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Dry powder inhaler

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https://www.readbyqxmd.com/read/28332886/inhaler-technique-mastery-and-maintenance-in-healthcare-professionals-trained-on-different-devices
#1
Sinthia Bosnic-Anticevich, Christina Callan, Henry Chrystyn, Federico Lavorini, Vasilis Nikolaou, Vicky Kritikos, P N Richard Dekhuijzen, Nicolas Roche, Leif Bjermer, Cynthia Rand, Nicholas Zwar, David B Price
OBJECTIVE: Healthcare professionals (HCPs) are required to assess and train patients in the correct use of inhalers but are often unable to demonstrate correct technique themselves. We sought to assess the level of training required for HCPs to master and maintain device mastery when using two different dry powder inhalers (DPIs). METHODS: We conducted a randomised, un-blinded, cross-over study in undergraduate HCPs who undertook a six-step training procedure (intuitive use, patient information leaflet, instructional video, individual tuition from expert, then two repeats of individual tuition) for the use of Turbuhaler® (an established device) and Spiromax® (a newer device, reportedly easier to use)...
March 23, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28323493/microparticles-containing-erlotinib-loaded-solid-lipid-nanoparticles-for-treatment-of-non-small-cell-lung-cancer
#2
Zahra Bakhtiary, Jaleh Barar, Ayuob Aghanejad, Amir Ata Saei, Elhameh Nemati, Jafar Ezzati Nazhad Dolatabadi, Yadollah Omidi
Non-small cell lung cancer (NSCLC) patients with sensitizing mutations in the exons 18-21 of the epithelial growth factor receptor (EGFR) geneshowincreased kinase activity of EGFR. Hence, tyrosine kinase inhibitors (TKIs) such as erlotinib (ETB) havecommonly been used as the second line therapeutic option in metastatic NSCLC. While the ETB is available as an oral dosage form, the local delivery of this TKI to the diseased cells of the lung may ameliorate its therapeutic impacts. In the current study, we report on the development of ETB-loaded solid lipid nanoparticle (SLN) based formulation of dry powder inhaler (ETB-SLN DPI)...
March 21, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28322599/dissolvit-an-in-vitro-method-for-simulating-the-dissolution-and-absorption-of-inhaled-dry-powder-drugs-in-the-lungs
#3
Per Gerde, Maria Malmlöf, Lina Havsborn, Carl-Olof Sjöberg, Pär Ewing, Stefan Eirefelt, Katarina Ekelund
The main purpose of this work was to develop an in vitro method for simulating the dissolution and absorption of inhaled dry powder drugs that also mimics systemic pharmacokinetic data. A second purpose was to evaluate this method. DissolvIt(®) was developed as a simulation of the air-blood barrier of the upper airways, constituting: "airborne" particles deposited on a glass cover slip, a mucus simulant, a polycarbonate (basal) membrane, and a pumped albumin buffer simulating the pulmonary blood flow. The PreciseInhale(®) exposure system was used to aerosolize and deposit test formulations onto cover slips...
February 2017: Assay and Drug Development Technologies
https://www.readbyqxmd.com/read/28288490/development-in-vitro-characterization-antitumor-and-aerosol-performance-evaluation-of-respirable-prepared-by-self-nanoemulsification-method
#4
Neda Naseri, Parvin Zakeri-Milani, Hamed Hamishehkar, Younes Pilehvar-Soltanahmadi, Hadi Valizadeh
Poor water solubility and low oral bioavailability limit the clinical application of Erlotinib as an anticancer. For this purpose, we encapsulated erlotinib in the solid lipid nanoparticles (SLN) and designed a spray-dried dry powder inhalable (DPI) formulation. Erlotinib-loaded SLNs were prepared using self-nanoemulsifying and characterized for physicochemical properties. Pulmonary deposition of spray-dried DPI formulation was performed using Next Generation Impactor. The particle size and zeta potential of Erlotinib-loaded SLNs were 300 to 800 nm and -18 to -32 mV, respectively...
March 13, 2017: Drug Research
https://www.readbyqxmd.com/read/28286157/inhaler-errors-in-the-critikal-study-type-frequency-and-association-with-asthma-outcomes
#5
David B Price, Miguel Román-Rodríguez, R Brett McQueen, Sinthia Bosnic-Anticevich, Victoria Carter, Kevin Gruffydd-Jones, John Haughney, Svein Henrichsen, Catherine Hutton, Antonio Infantino, Federico Lavorini, Lisa M Law, Karin Lisspers, Alberto Papi, Dermot Ryan, Björn Ställberg, Thys van der Molen, Henry Chrystyn
BACKGROUND: Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. OBJECTIVE: The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific inhaler errors and asthma outcomes. METHODS: This analysis used data from the iHARP asthma review service-a multicenter cross-sectional study of adults with asthma...
March 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28285981/novel-budesonide-particles-for-dry-powder-inhalation-dpi-prepared-using-a-microfluidic-reactor-coupled-with-ultrasonic-spray-freeze-drying
#6
Denis Saboti, Uroš Maver, Hak-Kim Chan, Odon Planinšek
Budesonide is a potent active pharmaceutical ingredient, often administered using respiratory devices such as metered dose inhalers (MDI), nebulizers and dry powder inhalers (DPI). Inhalable drug particles are conventionally produced by crystallization followed by milling. This approach tends to generate partially amorphous materials that require post-processing to improve the formulations' stability. Other methods involve homogenization or precipitation and often require the use of stabilizers, mostly surfactants...
March 9, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28284323/optimizing-drug-delivery-in-copd-the-role-of-inhaler-devices
#7
REVIEW
Paola Rogliani, Luigino Calzetta, Angelo Coppola, Francesco Cavalli, Josuel Ora, Ermanno Puxeddu, Maria Gabriella Matera, Mario Cazzola
Inhaled medication is the cornerstone of the pharmacological treatment for patients with asthma and chronic obstructive pulmonary disease (COPD). Several inhaler devices exist, and each device has specific characteristics to achieve the optimal inhalation of drugs. The correct use of inhaler devices is not granted and patients may incur in mistakes when using pressurized metered-dose inhalers (pMDIs) or dry-powder inhaler (DPIs). The incorrect use of inhaler devices can lead to a poorly controlled disease status...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28282259/study-on-the-pulmonary-delivery-system-of-apigenin-loaded-albumin-nanocarriers-with-antioxidant-activity
#8
Zsófia Edit Pápay, Annamária Kósa, Béla Böddi, Zahra Merchant, Imran Y Saleem, Mohammed Gulrez Zariwala, Imre Klebovich, Satyanarayana Somavarapu, István Antal
BACKGROUND: Respiratory diseases are mainly derived from acute and chronic inflammation of the alveoli and bronchi. The pathophysiological mechanisms of pulmonary inflammation mainly arise from oxidative damage that could ultimately lead to acute lung injury. Apigenin (Api) is a natural polyphenol with prominent antioxidant and anti-inflammatory properties in the lung. Inhalable formulations that consist of nanoparticles (NPs) have several advantages over other administration routes, and therefore, this study investigated the application of apigenin-loaded bovine serum albumin nanoparticles (BSA-Api-NPs) for pulmonary delivery...
March 10, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28281196/pharmacokinetics-of-the-inhaled-selective-glucocorticoid-receptor-modulator-azd5423-following-inhalation-using-different-devices
#9
Johanna Melin, Susanne Prothon, Charlotte Kloft, Adriaan Cleton, Carl Amilon, Carin Jorup, Per Bäckman, Bo Olsson, Ulrika Wählby Hamrén
AZD5423 is a non-steroidal glucocorticoid receptor modulator, with low aqueous solubility, developed for treatment of asthma and COPD. In this work, we aim to evaluate and compare the absorption pharmacokinetics (PK) of AZD5423 after inhalation via four devices, (Spira®, I-neb®, Turbuhaler® and a new dry powder inhaler (new DPI)) with two formulations using differently sized primary particles, and to compare the pulmonary bioavailability with the predicted lung deposited dose. Plasma concentration-time data after intravenous, oral and inhaled administration via four devices were available from two clinical studies in healthy and asthmatic subjects...
March 9, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28277810/the-impact-of-common-inhaler-errors-on-drug-delivery-investigating-critical-errors-with-a-dry-powder-inhaler
#10
Imran Sulaiman, Jansen Seheult, Nirmal Sadasivuni, Elaine MacHale, Isabelle Killane, Spiros Giannoutsos, Breda Cushen, Matshediso Constantina Mokoka, Aoife Sartini Bhreathnach, Fiona Boland, Richard B Reilly, Richard W Costello
BACKGROUND: Researchers, using checklists, have identified that 30%-90% of patients make errors in inhaler use. It is not certain whether these errors affect the delivery of medication. We have developed an electronic monitor (INCA™) that records audio each time an inhaler is used, providing objective information on inhaler technique. The aim of this study was to assess the effect that correctly identified inhaler errors, with the INCA device, have on drug delivery. METHODS: This was a prospective study of healthy volunteers using a salbutamol Diskus™...
March 9, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28276783/application-of-cyclodextrins-in-antibody-microparticles-potentials-for-antibody-protection-in-spray-drying
#11
Vahid Ramezani, Alireza Vatanara, Mohammad Seyedabadi, Mohsen Nabi Meibodi, Hamed Fanaei
OBJECTIVES: Dry powder formulations are extensively used to improve the stability of antibodies. Spray drying is one of important methods for protein drying. This study investigated the effects of trehalose, hydroxypropyl beta cyclodextrin (HPBCD) and beta cyclodextrin (BCD) on the stability and particle properties of spray-dried IgG. METHODS: D-optimal design was employed for both experimental design and analysis and optimization of the variables. The size and aerodynamic behavior of particles were determined using laser light scattering and glass twin impinger, respectively...
March 1, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28260934/peak-inspiratory-flow-rate-measurement-by-using-in-check-dial-for-the-different-inhaler-devices-in-elderly-with-obstructive-airway-diseases
#12
Theerasuk Kawamatawong, Supattra Khiawwan, Prapaporn Pornsuriyasak
BACKGROUND: Inhaler device technique is a common cause of treatment failure in patients with asthma and chronic obstructive pulmonary disease. Dry powder inhaler (DPI) requires optimal peak inspiratory flow rate (PIFR) for drug delivery. Low PIFR generation is common in the elderly. Patient lung function and intrinsic inhaler resistance are factors for determining generated PIFR and drug delivery from DPI. OBJECTIVES: We aimed to identify the PIFR of the older (aged >60 years) and the younger (aged ≤60 years) patients with obstructive airway diseases for the different inhaler devices (Turbuhaler(®) and Accuhaler)...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28258928/inhaled-dry-powder-mannitol-in-children-with-cystic-fibrosis-a-randomised-efficacy-and-safety-trial
#13
K De Boeck, E Haarman, J Hull, L C Lands, A Moeller, A Munck, J Riethmüller, H Tiddens, S Volpi, J Leadbetter, B Charlton, A Malfroot
INTRODUCTION: Inhaled mannitol has beneficial effects on lung function, mucociliary clearance, quality of life and sputum properties. This trial examined the efficacy of inhaled mannitol in children with cystic fibrosis (CF). METHODS: The efficacy of inhaled mannitol in children with CF aged 6-17years was assessed in a phase 2, randomised, placebo-controlled crossover study. Subjects were randomly assigned to mannitol 400mg every 12h or matching placebo for 8weeks, followed by an 8week washout and an 8week period with the alternate treatment...
February 28, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28256307/efficacy-and-safety-of-budesonide-formoterol-pmdi-vs-budesonide-pmdi-in-asthmatic-children-6-12-years
#14
David S Pearlman, Göran Eckerwall, Julie McLaren, Rosa Lamarca, Margareta Puu, Ileen Gilbert, Carin Jorup, Kristina Sandin, Miguel J Lanz
BACKGROUND: The efficacy and safety of budesonide/formoterol pressurized metered-dose inhaler (pMDI) have been demonstrated in patients with asthma at least 12 years old. OBJECTIVE: To evaluate the efficacy of 2 formoterol doses added to budesonide as fixed combinations vs budesonide alone in children 6 to younger than 12 years with asthma. METHODS: This randomized, double-blinded, parallel-group, multicenter study (NCT02091986; CHASE 3) included children 6 to younger than 12 years with asthma previously receiving a medium-dose inhaled corticosteroid (ICS) or an ICS plus a long-acting β2-agonist...
February 27, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28254655/real-life-dose-emission-characterization-using-copd-patient-inhalation-profiles-when-they-inhaled-using-a-fixed-dose-combination-fdc-of-the-medium-strength-symbicort-%C3%A2-turbuhaler-%C3%A2
#15
Golshan Bagherisadeghi, El Hassane Larhrib, Henry Chrystyn
The dose emitted from dry powder inhalers (DPI) is inhalation flow dependent and so varies with the peak inhalation flow (PIF) of a patient's inhalation maneuver (IM). Dose emission could also be affected by other IM parameters-the inhaled volume (Vin) and the initial acceleration rate of the IM (ACIM). We have adapted the compendial method for in-vitro DPI determinations so that inhalation profiles replace the inhalation square profile generated by a vacuum pump. These real-life patient inhalation profiles were measured when 18 COPD patients inhaled through an empty placebo Symbicort(®) Turbuhaler(®)...
February 28, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28245825/predictors-of-correct-technique-in-patients-using-pressurized-metered-dose-inhalers
#16
Kyra Bartolo, Martin Balzan, Emma Louise Schembri, Rachelle Asciak, Darlene Mercieca Balbi, Michael Pace Bardon, Stephen Montefort
BACKGROUND: Corret inhaler technique is recommended by guidelines for optimum asthma care. The objective of the study is to determine real life predictors of correct pressurized metered dose inhaler (pMDI) technique in Asthma and COPD patients. METHODS: Two hundred eight adult patients aged 18+ from respiratory outpatients (69.2%) and the community on regular pMDI for a diagnosis of Asthma (78.9%) or COPD, were recruited. A questionnaire containing 31 possible predictors was administered and pMDI technique with or without spacer was observed by trained researchers on 12 point steps, of which 4 were considered critical...
February 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28228660/estimating-the-economic-consequences-of-an-increased-medication-adherence-due-to-a-potential-improvement-in-the-inhaler-technique-with-spiromax-%C3%A2-compared-with-turbuhaler-%C3%A2-in-patients-with-moderate-to-severe-chronic-obstructive-pulmonary-disease-in-spain
#17
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas, José Francisco Pascual, Diego Vargas, Adi Bijedic
OBJECTIVE: The objective of this study was to estimate the economic impact of the introduction of DuoResp(®) Spiromax(®), budesonide/formoterol fixed-dose combination (FDC), focusing on an increase in medication adherence due to an enhancement of the inhalation technique for the treatment of COPD patients in Spain and 5 regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the time period of 2015-2018...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28184045/effect-of-novel-inhaler-technique-reminder-labels-on-the-retention-of-inhaler-technique-skills-in-asthma-a-single-blind-randomized-controlled-trial
#18
Iman A Basheti, Nathir M Obeidat, Helen K Reddel
Inhaler technique can be corrected with training, but skills drop off quickly without repeated training. The aim of our study was to explore the effect of novel inhaler technique labels on the retention of correct inhaler technique. In this single-blind randomized parallel-group active-controlled study, clinical pharmacists enrolled asthma patients using controller medication by Accuhaler [Diskus] or Turbuhaler. Inhaler technique was assessed using published checklists (score 0-9). Symptom control was assessed by asthma control test...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28170282/pharmacokinetics-of-salbutamol-delivered-from-the-unit-dose-dry-powder-inhaler-comparison-with-the-metered-dose-inhaler-and-diskus-dry-powder-inhaler
#19
Alison Moore, Kylie Riddell, Shashidhar Joshi, Robert Chan, Rashmi Mehta
AIM: To compare the systemic exposure of salbutamol following delivery from the unit dose dry powder inhaler (UD-DPI) system with that from the Diskus(®) and metered dose inhaler (MDI). MATERIALS AND METHODS: This open-label, two-part, six-way crossover, randomized single-dose study in healthy subjects evaluated salbutamol systemic exposure of three dose strengths (using three inhalations: 3 × 150 μg [450 μg], 3 × 200 μg [600 μg], and 3 × 250 μg [750 μg]) and 2% of drug in lactose blends (1...
February 7, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28161667/aerodynamic-properties-and-in-silico-deposition-of-meloxicam-potassium-incorporated-in-a-carrier-free-dpi-pulmonary-system
#20
Anita Chvatal, Árpád Farkas, Imre Balásházy, Piroska Szabó-Révész, Rita Ambrus
Dry powder inhalers (DPIs) have been among the fastest developing inhaler forms in the past decades. Researches are focusing on the formulation of carrier-free powders to obtain a higher deep-lung deposition and hereby to increase the effectiveness of the medicine. The aim of our study was to prepare a carrier-free dry powder formulation of meloxicam potassium (MP), a novel salt form of meloxicam, using a one-step co-spray drying technology. Different types of excipients were used to modify the crystal structure and to increase aerosolization efficacy...
February 1, 2017: International Journal of Pharmaceutics
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