Delivery of HFA and CFC salbutamol from spacer devices used in infancy

Dubus, Jean‐Christophe; Rhem, Rodney; Dolovich, Myrna

doi:10.1016/s0378-5173(01)00702-5

Cited by 16 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the increase in fine practical fraction (less than 5.8 mm) has been demonstrated in vitro, reaching 63.5% on average with Airomir 1 (3M Pharmaceuticals) (HFA albuterol) compared to 38.1%, 54.8%, and 41.6% for Eolene 1 (Rhône Poulenc Rorer), Spreor 1 (Inava Pierre Fabre Médicaments) and Ventoline 1 (Glaxo Smith Kline), respectively (CFC albuterol) (17).…”

Section: Hfa 134a Albuterolmentioning

confidence: 98%

HFA inhalers

et al. 2004

View full text Add to dashboard Cite

Section: Hfa 134a Albuterolmentioning

confidence: 98%

HFA inhalers

et al. 2004

View full text Add to dashboard Cite

“…These differences are likely explained by the large dead space, larger volume and potentially electrostatic material of Babyhaler ® resulting in a reduced aerosol half-life into the Babyhaler ® compared to Nebuchamber ® , which has no deadspace, a smaller volume and is of non-electrostatic material. 2,4,7,10 A reduced aerosol-half life affects the spacer output depending on tidal volume and thereby the size of the patient. An infant with a tidal volume in the order of 50 mL needs longer time to empty the holding chamber than an older child, who empties the holding chamber in one or two breaths.…”

Section: Dubus and Anhøj 228mentioning

confidence: 99%

“…However, this delivery may be af-fected by various factors, such as holding chamber volume, type of valve, dead space between inlet and outlet valve, electrostatic charge, spacer emptying pattern, mode of inhalation breathing, or drug-holding chamber combination. 1,2 The effect of patient age (or size) on the dose available for inhalation when using holding chambers is less convincing. Several pediatric studies showed that lung deposition is age-dependent, but that the delivery of inhaled corticosteroids (ICS) from small volume holding chambers, assessed by the dosage of the drug on a filter placed between the delivery system and the patient, was independent of age.…”

Section: Introductionmentioning

confidence: 99%

Inhaled Steroid Delivery from Small-Volume Holding Chambers Depends on Age, Holding Chamber, and Interface in Children

Dubus

Anhøj

2004

Journal of Aerosol Medicine

Self Cite

View full text Add to dashboard Cite

The relationship between the amount of inhaled steroids delivered from pressurized metered-dose inhalers used with their recommended holding chambers and age of the patients using these devices was studied in an open randomised cross-over filter study. We recruited 1-2-month-old healthy infants (n = 21), 2-3-year-old asthmatics (n = 13), 4-6-year-old asthmatics (n = 15), and 10-15-year-old asthmatics (n = 20). Each child inhaled two puffs, administered by a single investigator, of both budesonide through Nebuchamber and fluticasone propionate through Babyhaler, on two occasions. Moreover, the 4-6-year-old group inhaled via both facemask and mouthpiece. Drug, collected on a filter interposed between holding chamber and patient, was analysed by high performance liquid chromatography. Filter dose, expressed in percent of the nominal dose, was analysed in a mixed effect linear regression model with age group, holding chamber and inhalation interface (facemask or mouthpiece) as fixed effects and subject as random effect. Filter dose from both holding chambers increased significantly with age, from 3% with Babyhaler and 7% with Nebuchamber in the youngest children, to 40-41% with both holding chambers in adolescents. Nebuchamber delivered more drug than Babyhaler (p = 0.002), but variability in drug delivery (about 11%) was similar between holding chambers. Filter dose decreased from 35% to 22% with Babyhaler, and from 42% to 27% with Nebuchamber when using a mouthpiece rather than a facemask (p < 0.0001). Delivery of inhaled steroids used with their recommended holding chambers depends from age and holding chamber, but also from the inhalation interface. Lung deposition and clinical studies comparing inhalation from holding chambers with mouthpiece and facemask are urgently required.

show abstract

“…Dose emission and the aerodynamic characteristics of the emitted dose will have an effect on lung deposition (Barry & O'Callaghan 2003) and the resultant therapeutic and systemic effects. It has been shown that dose emission varies from one type of spacer to another (Barry & O'Callaghan 1996) when used with chlorofluorocarbon (CFC) and CFC-free propellant formulations (Dubus et al 2001). The majority of salbutamol MDIs now contain CFC-free propellants.…”

Section: Introductionmentioning

confidence: 99%

“…When this product was reformulated with HFA propellants it was designed as a seamless transitional change when used alone and when attached to the Volumatic spacer (Cripps et al 2000). Since dose emission from spacers is dependent on the drug (Barry & O'Callaghan 1999), spacer (Barry & O'Callaghan 1996;Lipworth & Clark 1998;Dubus et al 2001) and the formulation (Kenyon et al 1995;Dubus et al 2001), we have compared the relative lung bioavailability of salbutamol when a Ventolin Evohaler was attached to a large and a small volume spacer. Using a urinary pharmacokinetic method (Hindle & Chrystyn 1992) we have determined the relative lung and systemic bioavailability following inhalation through a small and large volume spacer.…”

Section: Introductionmentioning

confidence: 99%

Salbutamol relative lung and systemic bioavailability of large and small spacers

Mazhar¹,

Chrystyn²

2008

j pharm pharmacol

View full text Add to dashboard Cite

Differences between the size and shape of spacers may affect the emitted dose and provide different effects when interchanged during routine use. Using a urinary pharmacokinetic method we have measured the relative lung and systemic bioavailability from urinary salbutamol excretion 30 min (USAL0.5) and 24 h (USAL24), respectively, after the inhalation of two 100-microg doses from a Ventolin Evohaler when used alone (MDI) and when attached to the Volumatic (VOL) or the Aerochamber Plus (AERO) spacers. The in-vitro properties of the emitted dose were determined. The mean (s.d.) USAL0.5 values following MDI, VOL and AERO (n = 13 volunteers) were 5.7 (1.9), 16.4 (8.2) and 14.8 (7.4) microg, respectively. VOL and AERO were significantly greater (P < 0.001 and < 0.01, respectively) than MDI. Comparison of VOL and AERO was similar with a mean ratio (90% confidence interval) of 108.2 (84.5, 138.6)%. USAL24 values between the three inhalation methods were similar. The values for the mean (s.d.) fine particle dose of two 100-microg doses emitted from MDI, VOL and AERO were 83.0 (6.8), 83.6 (4.6) and 73.6 (2.9) microg and the mass median aerodynamic diameters were 2.7 (0.03), 2.8 (0.07) and 2.9 (0.10) mum, respectively. The results showed that during routine use the Volumatic and the Aerochamber Plus spacers should provide similar lung and systemic delivery when attached to a Ventolin Evohaler.

show abstract

Delivery of HFA and CFC salbutamol from spacer devices used in infancy

Cited by 16 publications

References 26 publications

HFA inhalers

HFA inhalers

Inhaled Steroid Delivery from Small-Volume Holding Chambers Depends on Age, Holding Chamber, and Interface in Children

Salbutamol relative lung and systemic bioavailability of large and small spacers

Contact Info

Product

Resources

About