; Rizzodepaoli"
                            4 => "J&#46; Keller"
                            5 => "J&#46;M&#46; Clay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12890-015-0007-1"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Pulm Med"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25885418"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/00257753/0000014600000007/v1_201603150321/S0025775315005862/v1_201603150321/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64287"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Revisi&#243;n"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00257753/0000014600000007/v1_201603150321/S0025775315005862/v1_201603150321/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775315005862?idApp=UINPBA00004N"
]
Información del artículo
ISSN: 00257753
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2022 Julio 1 0 1
2020 Marzo 0 1 1
2019 Septiembre 4 6 10
2018 Octubre 1 2 3
2018 Agosto 1 0 1
2018 Junio 1 0 1
2018 Abril 1 0 1
2018 Febrero 1 0 1
2017 Noviembre 1 0 1
2017 Septiembre 3 0 3
2017 Julio 1 0 1
2017 Mayo 1 0 1
2017 Abril 1 0 1
2017 Marzo 2 0 2
2017 Febrero 1 0 1
2017 Enero 4 0 4
2016 Diciembre 6 0 6
2016 Octubre 2 0 2
2016 Septiembre 2 4 6
2016 Julio 1 2 3
2016 Junio 2 5 7
2016 Mayo 1 1 2
2016 Abril 9 1 10
2016 Marzo 45 1 46
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos