In vitro deposition of fluticasone aerosol from a metered-dose inhaler with and without two common valved holding chambers

Performance of a Corticosteroid Inhaler with a Spacer Fashioned from a Plastic Cold-Drink Bottle: Effects of Changing Bottle Volume

“…In a similar study of a commercially available spacer (AeroChamber-Plus, Monaghan, Plattsburgh, NY), the respirable dose from a fluticasone 110 mg MDI was 48 mg/actuation (29). The highest respirable dose in the present study (51.6 mg/actuation with the 237-mL bottle spacer) was comparable, indicating that these bottle spacers work at least as well as some of the leading commercial spacers.…”

Potential adverse effects of the inhaled corticosteroids

“…In addition, it is well known that different VHCs will alter the FPF from the same MDI differently. 22 Because of the significant effect that the delivery device can have on systemic availability of an ICS, all ICSs will be identified with their delivery device when results of clinical trials are discussed.…”

Real-Life Outcomes for Patients with Asthma Prescribed Spacers for Use with Either Extrafine- or Fine-Particle Inhaled Corticosteroids

“…One possible explanation might be that adding a spacer to pMDI therapy adds more handling steps, thereby increasing the potential for introducing errors into the process. 6,7 Finally, it is possible that the fine-particle dose delivery was the same with and without the spacers 14,15 ; thus, the effective ICS dose delivered to the lung was comparable.…”

“…6,11 Conversely, drug deposition on spacer walls and valves may decrease the total amount of drug available for inhalation from the spacer, 12,13 although an equivalent fine-particle dose from the spacer as from the pMDI alone has been reported in studies of antistatic valved holding chambers. 14,15 The transition to hydrofluoroalkane pMDI propellants in the 1990s led to the development of extrafine-particle solution ICS with MMADs of approximately 1 mm and lower velocity aerosol plumes than the standard fine-particle suspension ICS with MMADs of 2.5 to 4.5 mm. These intrinsic features of extrafine-particle ICS pMDIs result in reduced oropharyngeal deposition and increased small airway and overall lung deposition.…”