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https://www.readbyqxmd.com/read/28929816/which-inhaled-corticosteroid-and-long-acting-%C3%AE-agonist-combination-is-better-in-patients-with-moderate-to-severe-asthma-a-dry-powder-inhaler-or-a-pressurized-metered-dose-inhaler
#1
Masato Muraki, Kyuya Gose, Soichiro Hanada, Hirochiyo Sawaguchi, Yuji Tohda
Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which should be recommended for asthma patients with given sets of characteristics. In the current study, the beneficial effects and side effects associated with DPIs and pMDIs were compared, and the question of which device should be recommended for asthma patients was investigated...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28890299/comparison-of-fluticasone-formoterol-with-budesonide-formoterol-pmdi-in-adults-with-moderate-to-severe-persistent-asthma-results-from-a-12-week-randomized-controlled-trial
#2
Akash Balki, S Balamurugan, Suhas Bardapurkar, Sonia Dalal, Ajeet Singh, B P Singh, Abhijit Vaidya, Jaideep A Gogtay
BACKGROUND: Combination therapy of inhaled corticosteroid/long acting β2-agonist (ICS/LABA) is the cornerstone of managing asthmatics who are uncontrolled with low-medium dose of ICS. The novel ICS/LABA combination of fluticasone propionate and formoterol (flu/form) provides potent anti-inflammatory and rapid bronchodilatory effect. This randomized, multi-centre, double-blind study compared the efficacy and safety of flu/form (125/6 mcg BD; Maxiflo(®)) with the well-established budesonide/formoterol combination (bud/form 200/6 mcg BD), both delivered through a pressurized metered dose inhaler (pMDI) in patients with moderate to severe persistent asthma over 12 weeks...
September 7, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28887061/advances-in-audio-based-systems-to-monitor-patient-adherence-and-inhaler-drug-delivery
#3
REVIEW
Terence E Taylor, Yaniv Zigel, Céline De Looze, Imran Sulaiman, Richard W Costello, Richard B Reilly
Hundreds of millions of people suffer from asthma and chronic obstructive pulmonary disease (COPD) worldwide. Current medications to control these chronic respiratory diseases can be administered using inhaler devices, such as the pressurized metered dose inhaler (pMDI) and dry powder inhaler (DPI). Providing that they are used as prescribed, inhalers can improve patients' clinical outcomes and quality of life. Poor patient inhaler adherence (both time of use and user technique) is, however, a major clinical concern and is associated with poor disease control, increased hospital admissions and increased mortality rates, particularly in low-middle income countries...
September 5, 2017: Chest
https://www.readbyqxmd.com/read/28860739/the-comparative-effectiveness-of-initiating-fluticasone-salmeterol-combination-therapy-via-pmdi-versus-dpi-in-reducing-exacerbations-and-treatment-escalation-in-copd-a-uk-database-study
#4
Rupert Jones, Jessica Martin, Vicky Thomas, Derek Skinner, Jonathan Marshall, Martina Stagno d'Alcontres, David Price
Chronic obstructive pulmonary disease (COPD), a complex progressive disease, is currently the third leading cause of death worldwide. One recommended treatment option is fixed-dose combination therapy of an inhaled corticosteroid (ICS)/long-acting β-agonist. Clinical trials suggest pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) show similar efficacy and safety profiles in COPD. Real-world observational studies have shown that combination therapy has significantly greater odds of achieving asthma control when delivered via pMDIs...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28846487/development-of-an-intelligent-spacer-data-logger-system
#5
Chris O'Callaghan, Nicholas J Smith, Peter W Barry, John Denyer
BACKGROUND: Although delivery of drugs from pressurized metered dose inhalers (pMDIs) via spacer devices is widespread it cannot be assumed that patients take their medication as prescribed or use their spacer appropriately. We developed a Spacer Data Logger device to record patient adherence and whether patients had shaken the pMDI, actuated it soon after shaking, and inhaled a sufficient volume from it. METHODS: We report an assessment of the Spacer Data Logger to measure and record that the pMDI was adequately shaken, the time to actuation, and the volume "inhaled" from the spacer up to 26 seconds after actuation...
August 28, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28732831/initiating-or-changing-to-a-fixed-dose-combination-of-fluticasone-propionate-formoterol-over-fluticasone-propionate-salmeterol-a-real-life-effectiveness-and-cost-impact-evaluation
#6
Simon Wan Yau Ming, John Haughney, Iain Small, Stephanie Wolfe, John Hamill, Kevin Gruffydd-Jones, Cathal Daly, Joan B Soriano, Elizabeth Gardener, Derek Skinner, Martina Stagno d'Alcontres, David B Price
OBJECTIVE: Asthma has a substantial impact on quality of life and health care resources. The identification of a more cost-effective, yet equally efficacious, treatment could positively influence the economic burden of this disease. Fluticasone propionate/Formoterol (FP/FOR) may be as effective as Fluticasone Salmeterol (FP/SAL). We evaluated non-inferiority of asthma control in terms of the proportion of patients free from exacerbations, and conducted a cost impact analysis. METHODS: This historical, matched cohort database study evaluated two treatment groups in the Optimum Patient Care Research Database in the UK: 1) an FP/FOR cohort of patients initiating treatment with FP/FOR or changing from FP/SAL to FP/FOR and; 2) an FP/SAL cohort comprising patients initiating, or remaining on FP/SAL pMDI combination therapy...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28723410/innovative-pmdi-formulations-of-spray-dried-nanoparticles-for-efficient-pulmonary-drug-delivery
#7
Hao-Ying Li, En-Yu Xu
For drug delivery to the lungs, the aerodynamic size of drug particles plays a predominant role in determining the sites of deposition in the airway, and the particles with the size less than 2μm are highly expected as they will be preferably delivered to the ideal site of alveolar regions. In this paper, a novel platform technology has been developed, where the water (containing pharmaceutically active agents)-in-oil (w/o) microemulsions were spray-dried to generate nanosized drug particles that were able to be homogeneously dispersed in the propellant to form an exceptionally stable suspensions with no precipitates or flocculates during a long time storage...
July 16, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28701014/-spacer-aerosol-therapy-through-space-and-time
#8
Thomas Voshaar, Peter Haidl, Rolf Michael Clös
Aim of the literature review Within this review, results of a literature analysis on the application of spacers with pressurized metered dose inhalers (pMDI) are described and evaluated. Methods Next to an extensive revision on effects of spacers, the impacts of current guidelines and the conditions for product authorisations on the use of spacers are described which result from the interplay of characteristics from dose inhalers with a spacer. Results Spacers are generally useful to avoid coordination problems concerning the actuation of a pMDI at the beginning of an inhalation...
July 2017: Pneumologie
https://www.readbyqxmd.com/read/28684363/investigation-of-multiphase-multicomponent-aerosol-flow-dictating-pmdi-spacer-interactions
#9
Saurabh Sarkar, S Prasad Peri, Bodhisattwa Chaudhuri
The use of Pressurized metered dose inhalers (pMDIs) for the treatment of asthma and other chronic obstructive pulmonary diseases is frequently associated with breath-actuation synchronization problems and poor pulmonary delivery, particularly amongst the pediatric and geriatric population groups. Spacers, or Valved Holding Chambers (VHCs), are frequently used to address these problems. However, the performance of spacers with different pMDIs is also highly variable and needs to be investigated. The purpose of the current study is to develop a computational fluid dynamics (CFD) model which can characterize multiphase multicomponent aerosol flow issuing from a commercial suspension-based pMDI into a spacer...
July 4, 2017: International Journal of Pharmaceutics
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
#10
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/28670327/asthma-pressurised-metered-dose-inhaler-performance-propellant-effect-studies-in-delivery-systems
#11
William F S Sellers
BACKGROUND: Current pressurised metered dose asthma inhaler (pMDI) propellants are not inert pharmacologically as were previous chlorofluorocarbons, have smooth muscle relaxant' partial pressure effects in the lungs and inhaled hydrofluoroalkane 134a (norflurane) has anaesthetic effects. Volumes of propellant gas per actuation have never been measured. METHODS: In-vitro studies measured gas volumes produced by pMDIs on air oxygen (O2) levels in valved holding chambers (VHC) and the falls in O2% following actuation into lung ventilator delivery devices...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28611228/effect-of-interval-between-actuations-of-albuterol-hydrofluoroalkane-pressurized-metered-dose-inhalers-on-their-aerosol-characteristics
#12
Ariel Berlinski, David Pennington
BACKGROUND: Albuterol hydrofluoroalkane (HFA) either alone or with a valved holding chamber is used to treat bronchoconstriction. Delays between actuation and inhalation are common. Currently, the recommended interval between actuations of an albuterol HFA is 60 s. Using a shorter interval when multiple actuations are ordered will improve productivity in the hospital setting. METHODS: We studied aerosol characteristics of albuterol HFA (Ventolin, ProAir, and Proventil) with a cascade impactor calibrated at 30 L/min...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28599855/impact-of-droplet-evaporation-rate-on-resulting-in-vitro-performance-parameters-of-pressurized-metered-dose-inhalers
#13
Poonam Sheth, Matthew R Grimes, Stephen W Stein, Paul B Myrdal
Pressurized metered dose inhalers (pMDIs) are widely used for the treatment of pulmonary diseases. The overall efficiency of pMDI drug delivery may be defined by in vitro parameters such as the amount of drug that deposits on the model throat and the proportion of the emitted dose that has particles that are sufficiently small to deposit in the lung (i.e., fine particle fraction, FPF). The study presented examines product performance of ten solution pMDI formulations containing a variety of cosolvents with diverse chemical characteristics by cascade impaction with three inlets (USP induction port, Alberta Idealized Throat, and a large volume chamber)...
August 7, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28589305/discriminating-ability-of-abbreviated-impactor-measurement-approach-aim-to-detect-changes-in-mass-median-aerodynamic-diameter-mmad-of-an-albuterol-salbutamol-pmdi-aerosol
#14
J David Christopher, Rajni B Patel, Jolyon P Mitchell, Terrence P Tougas, Adrian P Goodey, Jorge Quiroz, Patrik U Andersson, Svetlana Lyapustina
This article reports on results from a two-lab, multiple impactor experiment evaluating the abbreviated impactor measurement (AIM) concept, conducted by the Cascade Impaction Working Group of the International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS). The goal of this experiment was to expand understanding of the performance of an AIM-type apparatus based on the Andersen eight-stage non-viable cascade impactor (ACI) for the assessment of inhalation aerosols and sprays, compared with the full-resolution version of that impactor described in the pharmacopeial compendia...
June 6, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28549971/tpp-dendrimer-nanocarriers-for-sirna-delivery-to-the-pulmonary-epithelium-and-their-dry-powder-and-metered-dose-inhaler-formulations
#15
Elizabeth Bielski, Qian Zhong, Hamad Mirza, Matthew Brown, Ashura Molla, Teresa Carvajal, Sandro R P da Rocha
The regulation of genes utilizing the RNA interference (RNAi) mechanism via the delivery of synthetic siRNA has great potential in the treatment of a variety of lung diseases. However, the delivery of siRNA to the lungs is challenging due to the poor bioavailability of siRNA when delivered intraveneously, and difficulty in formulating and maintaining the activity of free siRNA when delivered directly to the lungs using inhalation devices. The use of non-viral vectors such as cationic dendrimers can help enhance the stability of siRNA and its delivery to the cell cytosol...
May 23, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28510491/short-term-growth-during-treatment-with-inhaled-fluticasone-propionate-formoterol-fluticasone-and-beclomethasone-treatment
#16
Ole D Wolthers, Ainslee Moore, Sabine Mersmann, Sanjeeva Dissanayake
BACKGROUND: Fluticasone propionate/formoterol (FP/FORM) is a pressurized metered-dose inhaler (pMDI; Flutiform(®)) approved for use in adolescents and adults and under development for pediatric use. OBJECTIVE: To compare short-term growth in asthmatic children treated with FP/FORM, FP pMDI with valved holding chamber, and beclomethasone dipropionate (BDP) in a breath-actuated device. METHODS: Children with persistent asthma (n = 48; 5 to <12 years) participated in an assessor-blinded, randomized, three-way crossover trial with run in, wash out, and active treatment periods, each of 2 weeks duration...
May 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28469943/deposition-dosages-of-three-cromolyn-forms-by-cascade-impactor
#17
Norihide Murayama, Kei Asai, Kikuno Murayama, Chihiro Kitatsuji, Satoru Doi
Among inhaled asthma therapies, the present study aimed to identify factors for selecting the type of inhalation therapy for asthma. Three methods are used to deliver inhaled cromoglycate, and the airway deposition rate was evaluated using a cascade impactor with 3 dosage forms: dry powder (DP), pressurized metered dose inhaler (pMDI), and solution (jet- and mesh-types). The percentage of particles with diameters of 2-6 μm was 17.0% for the capsule, 51.8% for pMDI, 49.0% for jet-type NE-C28, and 40.4% for mesh-type NE-U22...
2017: Journal of Drug Delivery
https://www.readbyqxmd.com/read/28463041/effect-of-pressurized-metered-dose-inhaler-spray-characteristics-and-particle-size-distribution-on-drug-delivery-efficiency
#18
Morteza Yousefi, Kiao Inthavong, Jiyuan Tu
BACKGROUND: A key issue in pulmonary drug delivery is improvement of the delivery device for effective and targeted treatment. Pressurized metered dose inhalers (pMDIs) are the most popular aerosol therapy device for treating lung diseases. This article studies the effect of spray characteristics: injection velocity, spray cone angle, particle size distribution (PSD), and its mass median aerodynamic diameter (MMAD) on drug delivery. METHODS: An idealized oral airway geometry, extending from mouth to the main bronchus, was connected to a pMDI device...
May 2, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28450164/a-novel-approach-to-study-the-pmdi-plume-using-an-infrared-camera-and-to-evaluate-the-aerodynamic-properties-after-varying-the-time-between-actuations
#19
Nitesh K Kunda, Julia Hautmann, Sebastián E Godoy, Patricia Marshik, Ramesh Chand, Sanjay Krishna, Pavan Muttil
Plume characteristics, such as temperature and velocity, emitted from pMDIs could significantly affect the dose delivered to the lung. Currently, high speed cameras and thermocouples are used separately to evaluate these parameters. We used a low-noise infrared camera to evaluate both the temperature and velocity of the emitted plume from pMDIs. Additionally, we investigated whether the fine particle fraction (FPF) is affected when time between actuations is varied. We tested three different albuterol sulfate pMDIs: ProAir(®) HFA, Proventil(®) HFA, and Ventolin(®) HFA...
April 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28437104/redox-active-macrocycles-for-organic-rechargeable-batteries
#20
Dong Jun Kim, Keith R Hermann, Aleksandrs Prokofjevs, Michael T Otley, Cristian Pezzato, Magdalena Owczarek, J Fraser Stoddart
Organic rechargeable batteries, composed of redox-active molecules, are emerging as candidates for the next generation of energy storage materials because of their large specific capacities, cost effectiveness, and the abundance of organic precursors, when compared with conventional lithium-ion batteries. Although redox-active molecules often display multiple redox states, precise control of a molecule's redox potential, leading to a single output voltage in a battery, remains a fundamental challenge in this popular field of research...
May 9, 2017: Journal of the American Chemical Society
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