Clinical Trial of Two Inhalation Techniques for Pressurized Aerosols

Stauder, J; Hidinger, K.-G.

doi:10.1177/030006058000800306

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…The method presented for simple label ing of |T-agonists in an MDI permits di rect measurement of the effectiveness of numerous expander models which have since been proposed [Bloomfield et al, 1979;Corr et al, 1980;Kim et al, 1981;Moren, 1978;Stauder, 1980]. In addition, optimization of the technology of MDI and of the inhalation maneuver is made easier.…”

Section: Discussionmentioning

confidence: 99%

New Method for Easy Labeling of Beta-2-Agonists in the Metered Dose Inhaler with Technetium 99 m

Köhler

Fleischer²,

Matthys³

1988

Respiration

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The actual deposition pattern of micronized drugs from metered dose inhalers (MDI) is incompletely known because there are no methods available to label the drugs (β₂-agonists) with γ-emitters. Indirect measurements of the distribution of the drug in man differed greatly due to the method used. Our method uses the better solubility of ^99mTcO^-₄ in the β₂-agonist-micronized drug in relation to the propellant with surfactant. The principle is to extract the ^99mTcO^-₄ from the original water phase into the liquid phase of the propellant with ethyl methyl ketone. For labeling the micronized drug particles, the original MDI must be cooled to -60 °C and some labeled propellant (including surfactant) with high specific activity of ^99mTcO^-₄ is added through an aperture in the bottom of the container. The aperture is sealed with a screw. After rewarming the MDI, more than 90% of the added ^99mTcO^-₄ is dissolved in the β₂-agonist-micronized drug in relation to its volume. This is proved by comparing the distribution of the radioactivity component with chemical analysis. The pattern of deposition of both MDIs -placebo and β₂-agonist-micronized drug – was shown to be similar in healthy volunteers. With a labeled MDI a preliminary study with 2 different inhaling maneuvers was performed in 7 volunteers: inhaling from residual volume after a pause of 2 s the intrabronchial deposition was 18.7%, and inhaling at 50% of vital capacity maneuver the intrabronchial deposition was 33.0%. The data obtained with actual measurement of the inhaled drug from MDI suggest greater intrabronchial deposition than was assumed before in the literature.

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Section: Discussionmentioning

confidence: 99%

New Method for Easy Labeling of Beta-2-Agonists in the Metered Dose Inhaler with Technetium 99 m

Köhler

Fleischer²,

Matthys³

1988

Respiration

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“…In healthy volunteers, the extension of the mouthpiece has been shown to decrease the total loss of drug substance in the actuator and mouth [14] and to increase the amount of particles de posited in the lung [15]. Coordination of the actuation of the pressurized aerosol and the inhalation becomes less important [12,13], We compared the bronchodilatory activity of terbutaline from a metered aerosol using either the regular device or a device with a tube extension in patients with reversible airways obstruction. In creasing doses of terbutaline were admin istered from a metered aerosol either with a normal mouthpiece or with a mouth piece extended by the attachment of a 10-cm long plastic tube.…”

Section: Discussionmentioning

confidence: 99%

“…By this evaporation, the particles contained in the aerosol spray decrease in size, re sulting again in a diminished impaction in the mouth and pharynx and a deeper penetration in the lower airways. A final, not neglectable mechanism by which the extension tube may favor drug penetra tion in the lungs is the fact that coordina tion between activation of the canister and inhalation becomes less critical [12,13]. Although all the patients involved in the study had been using metered aerosols for several years, this latter mechanism can not be excluded.…”

Section: Discussionmentioning

confidence: 99%

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Influence of an Extension Tube on the Bronchodilator Efficacy of Terbutaline Delivered from a Metered Dose Inhaler

Pauwels¹,

Lamont²,

Hidinger³

et al. 1984

Respiration

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Pressurized aerosols of sympathomimetic drugs are widely used in the treatment of bronchial asthma. The efficacy of this form of treatment is diminished in a number of patients by difficulties in coordination between the aerosol actuation and the inhalation. In order to improve the intrapulmonary deposition of terbutaline, an extension tube has been adapted to the regular pressurized aerosol device. In a cross-over randomized study we compared the bronchodilatory effect of increasing doses of terbutaline (250, 500 and 750 μg at 25-min intervals) either delivered by the regular pressurized aerosol device or by the device with the extension tube. The study was performed on 11 adult patients with reversible airways obstruction. Spirometry, body plethysmography and flow volume curves were performed. The onset of the bronchodilatory effect of a single dose of 250 μg terbutaline was more rapid after delivery via the extension tube. The addition of the extension tube caused a significantly higher bronchodilator efficacy of aerosolized terbutaline on the small airways. Our results show that the addition of an extension tube improves the bronchodilator efficacy of terbutaline delivered from a pressurized aerosol.

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“…A number of studies assessing delivery of MDI aerosols using the tube spacer or the large (750 ml) flask have shown additional benefit with improvement in the FEVi, FVC, and SG aw , compared to metered dose inhaler delivery without auxiliary devices, 167 whereas other studies have shown no additional benefit. 34 ' 8,9 Th e Aerochamber® has also been shown to have clinical advantages compared with the MDI alone. 51011 In the studies using the tube spacer and/or flask, the index of benefit most commonly used was the FEVi, although studies by Gomm 3 and Poppius 4 also looked at changes in SG aw .…”

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confidence: 99%