Pressure and inspiratory flow characteristics of dry powder inhalers

Cegla, U. H.

doi:10.1016/j.rmed.2004.02.003

Cited by 36 publications

(21 citation statements)

References 8 publications

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“…Ideally, the choice for the most appropriate dry powder inhaler in elderly patients should, therefore, depend on the objective measurement of peak inspiratory flow against a certain resistance. Alternatively, the direct choice of a lowresistance dry powder inhaler, which is relative insensitive to changes in peak inspiratory flow at lower flow levels, might be beneficial in situations such as exacerbations characterised by a further reduction of inspiratory flow [12,21,35].…”

Section: Discussionmentioning

confidence: 99%

Inspiratory flow rates at different levels of resistance in elderly COPD patients

Janssens¹,

VandenBrande²,

Hardeman³

et al. 2008

European Respiratory Journal

165

166

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Dry powder inhalers (DPIs) are increasingly replacing metered dose inhalers in elderly chronic obstructive pulmonary disease (COPD) patients. However, most DPIs are dependent on inspiratory flow, which is compromised by the ageing process itself.Using the in-check dial method, the present study compared peak inspiratory flow (PIF) rates in 26 elderly COPD patients and 14 matched control subjects, at a pre-set resistance level of the Aeroliser1, Diskus1 and Turbuhaler1 inhalers.It was found that the PIF measured by the in-check method positively correlated with the PIF derived from spirometry, forced vital capacity and maximal inspiratory pressure, while a negative, but significant, correlation was observed with age. PIF derived from spirometry and age were independent variables which determined PIF across the device, whereas the presence or absence of COPD was not related. When comparing elderly COPD patients with matched elderly controls no difference could be found in PIF at the different resistances. However, an important number of patients did not reach the recommended flow rate, especially when using the Turbuhaler1 (30%).In conclusion, the present study demonstrates that, in elderly patients, the ability to generate sufficient inspiratory flow across a dry powder inhaler is compromised, irrespective of the presence of chronic obstructive pulmonary disease.

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Section: Discussionmentioning

confidence: 99%

Inspiratory flow rates at different levels of resistance in elderly COPD patients

Janssens¹,

VandenBrande²,

Hardeman³

et al. 2008

European Respiratory Journal

165

166

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show abstract

“…69 significant dose uniformity problems (Cegla, 2004). In addition, 70 DPIs demonstrated low efficiency of drug delivery to the lower air-71 way regions (Islam and Cleary, 2012).…”

mentioning

confidence: 99%

Dry powder inhalers: Physicochemical and aerosolization properties of several size-fractions of a promising alterative carrier, freeze-dried mannitol

Kaialy

Nokhodchi

2015

European Journal of Pharmaceutical Sciences

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The purpose of this work was to evaluate the physicochemical and inhalation characteristics of different size fractions of a promising carrier, i.e., freeze-dried mannitol (FDM). FDM was prepared and sieved into four size fractions. FDMs were then characterized in terms of micromeritic, solid-state and bulk properties. Dry powder inhaler (DPI) formulations were prepared using salbutamol sulphate (SS) and then evaluated in terms of drug content homogeneity and in vitro aerosolization performance. The results showed that the crystalline state of mannitol was maintained following freeze-drying for all size fractions of FDM. All FDM particles showed elongated morphology and contained mixtures of α-, β- and δ-mannitol. In comparison to small FDM particles, FDMs with larger particle sizes demonstrated narrower size distributions, higher bulk and tap densities, lower porosities and better flowability. Regardless of particle size, all FDMs generated a significantly higher (2.2-2.9-fold increase) fine particle fraction (FPF, 37.5 ± 0.9%-48.6 ± 2.8%) of SS in comparison to commercial mannitol. The FPFs of SS were related to the shape descriptors of FDM particles; however, FPFs did not prove quantitative apparent relationships with either particle size or powder bulk descriptors. Large FDM particles were more favourable than smaller particles because they produced DPI formulations with better flowability, better drug content homogeneity, lower amounts of the drug depositing on the throat and contained lower fine-particle-mannitol. Optimized stable DPI formulations with superior physicochemical and pharmaceutical properties can be achieved using larger particles of freeze-dried mannitol (FDM).

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“…Depending on the DPI device, elderly patients and/or those with more severe COPD may be unable to achieve a suffi cient peak inspiratory fl ow rate for optimal drug delivery ( Figure 1B-C). 11,13,28,31,[44][45][46] Different DPI models operate dissimilarly from one another in loading and priming of the device. Therefore, DPI devices cannot be interchanged with the assumption that they will work in the same way, and deliver an equivalent dose to the patient's lungs.…”

Section: Dry Powder Inhalersmentioning

confidence: 99%

Customizing Inhaled Therapy to Meet the Needs of COPD Patients

Fromer

Goodwin

Walsh

2010

Postgraduate Medicine

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Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airflow limitation resulting from emphysema and chronic bronchitis. Inhaled therapy is the major therapeutic approach for treating COPD. Multiple inhaler medications are available in the United States and are delivered by a variety of different devices: metered-dose inhalers, dry powdered inhalers, and nebulizers. Each inhaler device has unique requirements for use that must be correctly performed by the patient for successful drug delivery. Patients with COPD represent a medically diverse population, with each patient having distinct characteristics, such as lung function, comorbidities, cognitive functions, hand strength, and lifestyle. These characteristics impact the patient's ability to properly use specific inhaler devices and therefore affect adherence to therapy, therapeutic outcomes, and quality of life. It is estimated that between 28% to 68% of patients do not use metered-dose inhalers or dry powder inhalers correctly. Worsening symptoms or increased frequency of exacerbations may not always indicate disease progression but may indicate a patient's inability to use their inhaler device properly. This review discusses the patient- and device-specific factors to be considered when choosing an inhaled therapy, which will be concordant with the patient's medical needs, preferences, and lifestyle. The review also considers how the ideas underlying the patient-centered medical home model can be incorporated into the choice and use of inhaler device for a given patient with COPD to improve treatment outcomes.

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Pressure and inspiratory flow characteristics of dry powder inhalers

Cited by 36 publications

References 8 publications

Inspiratory flow rates at different levels of resistance in elderly COPD patients

Inspiratory flow rates at different levels of resistance in elderly COPD patients

Dry powder inhalers: Physicochemical and aerosolization properties of several size-fractions of a promising alterative carrier, freeze-dried mannitol

Customizing Inhaled Therapy to Meet the Needs of COPD Patients

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