2005, Number 4
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Bol Med Hosp Infant Mex 2005; 62 (4)
Types and characteristics of devices for the treatment of asthma.
Rosas-Vargas M, del Rio-Chivardi J, Castro-Hidalgo E, del Rio-Navarro BE, Sienra-Monge JJL
Language: Spanish
References: 85
Page: 273-286
PDF size: 151.83 Kb.
ABSTRACT
Asthma management requires the use of many drugs for long time with the purpose of achieving control. Inhalator delivery of asthma medications is the best way. In the previous 2 decades, technology has improved delivery devices, changes in design, materials and outsize particles. Physicians should know all the technical points in order to take advantage of these new devises to be able to make appropriate recommendations for their use.
There is a large quantity of options for the delivery of asthma medications: nebulizers, metered dose inhaler and dry powder inhalers. Particular characteristics of delivery devices should be known and applied in particular patients. The aim of this review article is assist physicians to choose the best device option.
REFERENCES
Warner J. Asthma: a follow up statement from an international pediatric asthma consensus group. Arch Dis Child. 1992; 67: 240-8.
Chua HL, Collis CC, Newbury AM, Chan K, Bower GD, Sly PD, et al. The influence of age on aerosol deposition in children with cystic fibrosis. Eur Respir J. 1994; 7: 2185-91.
Bisgaard H, Munck SL, Nicisen JP, Petersen W, Ohisson SV. Inhaled budesonide for treatment of recurrent wheezing in carry childhood. Lancet. 1990; 336: 649-51.
Noble V, Rugos R, Everard ML, Nfilner AD. Budesonide for chronic wheezing under 18 months of age. Arch Dis Child. 1992; 67: 285-8.
Connett GJ, Warde C, Wooler E, Lenney W. Use of budesonide in severe asthmatics aged 1-3 years. Arch Dis Child. 1992; 69: 351-5.
Amirav I, Newhouse MT. Metered dose inhaler accessory devices in acute asthma: Efficacy and comparison with nebulizers. Arch Pediatr Adolesc Med. 1997; 151: 876-82.
World Health Organization Program for the Control of Acute Respiratory Infections. Bronchodilators and other medications for the treatment of wheeze-associated illnesses in young children. Geneva: WHO/ARI/93.29; 1993. p. 14-7.
Vaswani S, Certicos P. Metered dose inhaler: past, present and future. Ann Allergy Asthma Immunol. 1998; 80: 11-21.
Pedersen S. Inhalers and nebulizers: which to choose and why? Respir Med J. 1996; 90: 69-77.
Clarck AR. Medical aerosol inhalers. Past, present and future. Aerosol Sci Technol. 1995; 22: 374-91.
Grossman J. The evolution of inhaler technology. J Asthma. 1994; 31: 55-64.
Anderson P. History and evolution of aerosolized therapeutics. Delivery options and devices for aerosolized therapeutics. Chest. 2001; 120: 87-93.
Bceuemin MH, Swift DL, Bouchikhi A, Roy M, Teillac A. Particle deposition and resistance in the noses of adults and children. Eur Respir J. 1991; 14: 694-702.
Johnson M. Pharmacodynamics and pharmacokinetics of inhaled glucocorticoids. J Allergy Clin Immunol. 1996; 97: 169-82.
Kelly W. Potential adverse effects of inhaled corticosteroids. J Allergy Clin Immunol. 2003; 112: 469-78.
Forte R, Dibble C. The role of international environmental agreements in metered dose inhaler technology changes. J Allergy Clin Immunol. 1999; 104: 217-20.
Thomas SHL, Batchelor B, O’Doherty MJ. Therapeutic aerosols in children. BMJ. 1993; 307: 245-7.
Oisson J. Aerosol particle generation from dry powder inhalers: Can they equal pressurized metered dose inhalers? J Aerosol Med. 1995; 8: 513-8.
Everard ML. Studies using radiolabeled aerosols in children. Thorax. 1994; 49: 1259-66.
Stahlhofen W, Rudolf G, James AC. lntercomparison of experimental regional aerosol deposition data. Aerosol Med J. 1989; 2: 285-308.
Agnew JE. Characterizing lung aerosol penetration. J Aerosol Med. 1991; 4: 237-49.
Martonen TB, Katz J. Deposition patters of polydisperse aerosols within human lungs. J Aerosol Med. 1993; 6: 251-74.
Agnew JE. Bronchiolar aerosol deposition and clearance. Eur Respir J. 1996; 9: 1118-99.
Persson G, Wiren JE. The bronchodilator response from inhaled terbutaline is influenced by the mass of, small particles: a study on a dry powder inhaler (turbuhaler). Eur Respir J. 1993; 2: 253-6.
Clay MM, Ciarke SW. Effect of nebulized aerosol size on lung deposition in patients with mild asthma. Thorax. 1987; 42: 190-4.
Zanen P, Co LT, Larnmers IVVJ. The optimal particle size for beta-adrenergic aerosols in mild asthmatics. Int J Pharm. 1994; 107: 211-7.
Oisson B, Borgstrijm L, Asking L, Bondesson E. Effect of inlet throat on the correlation between measured fine particle dose and lung deposition. Respir Drug Deliver. 1996; Vol.?? : 273-81. 28. Kenyon CJ, Dewsbuy NJ, Newman SP. Differences in aerodynamic particle size distributions of innovator and generic beclomethasone dipropionate. Aerosols used with and with out a large volume spacer. Thorax. 1995; 50: 846-50.
Farr SJ, Rowe AM, Rubsamen R, Taylor G. Aerosol deposition in the human lung following administration from a microprocessor controlled pressurized metered dose inhaler. Thorax. 1995; 50: 639-44.
Pedersen S. Inhalers and nebulizers: Which to choose and why. Respir Med. 1996; 90: 69-77.
Blake KV, Harman E, Hendeles L. Evaluation of a generic albuterol metered-dose inhaler. lmportance of prirning the MDI. Ann Allergy. 1992; 68: 169-74.
Derom E, Pauwels R. Bioequivalence of inhaled drugs. Eur Respir J. 1995; 8: 1634-6.
Jiner J, Basualdo L, Casan P, et al. Normativa sobre la utilización de fármacos inhalados. Arch Bronconeumol. 2000; 36: 34-43.
Bisgaard H, Anhoj J, Kiug B, Berg E. A non-electrostatic spacer for aerosol delivery. Arch Dis Child. 1995; 73: 226-30.
Wildhaber JH, Devadason SG, Hayden MJ, James R, Dufty AP, Fox RA, et al. Electrostatic charge on a plastic spacer device influences the delivery of salbutamol. Eur Respir J. 1996; 9: 1943-6.
Allen D, Bielory L, Derendrof H, Dulhy R. Inhaled corticosteroids: past lessons and future issues. J Allergy Clin Immunol. 2003; 112:1-40.
Johnson M. Development of fluticasone propionate and comparison with other inhaled corticosteroids. J Allergy Clin Immunol. 1998; 101: 434-9.
Pavia D, McLeod L. The environmental impact of inhaled aerosols. Eur Respir Rev. 1994; 4: 75-7.
Atkins P. Chlorofluorocarbon to hydrofluoroalkane formulations: an industry perspective. J Allergy Clin Immunol. 1999; 104: 268-70.
D’Souza A. The Montreal Protocol and essential use exemptions. J Aerosol Med. 1995; 8: S13-7.
Leach C. Enhanced drug delivery through reformulating MDls with HFA propellants-drug deposition and its effect on preclinical and clinical programs. En: Dalby RN, Byron PR, Farr SY, editores. Respiratory drug delivery. V. Buffalo Grove, IL: Interpharm Press, Phoenix, AZ; 1996. p. 133-44.
Tashkini D. New devices for asthma. J Allergy Clin Immunol. 1998; 101: 409-16.
Clark D, Lipworth D. Lung bioavailability for chlorofluorocarbon free, dry powder and chlorofluorocarbon containing formulations of salbutamol. Br J Clin Pharmacol. 1996; 41: 247-9.
Lmry W, Noveck R, Weinstein S, Barnhart F, Vandermeer A. Swiching from ventolin CFC to ventolin HFA is well tolerated and effective in patients with asthma. Ann Allergy Asthma Immunol. 2001; 86: 297-303.
Harrison L, Dahl D, Cline A. Pharmacokinetics and dose proportionality of beclomethasone form three strengths off a CFC free beclomethasone dipropionato metered dose inhaler. Biopharm Drug Disp. 1997; 18: 635-43.
Leach C. Improved delivery of inhaled steroids to the large and small airway. Respir Med. 1998; 92: 3-8.
Purewal T, Patel N, Warren D. The non CFC salbutamol metered dose inhaler performance with a spacer device. Am J Respir Crit Care Med. 1998; 157: 638-44.
Borgström L. The pharmacokinetics of inhaled hidrofluoroalkane formulations. J Allergy Clin Immunol. 1999; 104: S246-9.
Jenkins M. Clinical evaluation of CFC-free metered dose inhalers. J Aerosol Med. 1995; 8: 41-7.
Gillies J. Overview of delivery system issues in pediatric asthma. Pediatr Pulmonol 1997; 15: 55-8.
Hindie M, Chrystyn H. Determination of the relative bioavailability of salbutamol to the lung following inhalation. Br J Clin Pharmacol. 1992; 34: 311-5.
Holgate ST, Fleming JS, Conway J, Hashish AH, Nassim MA, Halson P, et al. Assessment of deposition of inhaled aerosol in the respiratory tract of man using three dimensional multimodality imaging and mathematical modeling. Respir Drug Delivery. 1996; 1: 1-10.
Newhouse M. Asthma therapy with aerosols: Are nebulizers obsolete? A continuing controversy. J Pediatr. 1999; 135: 5-8.
Bisgaard H, Kiug PKP, Burnell P, Surnby BS. Use of inhalation profiles from pediatric asthmatics using the diskus and turbuhaler inhalers to evaluate product performance in vitro. Am Respir Crit Care Med. 1996; 153: 75.
Svartengren K, Lindestad P, Svartengren M, Philipson K, Bylin C, Camner P. Added external resistance reduces oropharyngeal deposition and mercases lung deposition of aerosol particles in asthmatics. Am J Respir Crit Care Med. 1995; 152: 32-7.
Kwong E, Mac-Neish CF, Meisner D, Kelemen S, Vadas EB, Coates AL. The use of osmometry as a means of determining changes in drug concentration during jet nebulization. J Aerosol Med. 1998; 11: 89-100.
Muers MF. The rational use of nebulizers in clinical practice. Eur Respir Rev. 1997; 7: 189-97.
Collis G, Cole CH, Le Souef PN. Dilution of nebulized aerosols by air entrainment in children. Lancet. 1990; 336: 341-3.
Labiris NR, Dolovich MB. Pulmonary drug delivery. Part II. The roll of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications. J Clin Pharmacol. 2003; 56: 600-12.
Denyer J, Nikander K. Halolite a novel liquid drug aerosol delivery system. Thorax. 1997; 52: 208.
Goodman DE, Israel E, Rosenberg M, Johnston R, Weiss ST, Drazen JM. The influence of age, diagnosis and gender on proper use of metered-dose inhalers. Am J Respir Crit Care Med. 1994; 150: 1256-61.
Berg E. Dose characterization from a pMDI and a new spacer with and without a cast of the throat of a child. En: Dalby RN, Byron PR, Farr SY, editores. Respiratory drug delivery. Buffalo Grove, IL: Interpharm Press, Phoenix AZ; 1996. p. 308-9.
Bisgaard H, Berg E, Madsen J. Dose delivery and fine particle dose of aerosol from spacers intended for asthma treatment in young children. Eur Respir J. 1996; 9: 431-7.
Bisgaard H. Drug delivery from inhaler devices. BMJ. 1996; 313: 89-96.
Rogers DF, Ganderton D. Determining equivalence of inhaled medications. Consensus statement from a workshop of the British Association for Lung Research. Respir Med. 1995; 89: 253-61.
Newman SP, Pavia D, Garland D, Clarck SW. Effects of various inhalations models on deposition of radioactive pressurized aerosols. Eur J Respir Dis. 1982; 63: 57-8.
Dolovich M, Ruffin RE, Roberts R. Optimal delivery of aerosols from metered dose inhalers. Chest. 1981; 80: 11-915.
Bisgaard H, Berg E. Cast of human airways from the lips to the trachea for in vitro estimate of lung dose. Eur Respir J. 1997; 10: 236-41.
Newman SP, Clarck SW. Inhalation devices and techniques in asthma. 3rd ed. London: Chapman and Hall Editors; 1992. p. 469-505.
Dolovich M. Delivery systems and propellants. Can Respir J. 1999; 6: 290-5.
Leach CL. Improved delivery of inhaled steroids to the large and small airways. Respir Med. 1998; 92: 3-8.
Leach CL, Davidson PJ, Bodreau RJ. Improved airway targeting with the CFC-free HFA-beclomethasone metered-dose inhaler compared with CFC-beclomethasone. Eur Respir J. 1998; 12: 1346-53.
Davies RJ, Stampone P, O’conor BJ. Hydrofluoroalkane-134a extrafine aerosol provides equivalent asthma control to chlorofluorocarbon beclomethasone dipropionate to approximately half of the total daily dose. Respir Med. 1998; 92: 23-33.
Miller MR, Bright P. Differences in output from corticosteroid inhalers used with a volumetric spacer. Eur Respir J. 1995; 8: 1637-8.
Berg E, Madsen J, Bisgard H. In vitro performance of three combinations of spacers and pressurized metered dose inhalers for the treatment in children. Eur Respir J. 1998; 12: 472-6.
O´Callaghan C. Delivery systems: the science. Pediatr Pulmonol.1997; 15: 51-4.
Bisgaard H. A metal aerosol holding chamber devised for young children with asthma. Eur Respir J. 1995; 8: 856-60.
Mallol J, Aguirre V, Hernández L. Carga electrostática basal en los espaciadores plásticos de uso común con los inhaladores de dosis medida. Bol Med Hosp Infant Mex. 2001; 58: 229-33.
Newman SP. Spacer device for metered dose inhalers. Clin Pharmacokinet. 2004; 43: 349-60.
Zar HJ, Asmus MJ, Weinberg EG. A 500 mL plastic bottle: An effective spacer for children with asthma. Pediatr Allergy Immunol. 2002; 13: 217-22.
Hindie M, Chrystyn H. Nebuhaler and volumetric improve pulmonary delivery. Arch Dis Child. 1992; 67: 580-5.
Barry PW, O’Callaghan C. The effect of delay, multiple actuations and spacer static charge on the in vitro delivery of budesonide from the nebuhaler. Br J Clin Pharmacol. 1995; 40: 76-8.
Agertoft L, Pedersen S. Influence of spacer’s device on drug delivery to young children with asthma. Arch Dis Child. 1994; 71: 217-20.
Leversha A, Campanella S, Aickim R, Asher M. Costs and effectiveness of spacer versus nebulizer in young children with moderate and severe acute asthma. J Pediatr. 2000; 136: 497-502.
Dolovich M. New propellant-free technologies under investigation. J Aerosol Med. 1999; 12: 9-17.
Pongracic J. Asthma delivery devices: Age appropriate use. Pediatr Anal. 2003; 32: 50-8.