Chest
Clinical InvestigationsClinical Evaluation of a Simple Demand Inhalation MDI Aerosol Delivery Device
Section snippets
Pulmonary Aerosol Deposition
Subjects. Seven nonsmoking adults with no history of respiratory disease served as the normal group (Table 1). For comparison, 14 adult ambulatory patients with varying degrees of airflow obstruction were selected from the Firestone Regional Chest and Allergy Unit of St. Joseph's Hospital (Table 1). Patients continued to receive their usual medication. Informed written consent was obtained from all subjects.
Metered-Dose Inhalers. The MDIs used in this experiment were prepared daily in our
Pulmonary Aerosol Deposition
Dose. The mean (± SD) dose deposited in the lungs and oropharynx from one MDI puff expressed in microliters and as a percentage of the puff volumes are given in Table 3 for both the normal and bronchitic subjects, with the breath-actuated device (Aerochamber) and with the MDI alone. The dose deposited in the lungs and oropharynx was the same for both the normal and bronchitic subjects when the MDI was used alone (lungs, 4.42μ1 vs 3.67μ1 [p = 0.46]; throat, 30.0μ1 vs 27.8μ1 [p = 0.58]) or with
DISCUSSION
The use of the breath-actuated device (Aerochamber) to aid the delivery of a pressurized aerosol yielded the same lower airway dose as direct MDI use in both normal subjects and subjects with obstructive airway disease.14 In contrast, deposition of aerosol in the upper respiratory tract was decreased, on average, 14-fold by use of the device (Aerochamber). This is due to impaction of the larger high-velocity particles from the MDI on the chamber walls and evaporation of the remaining suspended
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Cited by (139)
Comparative pharmacokinetics of salbutamol inhaled from a pressurized metered dose inhaler either alone or connected to a newly enhanced spacer design
2020, European Journal of Pharmaceutical SciencesCitation Excerpt :The present findings, therefore, confirm the importance that patients prescribed pMDIs receive frequent VC during their routine clinic visits. Oropharyngeal deposition of inhaled medicines decreases by up to 90% when VHCs are connected to pressurized inhalers [11, 30–32]. Inhalation of salbutamol through AS reduced oropharyngeal deposition by approximately 96% (AS mean (SD): 0.48 (0.3) µg versus VC mean (SD): 11.35 (3.4) µg).
Inhaled Corticosteroids and Voice Problems. What Is New?
2017, Journal of VoiceCitation Excerpt :Oropharyngeal deposition of inhaled isotope-labeled aerosols is decreased with the use of a spacer, whereas the intrapulmonary deposition is increased.43 The use of a large-volume spacer seems to reduce the local side effects and especially candidiasis by reducing oropharyngeal deposition.44,45 According to other studies, voice problems were either more frequently observed in patients using a spacer device46,47 or the use of a large-volume spacing device did not appear to have an effect on the occurrence of dysphonia.38
Airway Pharmacology
2007, Benumof's Airway ManagementAirway Pharmacology
2007, Benumof's Airway Management: Principles and Practice16 Drugs acting on the respiratory tract
2007, Side Effects of Drugs AnnualCitation Excerpt :The use of breath-actuated metered-dose inhalers leads to high oropharyngeal deposition of glucocorticoids, which can be 80% of the delivered dose(5R). Spacer devices reduce the oropharyngeal deposition of inhaled aerosols, improve intrapulmonary deposition(10c), and reduce local adverse effects(11R). Oropharyngeal deposition of inhaled glucocorticoids is less than 60% of the delivered dose when dry powder inhalers are used, but patients should still be advised to rinse the mouth after inhaling from a dry powder inhaler, in order to minimize local adverse effects(8c).
Pharmacokinetic and Pharmacodynamic Comparison of Fluticasone Propionate/Formoterol Fumarate Administered via a Pressurized Metered-Dose Inhaler and a Novel Breath-Actuated Inhaler in Healthy Volunteers
2023, Journal of Aerosol Medicine and Pulmonary Drug Delivery
Manuscript received September 22; revision accepted December 28.