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Ross H M Hatley, Jacob Parker, John N Pritchard, Dirk von Hollen
BACKGROUND: Pressurized metered-dose inhalers (pMDIs) should be shaken before use to prevent creaming or sedimentation of the drugs in solution; however, data published on this topic are limited, and it is rarely specified how soon after shaking the device should be actuated. Delays between shaking and firing the pMDI have previously been shown to cause significant inhomogeneity in delivered dose. We studied the effect of various shake-fire delays on the drug delivered from five commercially available pMDIs commonly prescribed for asthma and chronic obstructive pulmonary disease to assess the potential variability in delivered dose...
September 16, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Jai Bharat Mullerpattan, Zarah Zarir Udwadia, Sushil S Kathar, Hardik D Shah, Sarthak Ashok Rastogi, Kamlesh V Pandey, Zarir Farokh Udwadia
INTRODUCTION: The proper use of inhalers is essential for ensuring proper control of the disease. Various studies have shown high levels of improper use and lack of knowledge of the correct technique among patients with asthma. However, less data are available on how health care workers (HCW's) use inhalers. MATERIALS AND METHODS: The study was conducted at a Tertiary Care Hospital in Mumbai. We evaluated the pMDI technique in 141 consecutive adult asthmatics and 100 HCW's...
September 2016: Lung India: Official Organ of Indian Chest Society
Wouter H van Geffen, W R Douma, Dirk Jan Slebos, Huib A M Kerstjens
BACKGROUND: Bronchodilators are a central component for treating exacerbations of chronic obstructive pulmonary disease (COPD) all over the world. Clinicians often use nebulisers as a mode of delivery, especially in the acute setting, and many patients seem to benefit from them. However, evidence supporting this choice from systematic analysis is sparse, and available data are frequently biased by the inclusion of asthma patients. Therefore, there is little or no formal guidance regarding the mode of delivery, which has led to a wide variation in practice between and within countries and even among doctors in the same hospital...
2016: Cochrane Database of Systematic Reviews
Abubaker Alatrash, Edgar Matida
BACKGROUND: Particle size and velocity are two of the most significant factors that impact the deposition of pressurized metered-dose inhaler (pMDI) sprays in the mouth cavity. pMDIs are prominently used around the world in the treatment of patients suffering from a variety of lung diseases such as asthma and chronic obstructive pulmonary disease. Since their introduction in the field, and as a result of their effectiveness and simplicity of usage, pMDIs are considered to be the most widely prescribed medical aerosol delivery system...
August 9, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
A Sicras, V Ferrer, J M Collar, R Navarro, M Sáez
OBJECTIVE: To assess the initial treatment persistence with inhaled corticosteroids and long-acting beta-2 adrenergic bronchodilators (ICS/LABA) depending on the inhaler device used (pMDI or DPI), for the treatment of asthma and COPD. MATERIAL AND METHODS: An multicenter observational study. Subjects in initial treatment with ICS/LABA during 2007-2011 were included, and a follow-up period of 3 years. 2 groups of study (asthma, COPD) and 2 subgroups were prepared according to the device type inhaler (pMDI or DPI)...
July 14, 2016: Semergen
Michael J Welch
INTRODUCTION: Incorrect use of inhaler devices by patients with asthma is common and can adversely affect clinical outcomes. Devices that are straightforward to use are less likely to result in dosing errors and can improve patients' satisfaction with therapy and adherence. A novel dry-powder formulation of the rescue bronchodilator albuterol (salbutamol) administered using a multidose dry-powder inhaler (mDPI; RespiClick™) has recently been approved in the USA. AREAS COVERED: Studies on the albuterol mDPI were identified in searches of PubMed and www...
September 2016: Expert Opinion on Drug Metabolism & Toxicology
Amal Bhattacharya, Salil Bhargava, Virendra Singh, Deepak Talwar, Jagdeep Whig, Juliet Rebello, Shrinivas Purandare, Jaideep Gogtay
BACKGROUND: The use of chlorofluorocarbons (CFCs) has contributed to the depletion of the stratospheric ozone layer resulting in serious health concerns. Ipratropium bromide/salbutamol sulphate CFC-pressurized metered-dose inhalers (IB/SAL-CFC pMDI) have been in widespread use for many years without any apparent ill consequences. This combination has now been reformulated using the hydrofluoroalkane (HFA) propellant. This study sought to establish the clinical noninferiority of a new HFA-containing IB/SAL pMDI to the conventional IB/SAL-CFC pMDI in subjects with mild/moderate COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Mario Cazzola, Josuel Ora, Alessanda Di Paolo, Ermanno Puxeddu, Luigino Calzetta, Paola Rogliani
Budesonide/formoterol (BF) is available in two delivery systems, the dry powder inhaler (DPI) Turbuhaler and a pressurized metered dose inhaler (pMDI) for use in patients with asthma or chronic obstructive pulmonary disease (COPD). Spiromax DPI was recently developed as an alternative to Turbuhaler DPI. In the present study, we examined whether there is a difference in the onset of bronchodilatation between BF 320/9 μg delivered by Spiromax and BF 320/9 μg delivered by Turbuhaler in 16 outpatients with stable moderate-to-severe COPD...
August 2016: Pulmonary Pharmacology & Therapeutics
Yang Chen, Paul M Young, Seamus Murphy, David F Fletcher, Edward Long, David Lewis, Tanya Church, Daniela Traini
The aim of this study is to investigate aerosol plume geometries of pressurised metered dose inhalers (pMDIs) using a high-speed laser image system with different actuator nozzle materials and designs. Actuators made from aluminium, PET and PTFE were manufactured with four different nozzle designs: cone, flat, curved cone and curved flat. Plume angles and spans generated using the designed actuator nozzles with four solution-based pMDI formulations were imaged using Oxford Lasers EnVision system and analysed using EnVision Patternate software...
June 17, 2016: AAPS PharmSciTech
Carlos E Rodríguez-Martínez, Monica P Sossa-Briceño, Gustavo Nino
OBJECTIVE: No previous studies have performed a systematic review of all available instruments intended to evaluate pressurized metered-dose inhaler (pMDI) administration technique in children. The objective of the present study was to perform a systematic review of instruments aimed at evaluating pMDI administration technique in children and evaluating the measurement properties of these instruments. METHODS: A systematic search of the literature in PubMed and Embase was performed in order to identify studies in which an instrument (scale, checklist, or questionnaire) for evaluating pMDI administration technique in children was described...
June 15, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Nicole Shaw, Peter Le Souëf, Lidija Turkovic, Lucy McCahon, Anthony Kicic, Peter D Sly, Sunalene Devadason, André Schultz
UNLABELLED: The importance of good device technique to maximise delivery of aerosolised medications is widely recognised. Pressurised metered dose inhaler (pMDI)-spacer technique was investigated in 122 children, aged 2-7 years, with asthma. Eight individual steps of device technique were evaluated before and after viewing an instructional video for correct device technique. Video measurements were repeated every three months for nine months. Device technique improved directly after video instruction at the baseline study visit (p < 0...
July 2016: European Journal of Pediatrics
Pussayaban Suwannakeeree, Jitladda Deerojanawong, Nuanchan Prapphal
BACKGROUND: Lack of asthma knowledge among the pediatric patients and their caregivers contribute to poor asthma control in children. There is no data from Thailand on the health outcomes of school-based educational interventions for asthmatic children. OBJECTIVE: To assess the effectiveness of school-based asthma educational interventions on health outcomes, asthma control, and management in asthmatic children. MATERIAL AND METHOD: Forty-seven asthmatic students (6-15 years old), 14 caregivers, and five teachers from the Homkred School participated in the study...
February 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
J De Backer, C Van Holsbeke, W Vos, S Vinchurkar, P Dorinsky, J Rebello, M Mangale, B Hajian, W De Backer
BACKGROUND: Unambiguously for inhaled products, PK measures are best suited for ensuring that the total systemic exposure is equivalent for two products but cannot provide regional information about lung deposition and structural changes. Functional respiratory imaging (FRI) has been demonstrated to be sensitive for distinguishing small but imperative differences related to a single treatment. METHODS: In this study FRI is used in 16 asthmatic patients to assess equivalence in regional deposition for two products (fluticasone/salmeterol, test and reference) by directly measuring regional functional and structural changes within the lungs following its administration...
August 2016: Expert Review of Respiratory Medicine
Nicholas Ogrodnik, Victor Azzi, Elizabeth Sprigge, Sandra Fiset, Edgar Matida
BACKGROUND: Pressurized metered-dose inhalers (pMDIs) are commonly used to administer medication to patients suffering from chronic lower respiratory tract diseases such as asthma. Inhaling medication directly from a pMDI can prove difficult for some patients and, as a result, add-on devices (or spacers) have been designed to aid in the delivery of medication. Although spacers increase the percentage of medication that reaches the patient, medication will also nonsymmetrically deposit on the walls of the device and will be lost to the device itself...
May 25, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Brent O Caldwell, Julian Crane
INTRODUCTION: In order to replicate the rewarding effects of smoking, nicotine replacement therapies must deliver nicotine via the pulmonary route. We aimed to measure the efficacy of a simple pressurized metered dose inhaler containing nicotine combined with a nicotine patch for smoking cessation. METHODS: Double-blind randomized placebo-controlled, parallel group trial conducted at the University of Otago, Wellington, New Zealand. Five-hundred two adults (≥18 years) who smoked at least nine cigarettes per day, with a Fagerström Test for Nicotine Dependence ≥3 who wanted to quit, were randomized (1:1)...
October 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Dave Singh, Winfried Schröder-Babo, Géraldine Cohuet, Annamaria Muraro, Françoise Bonnet-Gonod, Stefano Petruzzelli, Martin Hoffmann, Zenon Siergiejko
UNLABELLED: This multicentre, double-blind, randomised, placebo-controlled, crossover study aimed to determine the dose-response of the long-acting muscarinic antagonist (LAMA) glycopyrronium bromide (GB) when added to beclometasone dipropionate plus formoterol fumarate (BDP/FF) in patients with COPD. Patients received extrafine GB 12.5, 25 or 50 μg twice daily (BID) or placebo for 7 days via pressurised metered dose inhaler (pMDI), and extrafine BDP/FF via pMDI throughout the study...
May 2016: Respiratory Medicine
I A Basheti, N M Obeidat, W G Ammari, H K Reddel
OBJECTIVES: To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) used as controller medication and asthma control variables measured using Asthma Control Test (ACT) scores. DESIGN: In this cross-sectional study, the inhaler technique of asthma patients using pMDIs or DPIs (Turbuhaler® [TH] and Accuhaler Diskus™ [ACC]) were assessed against published inhaler technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma control) were assessed...
May 2016: International Journal of Tuberculosis and Lung Disease
Emily Farrington, Alison Saunders, Louise Heron, William Dunlop
INTRODUCTION: Pressurized metered-dose inhalers (pMDI) such as fluticasone propionate and salmeterol (FP/SAL) are commonly used for the treatment of asthma in the UK. Previously, a budget impact analysis demonstrated that use of FP and formoterol fumarate (FP/FORM) pMDI as an alternative to FP/SAL pMDI, would be a cost-saving option for the UK National Health Service (NHS). This budget impact analysis aimed to update the existing analysis with prescription volume data and real-world evidence since the introduction of FP/FORM to the UK market...
May 2016: Advances in Therapy
Siva Krishna Mohan Nalluri, Zhichang Liu, Yilei Wu, Keith R Hermann, Avik Samanta, Dong Jun Kim, Matthew D Krzyaniak, Michael R Wasielewski, J Fraser Stoddart
Designing small-molecule organic redox-active materials, with potential applications in energy storage, has received considerable interest of late. Herein, we report on the synthesis, characterization, and application of two rigid chiral triangles, each of which consist of non-identical pyromellitic diimide (PMDI) and naphthalene diimide (NDI)-based redox-active units. (1)H and (13)C NMR spectroscopic investigations in solution confirm the lower symmetry (C2 point group) associated with these two isosceles triangles...
May 11, 2016: Journal of the American Chemical Society
Donald P Tashkin, Gary E Moore, Frank Trudo, Michael DePietro, Bradley E Chipps
BACKGROUND: The consistency of fixed airflow limitation status during treatment in patients with asthma is unknown. OBJECTIVE: The objective of this study was to determine the consistency of fixed airflow obstruction (FAO) status during treatment and effects on treatment response. METHODS: This post hoc analysis from a 12-week study (NCT00652002) assessed patients aged 12 years or more with moderate-to-severe asthma randomized to twice-daily budesonide/formoterol (BUD/FM) via pressurized metered-dose inhaler (pMDI) 320/9 μg, BUD pMDI 320 μg, FM 9 μg via dry-powder inhaler, or placebo...
July 2016: Journal of Allergy and Clinical Immunology in Practice
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