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Inhalation device

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https://www.readbyqxmd.com/read/28744110/confidence-in-correct-inhaler-technique-and-its-association-with-treatment-adherence-and-health-status-among-us-patients-with-chronic-obstructive-pulmonary-disease
#1
Alpesh N Amin, Vaidyanathan Ganapathy, Adam Roughley, Mark Small
BACKGROUND: Improper use of bronchodilators is associated with poor disease control, nonadherence to long-term therapy, and poor clinical outcomes. Our current understanding of factors associated with correct inhaler use and adherence is limited. We measured physician-and patient-reported confidence in device usage and associations with treatment adherence and COPD-related health status. METHODS: This was an analysis of a US observational, point-in-time survey of physicians and patients...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28743094/a-personalized-medicine-approach-to-the-design-of-dry-powder-inhalers-selecting-the-optimal-amount-of-bypass
#2
Thomas Kopsch, Darragh Murnane, Digby Symons
In dry powder inhalers (DPIs) the patient's inhalation manoeuvre strongly influences the release of drug. Drug release from a DPI may also be influenced by the size of any air bypass incorporated in the device. If the amount of bypass is high less air flows through the entrainment geometry and the release rate is lower. In this study we propose to reduce the intra- and inter-patient variations of drug release by controlling the amount of air bypass in a DPI. A fast computational method is proposed that can predict how much bypass is needed for a specified drug delivery rate for a particular patient...
July 22, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28741229/inhaled-antimicrobials-for-ventilator-associated-pneumonia-practical-aspects
#3
Garyphallia Poulakou, Dimitrios K Matthaiou, David P Nicolau, Georgios Siakallis, George Dimopoulos
Positive experience with inhaled antibiotics in pulmonary infections of patients with cystic fibrosis has paved the way for their utilization in mechanically ventilated, critically ill patients with lower respiratory tract infections. A successful antibiotic delivery depends upon the size of the generated particle and the elimination of drug impaction in the large airways and the ventilator circuit. Generated droplet size is mainly affected by the type of the nebulizer employed. Currently, jet, ultrasonic, and vibrating mesh nebulizers are marketed; the latter can deliver optimal antibiotic particle size...
July 24, 2017: Drugs
https://www.readbyqxmd.com/read/28737262/overnight-delivery-of-hypertonic-saline-by-nasal-cannula-aerosol-for-cystic-fibrosis
#4
Timothy E Corcoran, Joseph E Godovchik, Karl H Donn, David R Busick, Jennifer Goralski, Landon W Locke, Matthew R Markovetz, Michael M Myerburg, Ashok Muthukrishnan, Lawrence Weber, Ryan T Lacy, Joseph M Pilewski
AIM: Inhaled hypertonic saline increases mucociliary clearance, improves pulmonary function, and decreases exacerbations in cystic fibrosis (CF) but contributes to the already significant treatment burden of CF. Overnight delivery of inhaled medications via a specially designed nasal cannula-aerosol device (Trans-nasal Pulmonary Aerosol Delivery [tPAD]) is an alternative approach. Here, we test whether overnight inhalation of hypertonic saline via tPAD improves mucociliary clearance and assess the tolerability of the device...
July 24, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28735415/cfd-simulation-of-aerosol-delivery-to-a-human-lung-via-surface-acoustic-wave-nebulization
#5
Morteza Yousefi, Oveis Pourmehran, Mofid Gorji-Bandpy, Kiao Inthavong, Leslie Yeo, Jiyuan Tu
Administration of drug in the form of particles through inhalation is generally preferable in the treatment of respiratory disorders. Conventional inhalation therapy devices such as inhalers and nebulizers, nevertheless, suffer from low delivery efficiencies, wherein only a small fraction of the inhaled drug reaches the lower respiratory tract. This is primarily because these devices are not able to produce a sufficiently fine drug mist that has aerodynamic diameters on the order of a few microns. This study employs computational fluid dynamics to investigate the transport and deposition of the drug particles produced by a new aerosolization technique driven by surface acoustic waves (SAWs) into an in silico lung model geometrically reconstructed using computed tomography scanning...
July 22, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28733370/reliable-adherence-to-a-copd-care-bundle-mitigates-system-level-failures-and-reduces-copd-readmissions-a-system-redesign-using-improvement-science
#6
Muhammad Ahsan Zafar, Ralph J Panos, Jonathan Ko, Lisa C Otten, Anthony Gentene, Maria Guido, Katherine Clark, Caroline Lee, Jamie Robertson, Evaline A Alessandrini
BACKGROUND: Readmissions of chronic obstructive pulmonary disease (COPD) have devastating effects on patient quality-of-life, disease progression and healthcare cost. Effective interventions to reduce COPD readmissions are needed. OBJECTIVES: Reduce 30-day all-cause readmissions by (1) creating a COPD care bundle that addresses care delivery failures, (2) using improvement science to achieve 90% bundle adherence. SETTING: An 800-bed academic hospital in Ohio, USA...
July 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28732821/optimizing-inhalation-technique-using-web-based-videos-in-obstructive-lung-diseases
#7
Tobias Müller, Annegret Müller, Christian Hübel, Verena Knipel, Wolfram Windisch, Christian Gabriel Cornelissen, Michael Dreher
BACKGROUND: Inhaled agents are widely used in the treatment of chronic airway diseases. Correct technique is required to ensure appropriate drug deposition, but poor technique is common. This study investigated whether inhalation technique could be improved by patient training using short videos from the German Airway League. METHODS: Outpatients from a university hospital respiratory clinic who had incorrect inhalation technique were asked to demonstrate this again immediately after viewing the training videos, and after 4-8 weeks' follow-up...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28730936/an-industry-update-what-is-the-latest-news-in-therapeutic-delivery
#8
Iain Simpson
This Industry Update covers the period from 1 through 30 April 2017, and is based on information sourced from company press releases, scientific literature, patents and various news websites. Biogen expanded its portfolio of developmental drugs targeting neurological diseases by licensing a drug from Bristol-Myers Squibb which is currently under investigation for the treatment of progressive supranuclear palsy. Takeda announced a deal with NuBiyota focused on developing treatments for gastrointestinal disorders, based on the manipulation of microbes living in the gut...
July 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28730933/drug-delivery-to-the-lungs-challenges-and-opportunities
#9
Stephen P Newman
Pulmonary drug delivery is relatively complex because the respiratory tract has evolved defense mechanisms to keep inhaled drug particles out of the lungs and to remove or inactivate them once deposited. In addition to these mechanical, chemical and immunological barriers, pulmonary drug delivery is adversely affected by the behavioral barriers of poor adherence and poor inhaler technique. Strategies to mitigate the effects of these barriers include use of inhaler devices and formulations that deliver drug to the lungs efficiently, appropriate inhaler technique and improved education of patients...
July 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28725455/effect-of-respiratory-pattern-on-automated-clinical-blood-pressure-measurement-an-observational-study-with-normotensive-subjects
#10
Natalia Herakova, Nnenna Harmony Nzeribe Nwobodo, Ying Wang, Fei Chen, Dingchang Zheng
BACKGROUND: It has been reported that deep breathing could reduce blood pressures (BP) in general. It is also known that BP is decreased during inhalation and increased during exhalation. Therefore, the measured BPs could be potentially different during deep breathing with different lengths of inhalation and exhalation. This study aimed to quantitatively investigate the effect of different respiratory patterns on BPs. METHODS: Forty healthy subjects (20 males and 20 females, aged from 18 to 60 years) were recruited...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28718049/good-things-in-small-packages-an-innovative-delivery-approach-for-inhaled-insulin
#11
James B Fink, Lisa Molloy, John S Patton, Valdecir Castor Galindo-Filho, Jacqueline de Melo Barcelar, Luciana Alcoforado, Simone Cristina Soares Brandão, Armèle Dornelas de Andrade
PURPOSE: The design development of a small, hand held, battery operated, breath actuated inhaler as a drug/device platform for inhaled insulin posed a number of technical challenges. Our goal was to optimize lung deposition and distribution with aerosol generators producing 3-6 μm particle size distribution. METHODS: In silico modeling with computational fluid dynamics (CFD) and in vitro testing of device components were assessed using an Alberta idealized adult airway (Copley, UK) to optimize mouthpiece and aerosol path design for dose delivered distal to the trachea...
July 17, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28717881/a-retrospective-comparison-of-inhaled-milrinone-and-iloprost-in-post-bypass-pulmonary-hypertension
#12
Kassiani Theodoraki, Apostolos Thanopoulos, Panagiota Rellia, Evangelos Leontiadis, Dimitrios Zarkalis, Konstantinos Perreas, Theophani Antoniou
During cardiac operations, weaning from cardiopulmonary bypass (CPB) may prove challenging as a result of superimposed acute right ventricular dysfunction in the setting of elevated pulmonary vascular resistance (PVR). The aim of this study was to retrospectively evaluate the effect of inhaled milrinone versus inhaled iloprost in patients with persistent pulmonary hypertension following discontinuation of CPB. Eighteen patients with elevated PVR post-bypass were administered inhaled milrinone at a cumulative dose of 50 μg kg(-1)...
July 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28710850/efficacy-and-safety-of-beclomethasone-dipropionate-breath-actuated-or-metered-dose-inhaler-in-pediatric-patients-with-asthma
#13
M Vandewalker, L Hickey, C J Small
BACKGROUND: Breath-actuated inhalers (BAI) eliminate the need for hand-breath coordination and, therefore, simplify thedelivery of inhaled medication. OBJECTIVE: To evaluate the efficacy and safety of beclomethasone dipropionate BAI and metered-dose inhaler (MDI) versus placebo in pediatric patients ages 4-11 years with persistent asthma. METHODS: In this double-blind, double-dummy, phase III study, 628 children with persistent asthma were randomly assigned(1:1:1:1:1) to twice-daily beclomethasone dipropionate (BAI 80 micrograms/day, BAI 160 micrograms/day, MDI 80 micrograms/day, or MDI 160 micrograms/day) or to placebo...
July 14, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28709688/multidisciplinary-consensus-on-the-nonadherence-to-clinical-management-of-inhaled-therapy-in-spanish-asthma-patients
#14
Antolín López-Viña, Jordi Giner, Jesús Molina, Javier Palicio, Javier Plaza, José Antonio Quintano, Santiago Quirce, Cristina Soria, Ana María Uréndez, Vicente Plaza
PURPOSE: Rates of nonadherence to asthma treatment in Spain are between 24% and 76%, which results in poor disease control and increased health care costs. The main objective of this multidisciplinary consensus was to investigate the opinions of health professionals and patients regarding adherence to inhaled therapy in Spain. The results will help to identify the causes of nonadherence and to establish strategies to detect and correct the problem. METHODS: This research was conducted by using a modified Delphi method organized into 2 rounds and involving a panel of 64 physicians, 16 nurses, and 10 community pharmacists...
July 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28708443/regulatory-approaches-and-considerations-in-establishing-bioequivalence-of-inhaled-compounds
#15
Irvin Mayers, Mohit Bhutani
To be considered bioequivalent to their branded counterparts, generic drugs must meet the standards for bioequivalence (BE) described by the regulatory agencies. While BE of generic inhalational drugs can be evaluated using a similar approach as that for oral dosage from products or drugs that are delivered systemically, the approach is insufficient to address the complexities of inhalational products (e.g., localized site of action, device-patient interface). Therefore, more considerations are needed and caution should be applied when evaluating BE of inhaled compounds...
July 14, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28695328/study-of-the-emitted-dose-after-two-separate-inhalations-at-different-inhalation-flow-rates-and-volumes-and-an-assessment-of-aerodynamic-characteristics-of-indacaterol-onbrez-breezhaler-%C3%A2-150-and-300%C3%A2-%C3%AE-g
#16
Mohamad Abadelah, Henry Chrystyn, Golshan Bagherisadeghi, Gaballa Abdalla, Hassan Larhrib
Onbrez Breezhaler® is a low-resistance capsule-based device that was developed to deliver indacaterol maleate. The study was designed to investigate the effects of both maximum flow rate (MIF) and inhalation volume (Vin) on the dose emission of indacaterol 150 and 300 μg dose strengths after one and two inhalations using dose unit sampling apparatus (DUSA) as well as to study the aerodynamic characteristics of indacaterol Breezhaler® using the Andersen cascade impactor (ACI) at a different set of MIF and Vin...
July 10, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28690715/a-novel-aerodynamic-sizing-method-for-pharmaceutical-aerosols-using-image-based-analysis-of-settling-velocities
#17
Rami Fishler, Josué Sznitman
This article discusses a novel method to estimate aerodynamic particle size distributions (APSDs) of pharmaceutical aerosols through direct measurement of particle settling velocities using image-based analysis and particle tracking techniques. This simple, optical method provides accurate and fast measurements (approximately 1 minute) with few sources of bias due to specific device design choices or operation conditions. A proof-of-concept for the method is demonstrated by measuring APSDs for widely available commercial dry powder inhalers (DPIs), then comparing the results with previously published data from cascade impactors (CIs) and the Aerodynamic Particle Sizer (APS)...
June 2017: Inhalation
https://www.readbyqxmd.com/read/28683805/patient-preferences-for-dry-powder-inhaler-attributes-in-asthma-and-chronic-obstructive-pulmonary-disease-in-france-a-discrete-choice-experiment
#18
Natalia Hawken, Saku Torvinen, Mohamed-Elmoctar Neine, Ikbel Amri, Mondher Toumi, Samuel Aballéa, Adam Plich, Nicolas Roche
BACKGROUND: Dry powder inhalers (DPIs) are often used in asthma and chronic obstructive pulmonary disease (COPD) therapies. Using the discrete choice experiment (DCE) methodology, this study conducted in France was designed to assess patients' preferences for different attributes of DPIs. METHODS: Attributes of DPIs were defined based on a literature review, patient focus group discussions and interviews with healthcare professionals (qualitative phase of the study)...
July 6, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28683212/a-randomized-crossover-trial-evaluating-patient-handling-preference-and-ease-of-use-of-the-fluticasone-propionate-formoterol-breath-triggered-inhaler
#19
David Bell, Lucielle Mansfield, Mark Lomax
BACKGROUND: Appropriate inhaler selection is of fundamental importance in obstructive lung disease management. Key factors in device selection include a patient's capacity to operate a particular device and their preference for it. METHODS: This randomized, open-label, two-period, crossover study (NCT01739387) compared the ability of adolescent and adult patients with obstructive lung disease to correctly handle the fluticasone propionate/formoterol fumarate (FP/FORM; Flutiform(®)) pressurized metered-dose inhaler (pMDI) and FP/FORM K-haler(®), a novel breath-triggered inhaler (BTI), following a simple, standardized training regimen...
July 6, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28678400/nicotine-vapor-method-to-induce-nicotine-dependence-in-rodents
#20
Marsida Kallupi, Olivier George
Nicotine, the main addictive component of tobacco, induces potentiation of brain stimulation reward, increases locomotor activity, and induces conditioned place preference. Nicotine cessation produces a withdrawal syndrome that can be relieved by nicotine replacement therapy. In the last decade, the market for electronic cigarettes has flourished, especially among adolescents. The nicotine vaporizer or electronic nicotine delivery system is a battery-operated device that allows the user to simulate the experience of tobacco smoking without inhaling smoke...
July 5, 2017: Current Protocols in Neuroscience
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