Effect of different modes of inhalation on drug delivery from a dry powder inhaler

Newman, Stephen P.; Hollingworth, Ann; Clark, Andrew R.

doi:10.1016/0378-5173(94)90047-7

Cited by 124 publications

(58 citation statements)

References 20 publications

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“…Scintigraphic and pharmacokinetic deposition studies have indicated that this device is capable of delivering a mean of 20-30% of the nominal dose to the lungs of adults [1,2]. Although it is difficult to compare results from studies utilizing different methods [3], these results suggest that the device delivers a greater proportion of the nominal dose to the lungs of adult patients than do other DPIs [4,5], metereddose inhalers (MDIs) [4,6,7], and jet nebulizers [8,9], and these results are similar to optimal values obtained using certain MDI-spacer combinations [6].In vitro deposition studies have indicated that the performance of the Turbuhaler®, and other DPIs, can be significantly influenced by the peak inspiratory flow (PIF) achieved through the device [2,5,[10][11][12][13][14][15][16]. The fine particle dose delivered by a Turbuhaler®, measured in vitro using multistage liquid impingers, decreases with decreasing flow [16].…”

mentioning

confidence: 64%

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confidence: 64%

“…Since we did not directly quantify the dose exhaled, this will slightly overestimate the lung dose, but previous studies have indicated that the exhaled dose using high inspiratory flows with DPIs is less than 1% of the nominal dose. Hence, the dose on the inspiratory filter will be very close to the delivered dose [1,2,4,5].…”

Section: Inhalation Proceduresmentioning

confidence: 99%

“…This is in line with instructions given in the instruction leaflets. Previous clinical studies [11,13] and deposition studies [5] have indicated that a breath holding pause does not appear necessary when using DPIs. Previous studies have also indicated that inhaling from functional residual capacity (FRC) is as effective as from residual capacity [13,15].…”

Section: Inhalation Proceduresmentioning

confidence: 99%

“…In vitro deposition studies have indicated that the performance of the Turbuhaler®, and other DPIs, can be significantly influenced by the peak inspiratory flow (PIF) achieved through the device [2,5,[10][11][12][13][14][15][16]. The fine particle dose delivered by a Turbuhaler®, measured in vitro using multistage liquid impingers, decreases with decreasing flow [16].…”

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confidence: 99%

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Lung deposition from the Turbuhaler in children with cystic fibrosis

Devadason¹,

Everard²,

MacEarlan³

et al. 1997

Eur Respir J

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Drug delivery to patients using dry powder inhalers, such as the Turbuhaler®, is believed to be influenced by the inspiratory flow used. Clinical studies have indicated that this delivery system can be used effectively by children. However, it is not known how the total and weight-corrected dose delivered to the airways varies with age. A deposition study using technetium-99m ( 99m Tc)-labelled budesonide was performed in order to determine the effect of age on delivery.Twenty one children with cystic fibrosis, aged 4-16 yrs, were recruited. They were clinically stable with normal lung function. Initially, a gamma camera scan was taken in front of a flood source containing 37 MBq of 99m Tc. Subsequently, subjects inhaled through a low resistance inspiratory filter connected to a commercially available Turbuhaler®. Immediately afterwards they inhaled from a noncommercial Turbuhaler® containing budesonide labelled with 99m Tc, and then underwent anterior and posterior gamma camera scans. Both Turbuhaler® inhalers were attached to a portable spirometer and the peak inspiratory flow through the Turbuhaler® was recorded for each inhalation. The total body dose was calculated from the dose deposited on the inspiratory filter connected to the commercial Turbuhaler®. Analysis of the gamma camera images provided information on the proportion of the radiolabel delivered to the lungs compared to that deposited in the upper airway and stomach.As expected, a highly significant positive correlation was noted between the peak inspiratory flow generated by the patient through the Turbuhaler® and the dose delivered to the lung. Similarly, there was a highly significant positive correlation between age and "total lung dose". However, when total lung dose was corrected for body weight, there was a nonsignificant negative correlation with age. This study suggests that the "weight-corrected lung dose" achieved when children aged >6 yrs use the Turbuhaler®, is largely independent of age. It would appear that the flow-dependent properties of this device are such that the reduced peak inspiratory flow generated by younger children results in a lower dose to the lungs, but that this is off-set by their lower body weight. This is unlikely to be a property of other devices with different flow/drug delivery characteristics. Eur Respir J 1997; 10: 2023-2028 The convenience and ease of use of Turbuhaler®, a multidose dry powder inhaler (DPI), has resulted in its widespread use for the treatment of children with respiratory disease. Scintigraphic and pharmacokinetic deposition studies have indicated that this device is capable of delivering a mean of 20-30% of the nominal dose to the lungs of adults [1,2]. Although it is difficult to compare results from studies utilizing different methods [3], these results suggest that the device delivers a greater proportion of the nominal dose to the lungs of adult patients than do other DPIs [4,5], metereddose inhalers (MDIs) [4,6,7], and jet nebulizers [8,9], and these results are similar to o...

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confidence: 64%

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confidence: 64%

Section: Inhalation Proceduresmentioning

confidence: 99%

Section: Inhalation Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Lung deposition from the Turbuhaler in children with cystic fibrosis

Devadason¹,

Everard²,

MacEarlan³

et al. 1997

Eur Respir J

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A Novel Apparatus for Rat in Vivo Evaluation of Dry Powder Formulations for Pulmonary Administration

Okamoto

Aoki

Danjo

2000

Journal of Pharmaceutical Sciences

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Aerosol Drug Delivery to the Lungs

Finlay

2011

Pharmaceutical Sciences Encyclopedia

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This chapter will begin with a very brief introduction to aerosol mechanics as related to the transport and deposition of inhaled drug particles throughout the respiratory tract. This familiarization then will serve as requisite background for the discussion of aerosol particle sizing instruments in use for research and development, regulatory, and quality assurance purposes, as well as for descriptions of the different types of aerosol delivery systems currently available and in development.

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Effect of different modes of inhalation on drug delivery from a dry powder inhaler

Cited by 124 publications

References 20 publications

Lung deposition from the Turbuhaler in children with cystic fibrosis

Lung deposition from the Turbuhaler in children with cystic fibrosis

A Novel Apparatus for Rat in Vivo Evaluation of Dry Powder Formulations for Pulmonary Administration

Aerosol Drug Delivery to the Lungs

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