Abstract:QVAR TM , an extrafine hydrofluoroalkane/beclomethasone dipropionate formulation, has been shown to double lung deposition in adults. The aim of the present study was to assess the total body deposition and distribution of technetium99m-labelled ( 99m Tc) QVAR TM in children after inhalation via an Autohaler TM . Sixteen male asthmatic children (5-14 yrs) inhaled labelled drug (v4 MBq 99m Tc; 100 mg beclomethasone dipropionate) via an Autohaler within 30 min after salbutamol (200 mg) administration. Simultaneo… Show more
“…or b.i.d. In light of these findings, it was surprising that the fall in FEV1 after exercise was only reduced from 28% to 21% in the present study, considering that the Autohaler used delivers twice as much drug to the intrapulmonary airways as budesonide Turbuhaler [13-18, 20, 24], and at least three times as much as the fluticasone propionate pressurised metered-dose inhaler [15,[17][18][19][20]24] in both children and adults. The reason for this is not clear.…”
Section: Discussionmentioning
confidence: 65%
“…A new formulation of hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP; QVAR TM ; 3M Pharmaceuticals, St. Paul, MN, USA) produces an extra-fine aerosol spray that, compared with conventional inhalers, increases the amount of drug delivered to the lungs [13][14][15][16][17][18][19][20]. Since more drug per puff is delivered to the site of the disease, it seems reasonable to assume that even very low doses of HFA-BDP will provide a significant therapeutic response.…”
A new hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) aerosol markedly increases drug delivery to the airways. Therefore, even low doses of HFA-BDP should be effective, and the present study assesses this.A randomised, double-blind, crossover study was used to compare the effect of placebo, HFA-BDP 50 mg or 100 mg given q.d. (QVAR TM Autohaler TM ; 3M Pharmaceuticals, St. Paul, MN, USA) on exercise-induced bronchoconstriction and exhaled nitric oxide (eNO). After a 14-day run-in, 25 children (5-14 yrs old) entered three 4-week treatment periods, separated by a 1-week washout. After each period, the fall in forced expiratory volume in one second (FEV1), after an exercise test, and eNO were measured.Significant treatment effects with no carry-over or period effects were seen for both eNO and maximum fall in FEV1 after exercise. Differences were seen between placebo (fall in FEV1=27.9%; eNO=14.4 parts per billion (ppb)) and either dose of HFA-BDP, but not between the two active doses (50 mg: fall in FEV1=20.8%, eNO=9.3 ppb; 100 mg: fall in FEV1=20.9%, eNO=8.9 ppb).In conclusion, low q.d. doses of hydrofluoroalkane-beclomethasone dipropionate reduced exhaled nitric oxide and exercise-induced bronchoconstriction. Further studies are needed to assess whether q.d. administration of beclomethasone dipropionate is as effective as b.i.d. administration. Eur Respir J 2004; 24: 932-937.
“…or b.i.d. In light of these findings, it was surprising that the fall in FEV1 after exercise was only reduced from 28% to 21% in the present study, considering that the Autohaler used delivers twice as much drug to the intrapulmonary airways as budesonide Turbuhaler [13-18, 20, 24], and at least three times as much as the fluticasone propionate pressurised metered-dose inhaler [15,[17][18][19][20]24] in both children and adults. The reason for this is not clear.…”
Section: Discussionmentioning
confidence: 65%
“…A new formulation of hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP; QVAR TM ; 3M Pharmaceuticals, St. Paul, MN, USA) produces an extra-fine aerosol spray that, compared with conventional inhalers, increases the amount of drug delivered to the lungs [13][14][15][16][17][18][19][20]. Since more drug per puff is delivered to the site of the disease, it seems reasonable to assume that even very low doses of HFA-BDP will provide a significant therapeutic response.…”
A new hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) aerosol markedly increases drug delivery to the airways. Therefore, even low doses of HFA-BDP should be effective, and the present study assesses this.A randomised, double-blind, crossover study was used to compare the effect of placebo, HFA-BDP 50 mg or 100 mg given q.d. (QVAR TM Autohaler TM ; 3M Pharmaceuticals, St. Paul, MN, USA) on exercise-induced bronchoconstriction and exhaled nitric oxide (eNO). After a 14-day run-in, 25 children (5-14 yrs old) entered three 4-week treatment periods, separated by a 1-week washout. After each period, the fall in forced expiratory volume in one second (FEV1), after an exercise test, and eNO were measured.Significant treatment effects with no carry-over or period effects were seen for both eNO and maximum fall in FEV1 after exercise. Differences were seen between placebo (fall in FEV1=27.9%; eNO=14.4 parts per billion (ppb)) and either dose of HFA-BDP, but not between the two active doses (50 mg: fall in FEV1=20.8%, eNO=9.3 ppb; 100 mg: fall in FEV1=20.9%, eNO=8.9 ppb).In conclusion, low q.d. doses of hydrofluoroalkane-beclomethasone dipropionate reduced exhaled nitric oxide and exercise-induced bronchoconstriction. Further studies are needed to assess whether q.d. administration of beclomethasone dipropionate is as effective as b.i.d. administration. Eur Respir J 2004; 24: 932-937.
“…High lung deposition of HFA-BDP delivered after inhalation via a breath-actuated MDI (Autohaler TM ; 3M Health Care Ltd) has been shown in a previous paediatric deposition study [17]. However, gastrointestinal deposition was f60% in children aged 5-14 yrs after inhalation via Autohaler TM .…”
Section: Abstract: Children Deposition Study Inhalation Technique mentioning
The aim of the present study was to measure airway, oropharyngeal and gastrointestinal deposition of 99m Tc-labelled hydrofluoroalkane-beclomethasone dipropionate after inhalation via a pressurised metered-dose inhaler and spacer (Aerochamber Plus TM ) in asthmatic children.A group of 24 children (aged 5-17 yrs) with mild asthma inhaled the labelled drug. A total of 12 children took five tidal breaths after each actuation (tidal group). The other 12 children used a slow maximal inhalation followed by a 5-10-s breath-hold (breath-hold group). Simultaneous anterior and posterior planar c-scintigraphic scans (120-s acquisition) were recorded.For the tidal group, mean¡SD lung deposition (% ex-actuator, attenuation corrected) was 35.4¡18.3, 47.5¡13.0 and 54.9¡11.2 in patients aged 5-7 (n54), 8-10 (n54) and 11-17 yrs (n54), respectively. Oropharyngeal and gastrointestinal deposition was 24.0¡10.5, 10.3¡4.4 and 10.1¡6.2. With the breath-hold technique, lung deposition was 58.1¡6.7, 56.6¡5.2 and 58.4¡9.2. Oropharyngeal and gastrointestinal deposition was 12.9¡3.2, 20.1¡9.5 and 20.8¡8.8.Inhalation of the extrafine formulation with the breath-hold technique showed significantly improved lung deposition compared with tidal breathing across all ages. Oropharyngeal and gastrointestinal deposition was markedly decreased, regardless of which inhalation technique was applied, compared with a previous paediatric study using the same formulation delivered via a breath-actuated metered-dose inhaler.
“…They allow patients to inhale a static cloud. VHCs overcome the issue of coordinating actuation with inhalation, and they increase pulmonary deposition in those subjects who do not have optimal coordination when actuating a pMDI [47][48][49][50]. Spacers and VHCs should not be used with BA-pMDIs.…”
A collaboration of multidisciplinary experts on the delivery of pharmaceutical aerosols was facilitated by the European Respiratory Society (ERS) and the International Society for Aerosols in Medicine (ISAM), in order to draw up a consensus statement with clear, up-to-date recommendations that enable the pulmonary physician to choose the type of aerosol delivery device that is most suitable for their patient. The focus of the consensus statement is the patientuse aspect of the aerosol delivery devices that are currently available.The subject was divided into different topics, which were in turn assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. To achieve consensus, draft reports and recommendations were reviewed and voted on by the entire panel.Specific recommendations for use of the devices can be found throughout the statement. Healthcare providers should ensure that their patients can and will use these devices correctly. This requires that the clinician: is aware of the devices that are currently available to deliver the prescribed drugs; knows the various techniques that are appropriate for each device; is able to evaluate the patient's inhalation technique to be sure they are using the devices properly; and ensures that the inhalation method is appropriate for each patient.
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