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Search Results: 1 - 10 of 4062 matches for " dry-powder inhaler "
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Asthma management: important issues
P. Barnes,J. C. Virchow,J. Sanchis,T. Welte
European Respiratory Review , 2005,
Abstract: Although most attention has been focused on the drugs used to control asthma, it is increasingly recognised that effective delivery of these drugs to the lungs is just as important. The most effective drugs, beta2-agonists and corticosteroids, are given by inhalation so there has been a search for more efficient inhaler devices that are easier for patients to use. A symposium at the European Respiratory Society Annual Meeting in 2005 discussed some of the important issues in inhaler therapy in adults and children. This article summarises the major points of discussion that arose out of this symposium. New more effective inhaler devices are now becoming available and are likely to have an important impact on asthma management.
Comparison of the systemic bioavailability of mometasone furoate after oral inhalation from a mometasone furoate/formoterol fumarate metered-dose inhaler versus a mometasone furoate dry-powder inhaler in patients with chronic obstructive pulmonary disease
Kosoglou T, Hubbell J, Xuan F, Cutler DL, Meehan AG, Kantesaria B, Wittmer BA
International Journal of Chronic Obstructive Pulmonary Disease , 2013, DOI: http://dx.doi.org/10.2147/COPD.S36592
Abstract: mparison of the systemic bioavailability of mometasone furoate after oral inhalation from a mometasone furoate/formoterol fumarate metered-dose inhaler versus a mometasone furoate dry-powder inhaler in patients with chronic obstructive pulmonary disease Original Research (421) Total Article Views Authors: Kosoglou T, Hubbell J, Xuan F, Cutler DL, Meehan AG, Kantesaria B, Wittmer BA Published Date March 2013 Volume 2013:8 Pages 107 - 116 DOI: http://dx.doi.org/10.2147/COPD.S36592 Received: 01 August 2012 Accepted: 12 September 2012 Published: 07 March 2013 Teddy Kosoglou,1 James Hubbell,2 Fengjuan Xuan,3 David L Cutler,1 Alan G Meehan,4 Bhavna Kantesaria,5 Bret A Wittmer6, 1Clinical Pharmacology, 2Exploratory Drug Metabolism, 3Early Development Statistics, 4Medical Communications, 5Drug Metabolism/Pharmacokinetics, Merck Sharp & Dohme Corp, Whitehouse Station, NJ, USA; 6Commonwealth Biomedical Research, LLC, Madisonville, KY, USA Dr Bret A Wittmer passed away on May 9, 2012. Background: Coadministration of mometasone furoate (MF) and formoterol fumarate (F) produces additive effects for improving symptoms and lung function and reduces exacerbations in patients with asthma and chronic obstructive pulmonary disease (COPD). The present study assessed the relative systemic exposure to MF and characterized the pharmacokinetics of MF and formoterol in patients with COPD. Methods: This was a single-center, randomized, open-label, multiple-dose, three-period, three-treatment crossover study. The following three treatments were self-administered by patients (n = 14) with moderate-to-severe COPD: MF 400 μg/F 10 μg via a metered-dose inhaler (MF/F MDI; DULERA /ZENHALE ) without a spacer device, MF/F MDI with a spacer, or MF 400 μg via a dry-powder inhaler (DPI; ASMANEX TWISTHALER ) twice daily for 5 days. Plasma samples for MF and formoterol assay were obtained predose and at prespecified time points after the last (morning) dose on day 5 of each period of the crossover. The geometric mean ratio (GMR) as a percent and the corresponding 90% confidence intervals (CI) were calculated for treatment comparisons. Results: Systemic MF exposure was lower (GMR 77%; 90% CI 58, 102) following administration by MF/F MDI compared to MF DPI. Additionally, least squares geometric mean systemic exposures of MF and formoterol were lower (GMR 72%; 90% CI 61, 84) and (GMR 62%; 90% CI 52, 74), respectively, following administration by MF/F MDI in conjunction with a spacer compared to MF/F MDI without a spacer. MF/F MDI had a similar adverse experience profile as that seen with MF DPI. All adverse experiences were either mild or moderate in severity; no serious adverse experience was reported. Conclusion: Systemic MF exposures were lower following administration by MF/F MDI compared with MF DPI. Additionally, systemic MF and formoterol exposures were lower following administration by MF/F MDI with a spacer versus without a spacer. The magnitude of these differences with respe
Tipos y características de los inhaladores para el manejo de asma
Rosas- Vargas, Miguel;del Rio- Chivardi, Jaime;Castro- Hidalgo, Emilia;del Rio - Navarro, Blanca E.;Sienra- Monge, Juan J. L.;
Boletín médico del Hospital Infantil de México , 2005,
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.
Tobramycin administered by the TOBI Podhaler for persons with cystic fibrosis: a review
VanDevanter DR, Geller DE
Medical Devices: Evidence and Research , 2011, DOI: http://dx.doi.org/10.2147/MDER.S16360
Abstract: bramycin administered by the TOBI Podhaler for persons with cystic fibrosis: a review Review (3749) Total Article Views Authors: VanDevanter DR, Geller DE Published Date September 2011 Volume 2011:4 Pages 179 - 188 DOI: http://dx.doi.org/10.2147/MDER.S16360 Donald R VanDevanter1, David E Geller2 1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, 2Nemours Children’s Clinic, Orlando, FL, USA Abstract: From its introduction, the antibiotic tobramycin has been an important tool in the management of persons with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infections. Initially an intravenous rescue treatment for pulmonary exacerbations, tobramycin delivered by inhalation has become a mainstay of chronic suppressive CF infection management. Platforms for tobramycin aerosol delivery have steadily improved, with increased lung deposition complimented by decreased device complexities, loaded tobramycin doses, delivery times, and treatment burdens. Most recently, a unique tobramycin inhalation powder (TIP) formulation with a portable delivery system, the TOBI Podhaler (Novartis AG, Basel, Switzerland) has been developed and approved in Europe, Canada, and Chile. Four capsules, each containing 28 mg of TIP are successively pierced and inhaled via the T-326 Dry Powder Inhaler Device (Novartis AG, Basel, Switzerland). No external power source is required to deliver an efficacious tobramycin dose in minutes. By comparison, tobramycin inhalation solution (TIS) (TOBI ; Novartis), is delivered by LC Plus (PARI Respiratory Equipment Inc, Midlothian, VA) jet nebulizer powered by an air compressor over 15–20 minutes. Comparative pharmacokinetics, safety, and efficacy studies of TIS and TIP in CF subjects with P. aeruginosa ≥ 6 years old demonstrate that: tobramycin lung deposition with 112 mg TIP is comparable to that attained with 300 mg TIS, TIP is more effective than placebo and not inferior to TIS with respect to pulmonary function benefit, and TIP has significantly faster treatment times and achieves higher patient satisfaction than TIS. TIP is associated with an increased frequency of mild to moderate local adverse events (cough, dysphonia, and dysgeusia) compared with TIS, however, these become less frequent as subjects gain TIP experience. These results suggest that the TOBI Podhaler may better meet the needs of many CF patients and families by reducing treatment time and complexity and improving patient satisfaction compared with TIS.
Nanosized rods agglomerates as a new approach for formulation of a dry powder inhaler
HF Salem, ME Abdelrahim, K Abo Eid, et al
International Journal of Nanomedicine , 2011, DOI: http://dx.doi.org/10.2147/IJN.S14309
Abstract: nosized rods agglomerates as a new approach for formulation of a dry powder inhaler Original Research (4263) Total Article Views Authors: HF Salem, ME Abdelrahim, K Abo Eid, et al Published Date February 2011 Volume 2011:6 Pages 311 - 320 DOI: http://dx.doi.org/10.2147/IJN.S14309 HF Salem1 ME Abdelrahim2 K Abo Eid3 MA Sharaf3,4 1Department of Pharmaceutics, 2Department of Clinical Pharmacy, Faculty of Pharmacy, The University of Beni Suef, Beni Suef; 3Department of Chemistry, Helwan University, Ain Helwan, Helwan, Egypt; 4Department of Chemistry, The American University in Cairo, New Cairo, Helwan 11835, Egypt Background: Nanosized dry powder inhalers provide higher stability for poorly water-soluble drugs as compared with liquid formulations. However, the respirable particles must have a diameter of 1–5 μm in order to deposit in the lungs. Controlled agglomeration of the nanoparticles increases their geometric particle size so they can deposit easily in the lungs. In the lungs, they fall apart to reform nanoparticles, thus enhancing the dissolution rate of the drugs. Theophylline is a bronchodilator with poor solubility in water. Methods: Nanosized theophylline colloids were formed using an amphiphilic surfactant and destabilized using dilute sodium chloride solutions to form the agglomerates. Results: The theophylline nanoparticles thus obtained had an average particle size of 290 nm and a zeta potential of 39.5 mV, whereas the agglomerates were 2.47 μm in size with a zeta potential of 28.9 mV. The release profile was found to follow first-order kinetics (r2 > 0.96). The aerodynamic characteristics of the agglomerated nanoparticles were determined using a cascade impactor. The behavior of the agglomerate was significantly better than unprocessed raw theophylline powder. In addition, the nanoparticles and agglomerates resulted in a significant improvement in the dissolution of theophylline. Conclusion: The results obtained lend support to the hypothesis that controlled agglomeration strategies provide an efficient approach for the delivery of poorly water-soluble drugs into the lungs.
Fluticasone propionate liposomes for pulmonary delivery
Nirale N,Vidhate R,Nagarsenker M
Indian Journal of Pharmaceutical Sciences , 2009,
Abstract: The objective of the present study was to entrap fluticasone propionate in liposomes and study in vitro lung deposition of both liposomal dispersion and dry powder inhalation using twin stage impinger and Anderson cascade impactor. Liposomes were prepared by lipid film hydration method and characterized for size, shape, morphology, entrapment efficiency and in vitro lung deposition. The spray dried liposomes were further characterized for various physicochemical properties such as physical appearance, density, flow properties, drug content and in vitro pulmonary deposition. Fine particle fraction was also determined. Liposomal dispersion of fluticasone propionate was successfully prepared with more than 90% entrapment. Spray dried liposomes had mean size of 3-4 μ and a fine powder fraction of 9-10 %. Inclusion of antistatic agents such as leucine and magnesium stearate did not improve the aerosolisation behaviour of dry inhalation powder in this study.
Taneja Ruchi,Sachdeva Vishal,Khatri Neetu,Singh Vikramjeet
International Research Journal of Pharmacy , 2012,
Abstract: DPI device presents medication to the patient as a dry powder in a form that can be inhaled orally for delivery to the target lung tissues. DPIs are bolus drug delivery devices that contain solid drug, suspended or dissolved in a non polar volatile propellant or in a dry powder mix (DPI) that is fluidized when the patient inhales. drug is inhaled as a cloud of a fine particles. The primary factor influencing the manufacture of DPI powders is the need to produce material that can penetrate into the lung. Development of various approaches to the controlled production of fine particles, primarily depending on the nature of the drug. Of the processes micronization and blending and, more recently, spray drying are used most often. Package dose metering can be accomplished by weight or by volume. Dry powders developed for DPIs are formulated to deliver a specific dose of drug per a given unit of drug powder. Drug powders can be packaged either in unit dose or in reservoir systems.
Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD
Price D, Haughney J, Sims E, Ali M, von Ziegenweidt J, Hillyer EV, Lee AJ, Chisholm A, Barnes N
Journal of Asthma and Allergy , 2011, DOI: http://dx.doi.org/10.2147/JAA.S17709
Abstract: tiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD Original Research (5724) Total Article Views Authors: Price D, Haughney J, Sims E, Ali M, von Ziegenweidt J, Hillyer EV, Lee AJ, Chisholm A, Barnes N Published Date April 2011 Volume 2011:4 Pages 37 - 47 DOI: http://dx.doi.org/10.2147/JAA.S17709 David Price1,2 John Haughney1, Erika Sims2, Muzammil Ali2, Julie von Ziegenweidt2, Elizabeth V Hillyer2, Amanda J Lee3, Alison Chisholm2, Neil Barnes4 1Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life Ltd, Cawston, Norwich, UK; 3Section of Population Health, University of Aberdeen, UK; 4Department of Respiratory Medicine, London Chest Hospital, Barts and The London NHS Trust, London, UK Purpose: Results of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS) in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI), breath-actuated MDI (BAI), and dry powder inhaler (DPI). Patients and methods: This retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5–60 years prescribed their first ICS (initiation population) by pMDI (n = 39,746), BAI (n = 9809), or DPI (n = 6792), or their first ICS dose increase (step-up population) by pMDI (n = 6245), BAI (n = 1388), or DPI (n = 1536). Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids). Outcomes were adjusted for potential confounding factors identified during a baseline year. Results: In the initiation population, adjusted odds ratios (95% confidence intervals [CI]) for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02–1.14]) and DPIs (1.13 [1.06–1.21]), while adjusted exacerbation rate ratios (95% CI) were 1.00 (0.93–1.08) and 0.88 (0.81–0.95), respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05–1.39) for BAIs and 1.13 (0.99–1.29) for DPIs; adjusted exacerbation rate ratios were 0.83 (0.71–0.98) for BAIs and 0.85 (0.74–0.98) for DPIs, compared with pMDIs. Conclusion: Inhaler device selection may have a bearing on clinical outcomes. Differences in real-world effectiveness among these devices require closer evaluation in well-designed prospective trials.
Inhaler choice in primary practice
K. R. Chapman,T. H. Voshaar,J. C. Virchow
European Respiratory Review , 2005,
Abstract: A broad range of inhaler devices is available for physicians to prescribe. Although newer devices are often easier to use than conventional pressurised metered-dose inhalers (pMDIs), many patients still use inhalers sub-optimally. Physicians must become familiar with the characteristics of several inhalers and choose the device that their patients can use correctly and beneficially if they are to prescribe successfully to those with chronic obstructive pulmonary disease (COPD). The selection of a device may also be influenced by patient comorbidities and by their ability to handle and inhale correctly from the device. A further challenge in the COPD setting is measuring the desired treatment outcome. A simple algorithm or checklist can guide device selection in primary care. The device must be affordable for the patient, the patient must be able to handle it correctly and the practitioner or other trained professional should monitor that it is being used correctly. The patient's and physician's preferences should also be taken into account. The most important device-handling skills that should be assessed are whether the patient can: properly prepare and actuate the device; take an adequate inspiration; and coordinate actuation of a pMDI with inspiration. Testing the practicality and advantages of such checklists will mean better use can be made of the inhaler types currently available as well as newer designs. In the interim, caregiver and patient education are needed.
Levofloxacin-Proliposomes: Opportunities for Use in Lung Tuberculosis
Wipaporn Rojanarat,Titpawan Nakpheng,Ekawat Thawithong,Niracha Yanyium,Teerapol Srichana
Pharmaceutics , 2012, DOI: 10.3390/pharmaceutics4030385
Abstract: Levofloxacin (LEV) is a relatively new-generation fluoroquinolone antibiotic that has good activity against Mycobacterium tuberculosis. The aims of this study were to develop and evaluate LEV-proliposomes in a dry powder aerosol form for pulmonary delivery. LEV-proliposomes containing LEV, soybean phosphatidylcholine, cholesterol and porous mannitol were prepared by a spray drying technique. The physicochemical properties of LEV-proliposomes were determined using a cascade impactor, X-ray diffraction (XRD), differential scanning calorimetry (DSC) and Fourier transform infrared spectroscopy (FT-IR). The toxicity of proliposomes to respiratory-associated cell lines and its potential to provoke immunological responses from alveolar macrophages (AMs) were evaluated. Antimycobacterial activity using flow cytometry and an in vivo repeated dose toxicity test in rats were carried out. LEV-proliposomes were successfully prepared with mass median aerodynamic diameters of 4.15–4.44 μm and with fine particle fractions (aerosolized particles of less than 4.4 μm) of 13%–38% at 60 L/min. LEV-proliposomes were less toxic to respiratory-associated cells than LEV, and did not activate AMs to produce inflammatory mediators that included interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and nitric oxide. The minimum inhibitory concentration (MIC) against M. bovis of LEV and LEV-proliposomes containing LEV 10% were 1 and 0.5 μg/mL, respectively. The efficacy of LEV-proliposomes against M. bovis was significantly higher than that of free LEV ( p < 0.05). The efficacy of the LEV-proliposomes against M. tuberculosis was equal to that of the free LEV (MIC = 0.195 μg/mL). In a repeated dose toxicity study in rats, renal and liver toxicity was not observed. LEV-proliposomes should now be tested as an alternative formulation for delivering LEV to the lower airways.
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