Academic literature on the topic 'Pressurised metered dose inhaler (pMDI)'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Pressurised metered dose inhaler (pMDI).'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Journal articles on the topic "Pressurised metered dose inhaler (pMDI)"
1
Ding, Bo, Shahid Siddiqui, Michael DePietro, Gunilla Petersson, and Ubaldo J. Martin. "Inhaler usability of a pressurized metered dose inhaler and a soft mist inhaler in patients with COPD: A simulated-use study." Chronic Respiratory Disease 16 (July 17, 2018): 147997231878791. http://dx.doi.org/10.1177/1479972318787914.
Full textAbstract:
The objective of this study was to evaluate task performance and handling errors with soft mist inhalers (SMIs) or pressurized metered-dose inhalers (pMDIs) among patients with chronic obstructive pulmonary disease (COPD) experienced with, but not recently trained in, using these devices. This exploratory, noninterventional, simulated-use study (D5970R00004) assessed handling/usability of SMIs and pMDIs in inhaler-experienced patients with COPD (40–78 years; diagnosis ≥6 months). Patients received a device and instruction-for-use leaflet but no training and were recorded while performing tasks required for checking the device, priming, and dosing. Errors that could substantially affect the lung-delivered dose were considered critical. Sixteen of 61 patients (52% male) had used SMIs and 55 had used pMDIs. Thirty-one patients received an SMI and 30 a pMDI. Overall, 79% made ≥5 performance errors (SMI 94%; pMDI 63%) and 49% made ≥5 critical errors (SMI 68%; pMDI 30%). All patients made ≥1 error; three (all pMDI) made no critical errors. Regardless of the device used and previous inhaler experience, patient-centered training, education, and continuous retraining on correct inhaler use should be key aspects of routine patient care in COPD.
2
Bryant, Linda, Christine Bang, Christopher Chew, Sae Hee Baik, and Diane Wiseman. "Adequacy of inhaler technique used by people with asthma or chronic obstructive pulmonary disease." Journal of Primary Health Care 5, no. 3 (2013): 191. http://dx.doi.org/10.1071/hc13191.
Full textAbstract:
INTRODUCTION: Asthma and chronic obstructive pulmonary disease (COPD) are ongoing concerns to the health system. Poor inhaler technique results in less than optimal delivery of medicine to the lungs and consequent inadequate symptom control. AIM: This study aimed to assess inhaler technique amongst people with asthma and/or COPD. The secondary aims were to investigate who provided education on inhaler technique and whether age, gender or ethnicity was associated with poor inhaler technique. METHODS: People with asthma or COPD who presented to a community pharmacy with a prescription for a respiratory inhaler were invited to participate in the study. Participants completed a brief questionnaire and had their inhaler technique assessed against a standard checklist. RESULTS: There were 103 participants from 26 pharmacies, 86 with asthma and 17 with COPD. Just over half (52.5%) of the assessments indicated good inhaler technique, with 68% of people using the Turbuhaler having good technique compared to 53% for the pressurised metered dose inhaler (pMDI) with spacer and 47% for the pMDI alone. The majority of people (76%) received their initial inhaler technique instruction from their doctor. Over half of participants did not recall having their inhaler technique rechecked. DISCUSSION: After prescribing appropriate therapy, correct inhaler technique is a cornerstone of achieving adequate therapy. Rechecking inhaler technique is a gap in care that needs to be addressed from an interdisciplinary perspective. KEYWORDS: Asthma; chronic obstructive pulmonary disease; dry powder inhalers; metered dose inhalers; spacer inhalers
3
Young, Paul M., and Robert Price. "Comparative Measurements of Pressurised Metered Dose Inhaler (pMDI) Stem Displacement." Drug Development and Industrial Pharmacy 34, no. 1 (January 2008): 90–94. http://dx.doi.org/10.1080/03639040701484205.
Full text
4
Lavorini, Federico. "The Challenge of Delivering Therapeutic Aerosols to Asthma Patients." ISRN Allergy 2013 (August 5, 2013): 1–17. http://dx.doi.org/10.1155/2013/102418.
Full textAbstract:
The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.
5
Attar-Zadeh, Darsuh, Harriet Lewis, and Martina Orlovic. "Health-care Resource Requirements and Potential Financial Consequences of an Environmentally Driven Switch in Respiratory Inhaler Use in England." Journal of Health Economics and Outcomes Research 8, no. 2 (September 23, 2021): 46–54. http://dx.doi.org/10.36469/jheor.2021.26113.
Full textAbstract:
Background: To reduce greenhouse gas emissions, national initiatives advocate the phasing down of respiratory inhalers that use a fluorinated gas as a propellant (pressurised metered-dose inhalers [pMDI]). Nevertheless, pMDIs continue to be an effective and common choice. Objective: To assess the potential financial impact of patients with asthma or chronic obstructive pulmonary disease (COPD) switching from pMDIs to dry powder inhalers (DPIs) in a representative primary care network (PCN) population of 50 000 and the English National Health Service (NHS). Methods: Epidemiological data were combined with current inhaler use patterns to estimate the resources and costs associated with this transition, varying patient acceptance scenarios. Results: Depending on the approach, resource requirements ranged from £18 000 – £53 000 for a PCN, and from £21 – £60 million for the English NHS. Discussion: Significant funds are needed to successfully manage targeted inhaler transitions, together with counselling and follow-up appointment with an appropriately skilled clinician to assess the patient’s inhaler technique and ensure disease control. Conclusions: Targeted transition of inhalers must achieve a balance between environmental impacts, organisational factors, and patient requirements. The resources for managing a switch can be substantial but are necessary to appropriately counsel and support patients, whilst protecting the environment.
6
Wong, Albert G., Paul M. O'Byrne, Christer Lindbladh, Mark D. Inman, Elisabeth Ståhl, and Frederick E. Hargreave. "Dose-response Protective Effect of Salbutamol on Methacholine Airway Responsiveness using Pressurized Metered Dose Inhalers and Turbuhalers." Canadian Respiratory Journal 5, no. 2 (1998): 119–23. http://dx.doi.org/10.1155/1998/865042.
Full textAbstract:
The purpose of this study was to estimate the relative dose potency of salbutamol Turbuhaler compared with salbutamol pressurized metered dose inhaler (pMDI) with respect to the protective effect against methacholine bronchoconstriction. Twenty-three asthmatic subjects with stable asthma participated in the study. Baseline forced expiratory volume in 1 s (FEV1) was 70% or more of predicted, and baseline methacholine provocative concentration causing a 20% fall in FEV1(PC20) was 4 mg/mL or less. The design was randomized, double-blind, double-dummy, crossover and placebo controlled and was conducted over seven study days. On each study day, the subjects inhaled 50 µg or 100 µg of salbutamol via Turbuhaler, 100 µg, 200 µg, 400 µg or 800 µg of salbutamol via pMDI, or placebo in randomized order. PC20was determined 30 mins after inhalation. Increasing doses of salbutamol pMDI increased the PC20in a dose-dependent fashion from 3.9 mg/mL after placebo to 13.3 mg/mL after pMDI 100 µg, 19.0 mg/mL after 200 µg, 32.6 mg/mL after 400 µg, and 35.1 mg/mL after 800 µg. The half-maximum response dose for pMDI (ED50) was 104 µg. Salbutamol Turbuhaler 50 µg increased the PC20to 10.0 mg/mL and 100 µg to 12.6 mg/mL. Salbutamol pMDI 200 µg provided significantly greater protection to methacholine than pMDI 100 µg or Turbuhaler 100 µg and significantly less protection than pMDI 400 µg (P<0.05). This study demonstrates that the relative protective dose potency of inhaled beta-agonists can be determined by comparing their effects on methacholine airway responsiveness. The estimated relative protective dose potency for salbutamol Turbuhaler in comparison with pMDI was 1.38 (95% CI 0.67 to 2.87) at 50 µg and was 0.96 (95% CI 0.56 to 1.64) at 100 µg.
7
Ernst, Pierre. "Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices." Canadian Respiratory Journal 5, no. 3 (1998): 180–83. http://dx.doi.org/10.1155/1998/802829.
Full textAbstract:
Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI); its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs) as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs) are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.
8
Lenney, J., J. A. Innes, and G. K. Crompton. "Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices." PULMONOLOGIYA, no. 4 (August 28, 2005): 80–84. http://dx.doi.org/10.18093/0869-0189-2005-0-4-80-84.
Full textAbstract:
Inefficient inhaler technique is a common problem resulting in decreased disease control and increased inhaler use. The aim of this study was to assess patients' use of different inhaler devices and to ascertain whether patient preference is indicative of ease of use and whether current inhaler use has any influence on either technique or preference. We also wished to define the most appropriate method of selecting an inhaler for a patient, taking into account observed technique and device cost. One hundred patients received instruction, in randomized order, in the use of seven different inhaler devices. After instruction they were graded (using predetermined criteria) in their inhaler technique. After assessment patients were asked which three inhalers they most preferred and which, if any, they currently used. Technique was best using the breath-actuated inhalers; the Easi-Breathe and Autohaler, with 91 % seen to have good technique. The pressurized metered dose inhaler (pMDI) fared poorly, in last position with only 79 % of patients showing good technique, despite being the most commonly prescribed. The Easi-Breathe was by far the most popular device with the patients. The Autohaler came in second position closely followed by the Clickhaler and Accuhaler. The majority of patients (55 %) currently used the pMDI but the pMDI did not score highly for preference or achieve better grades than the other devices. Only 79 % of patients tested could use the pMDI effectively even after expert instruction yet it continues to be commonly prescribed. This has important repercussions for drug delivery and hence disease control. Prescribing a patient's preferred device increases cost but can improve efficiency and therefore be cost effective in the long term. Using an inexpensive device (pMDI) when technique is good and the patient's preferred inhaler device when not is one way to optimize delivery and may even reduce cost.
9
Sanders, Mark, and Ronald Bruin. "A Rationale for Going Back to the Future: Use of Disposable Spacers for Pressurised Metered Dose Inhalers." Pulmonary Medicine 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/176194.
Full textAbstract:
The introduction of pressurised metered dose inhalers (MDIs) in the mid-1950s completely transformed respiratory treatment. Despite decades of availability and healthcare support and development of teaching aids and devices to promote better use, poor pMDI user technique remains a persistent issue. The main pMDI user aid is the spacer/valved holding chamber (VHC) device. Spacer/chamber features (size, shape, configuration, construction material, and hygiene considerations) can vie with clinical effectiveness (to deliver the same dose as a correctly used pMDI), user convenience, cost, and accessibility. Unsurprisingly, improvised, low-cost alternatives (plastic drink bottles, paper cups, and paper towel rolls) have been pressed into seemingly effective service. A UK law change permitting schools to hold emergency inhalers and spacers has prompted a development project to design a low-cost, user-friendly, disposable, and recyclable spacer. This paper spacer requires neither preuse priming nor washing, and has demonstrated reproducible lung delivery of salbutamol sulphate pMDI, comparable to an industry-standard VHC, an alternative paperboard VHC, and pMDI alone. This new device appears to perform better than these other VHC devices at the low flow rates thought achievable by paediatric patients. The data suggest that this disposable spacer may have a place in the single-use emergency setting.
10
Day, James, Michael Alexander, Michel Drouin, Charles Frankish, Jorge Mazza, William Moote, Piyush Patel, Helen Ramsdale, and William Yang. "Budesonide Aqueous Nasal Spray and Pressurized Metered Dose Inhaler in the Treatment of Adult Patients with Seasonal Allergic Rhinitis." American Journal of Rhinology 11, no. 1 (January 1997): 77–84. http://dx.doi.org/10.2500/105065897781446847.
Full textAbstract:
Budesonide, a topical corticosteroid used in the treatment of seasonal allergic rhinitis, can be administered to the nose as an aerosol via a pressurized metered dose inhaler (pMDI) or as a metered nasal pump spray. Studies have shown that about 64% (256 μg) of a nominal dose of 400 μg budesonide pMDI preparation is delivered to the patient compared with 100% of the nominal dose of the pump spray. The present study was undertaken to assess the efficacy and safety of budesonide delivered via a nasal pMDI twice daily (Rhinocort® pMDI, at 400 μg/day) with an aqueous suspension of budesonide delivered via a metered nasal pump spray once daily (Rhinocort® Aqua, at 256 μg/day or 400 μg/day). The multicenter, double-blind, randomized, placebo-controlled, parallel-group study was conducted in 318 patients (154 men, 164 women; aged 12–67 years) with ragweed-induced seasonal allergic rhinitis. A 1-week baseline period was followed by a 3-week treatment. Nasal symptoms were recorded by the patients, adverse events were noted, an overall evaluation of treatment efficacy was made, and urine cortisol and creatinine levels were measured. Substantial or total control of symptoms was achieved in 83.8% of patients treated with 256 μg of aqueous budesonide, 76.3% with 400 μg of aqueous budesonide, and 80.8% with 400 μg of budesonide pMDI; these were all significantly different (p < 0.001) compared with placebo (23.4% of patients). There were no significant differences in the 24-hour urine cortisol levels between the groups and there were few, infrequent adverse events, similar between the groups and resolved completely on discontinuation of treatment. It was concluded that budesonide, given once daily as 256 μg or 400 μg in an aqueous suspension or twice daily as 400 μg in a pMDI provides good alleviation of the symptoms of seasonal allergic rhinitis with no significant risk of suppression of urine cortisol.
Dissertations / Theses on the topic "Pressurised metered dose inhaler (pMDI)"
1
Davis, A. J. "A fundamental study of the flow and droplet delivery from a pressurised metered dose inhaler (pMDI)." Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/12222.
Full textAbstract:
The assessment of drug formulations delivered by the pressurised metered dose inhaler and used in the treatment of Asthma are assessed commercially using cascade impactors which are the preferred instruments for the assessment of particle size and respirable mass or fraction delivered by inhalation devices. The fundamental principle underpinning the design of cascade impactors is particle motion defined by Stokes theory. The analysis of impactor data raises a number of functional issues as calibration curves have long tails, which are not easily explained by a simplistic application of Stokes law. The atomisation process, propellant flashing, evaporation and aerodynamic properties of the residual drug particle detennine the distribution of the drug particles within the lung and resultant therapeutic effect. The research uses mathematical modelling and computational fluid dynamics (CFD) to evaluate the flow and inertial deposition in the USP throat and the plates of the ACI which is the most widely used cascade impactor. The CFD analysis shows the flow in the outlet section of the USP throat to be unstable for the basic design, when coupled to an outlet extension and when coupled to the ACI via the standard coupler and first jet stage. The modelling also provides insight as to why the calibration curves of the ACI have long tails and reveals a number of issues with the design of the ACI coupler and the fundamental design of impactor jet arrays as well as the position and functional response of upper impactor plates. Additional particle sizing methodologies were used to assess the lognonnal characteristics of the atomised droplets and residual drug particles. The experimental data was compared to current atomisation model and modification recommended and a proposed alternative model with improved fit to the data.
2
Grimble, David. "Ultra-thin film tribology of elastomeric seals in pressurised metered dose inhalers." Thesis, Loughborough University, 2009. https://dspace.lboro.ac.uk/2134/6376.
Full textAbstract:
Within pressurised Metered Dose Inhalers (pMDIs) the contact between the valve components and elastomeric seals is of major significance, representing the main contributory factor to the overall system frictional characteristics. Therefore, the seal performance is extremely important and must be optimised to meet the contradictory requirements of preventing leakage and allowing smooth actuation. The environmentally driven trend to HFA formulations as opposed to CFC based ones has deteriorated this problem due to poor lubrication conditions and it has, consequently, increased the frictional losses during the pMDI actuation (hysteresis cycle). Research has been conducted into the key areas of the inhaler mechanism. As such, the contact pressure distribution and resulting reactions have been investigated, with emphasis on the correct treatment of the elastomer (seal) characteristics. The modelling of the device has been conducted within the environment of the multibody dynamics commercial software ADAMS, where a virtual prototype has been built using solid CAD geometries of the valve components. An equation was extrapolated to describe the relation between the characteristics of the ultra thin film contact conditions (sliding velocity, surface geometry, film thickness and reaction force) encountered within the inhaler valve and integrated into the virtual prototype allowing the calculation of friction within the conjuncture (due to viscous shear and adhesion). The latter allowed the analysis and optimisation of key device parameters, such as seal geometry, lubricant properties etc. It has been concluded that the dominant mechanism of friction is adhesion, while boundary lubrication is the prevailing lubrication regime due to the poor surface roughness to film thickness ratio. The multibody dynamics model represents a novel multi physics approach to study the behaviour of pMDIs, including rigid body inertial dynamics, general elasticity, surface interactions (such as adhesion), hydrodynamics and intermolecular surface interactions (such as Van der Waals forces). Good agreement has been obtained against experimental results at component and device level.
3
Telford, Richard. "The Physical Chemistry of pMDI Formulations Derived from Hydrofluoroalkane Propellants. A Study of the Physical Behaviour of Poorly Soluble Active Pharmaceutical Ingredients; Bespoke Analytical Method Development Leading to Novel Formulation Approaches for Product Development." Thesis, University of Bradford, 2013. http://hdl.handle.net/10454/10098.
Full textAbstract:
Active Pharmaceutical Ingredients (APIs) are frequently prepared for delivery to the lung for local topical treatment of diseases such as Chronic Obstructive Pulmonary Disease (COPD) and asthma, or for systemic delivery. One of the most commonly used devices for this purpose is the pressurised metered dose inhaler (pMDI) whereby drugs are formulated in a volatile propellant held under pressure. The compound is aerosolised to a respirably sized dose on actuation, subsequently breathed in by the user. The use of hydrofluoroalkanes (HFAs) in pMDIs since the Montreal Protocol initiated a move away from chlorofluorocarbon (CFC) based devices has resulted in better performing products, with increased lung deposition and a concomitant reduction in oropharyngeal deposition. The physical properties of HFA propellants are however poorly understood and their capacity for solubilising inhaled pharmaceutical products (IPPs) and excipients used historically in CFCs differ significantly. There is therefore a drive to establish methodologies to study these systems in-situ and post actuation to adequately direct formulation strategies for the production of stable and efficacious suspension and solution based products. Characterisation methods have been applied to pMDI dosage systems to gain insight into solubility in HFAs and to determine forms of solid deposits after actuation. A novel quantitative nuclear magnetic resonance method to investigate the physical chemistry of IPPs in these preparations has formed the centrepiece to these studies, accessing solubility data in-situ and at pressure for the first time in HFA propellants. Variable temperature NMR has provided thermodynamic data through van’t Hoff approaches. The methods have been developed and validated using budesonide to provide limits of determination as low as 1 μg/mL and extended to 11 IPPs chosen to represent currently prescribed inhaled corticosteroids (ICS), β2-adrenoagonists and antimuscarinic bronchodilators, and have highlighted solubility variations between the classes of compounds with lipophilic ICSs showing the highest, and hydrophilic β2- agonist/antimuscarinics showing the lowest solubilities from the compounds under study. To determine solid forms on deposition, a series of methods are also described using modified impaction methods in combination with analytical approaches including spectroscopy (μ-Raman), X-ray diffraction, SEM, chromatography and thermal analysis. Their application has ascertained (i) physical form/morphology data on commercial pMDI formulations of the ICS beclomethasone dipropionate (QVAR®/Sanasthmax®, Chiesi) and (ii) distribution assessment in-vitro of ICS/β2-agonist compounds from combination pMDIs confirming co-deposition (Seretide®/Symbicort®, GlaxoSmithKline/AstraZeneca). In combination, these methods provide a platform for development of new formulations based on HFA propellants. The methods have been applied to a number of ‘real’ systems incorporating derivatised cyclodextrins and the co-solvent ethanol, and provide a basis for a comprehensive study of solubilisation of the ICS budesonide in HFA134a using two approaches: mixed solvents and complexation. These new systems provide a novel approach to deliver to the lung, with reduced aerodynamic particle size distribution (APSD) potentially accessing areas suitable for delivery to peripheral areas of the lung (ICS) or to promote systemic delivery.
4
Grimes, Matthew, Paul Myrdal, and Poonam Sheth. "Cosolvent Effect on Droplet Evaporation Time, Aerodynamic Particle Size Distribution, and Differential Throat Deposition for Pressurized Metered Dose Inhalers." The University of Arizona, 2015. http://hdl.handle.net/10150/614123.
Full textAbstract:
Class of 2015 AbstractObjectives: To evaluate the in vitro performance of various pressurized metered dose inhaler (pMDI) formulations by cascade impaction primarily focusing on throat deposition, fine particle fraction (FPF), and mass-median aerodynamic diameter (MMADR) measurements Methods: Ten solution pMDIs were prepared with varying cosolvent species in either low (8% w/w) or high (20% w/w) concentration. The chosen cosolvents were either alcohol (ethanol, n-propanol) or acetate (methyl-, ethyl-, and butyl acetate) in chemical nature. All formulations used HFA-134a propellant and 0.3% drug. The pMDIs were tested by cascade impaction with three different inlets to determine the aerodynamic particle size distribution (APSD), throat deposition, and FPF of each formulation. Theoretical droplet evaporation time (DET), a measure of volatility, for each formulation was calculated using the MMADR. Results: Highly volatile formulations with short DET showed consistently lower throat deposition and higher FPF than their lower volatility counterparts when using volume-constrained inlets. However, FPF values were not significantly different for pMDI testing with a non-constrained inlet. The MMADR values generated with volume-constrained inlets did not show any discernible trends, but MMADR values from the non-constrained inlet correlated with DET. Conclusions: Formulations with shorter DET exhibit lower throat deposition and higher FPF, indicating potentially better inhalational performance over formulations with longer DET. There appear to be predictable trends relating both throat deposition and FPF to DET. The shift in MMADR values for volume-constrained inlets suggests that large diameter drug particles are preferentially collected in these inlets.
5
Al, Sultan Huriah A. "In-Vitro Comparison of Aerosol Drug Delivery in Pediatrics Using Pressurized Metered Dose Inhaler, Jet Nebulizer, and Vibrating Mesh Nebulizers." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/rt_theses/15.
Full textAbstract:
Background: Aerosol therapy has been established as an efficient form of drug delivery to pediatric and adult patients with respiratory diseases; however, aerosol delivery to the pediatric population is quite challenging. While some studies compare jet nebulizer (JN), vibrating mesh nebulizer (VMN), or JN and pMDI, there is no study comparing these three devices in pediatric and young children. The aim of this study quantifies aerosol deposition using JN, VMN, and pMDI/VHC in a simulated pediatric with active and passive breathing patterns.
Methods: Each aerosol generator was placed between manual resuscitator bag (Ambu SPUR II Disposable Resuscitator, Ambu Inc, Glen Burnie, MD) and infant facemask (Mercury Medical, Cleanwater, FL), which was held tightly against the SAINT model. Breathing parameters used in this study were Vt of 100 mL, RR of 30 breaths/min, and I:E ratio of 1: 1.4. Active and passive breathing patterns were used in this study with aerosol device; active breathing pattern was created using a ventilator (Esprit Ventilator, Respironics/Philips Healthcare, Murrysville, PA) connected to a dual chamber test lung (Michigan Instruments, Grand Rapids, MI), which was attached to an absolute filter (Respirgard II, Vital Signs Colorado Inc, Englewood, CO), to collect aerosolized drug, connected to the SAINT model. Pediatric resuscitator bag was run at 10 L/min of oxygen and attached to aerosol generator with facemask. In passive breathing pattern, SAINT model was attached to test lung and ventilated using the resuscitator bag with the same breathing parameters. Each aerosol device was tested three times (n=3) with each breathing patterns. Drug was eluted from the filter and analyzed using spectrophotometry. The amount of drug deposited on the filter was quantified and expressed as a percentage of the total drug dose. To measure the differences in the inhaled drug mass between JN, VMN, and pMDI/VHC in active or passive breathing, one-way analysis of variance (one-way ANOVA) was performed. To quantify the difference in aerosol depositions between the two breathing patterns, independent t-test was performed. A p < 0.05 was considered to be statistically significant.
Results: Although the amount of aerosol deposition with the JN was the same in passive and active breathing without any significant difference, the VMN was more efficient in active breathing than the JN (p = 0.157 and p = 0.729, respectively). pMDI/VHC had the greatest deposition in the simulated spontaneous breathing (p=0.013)
Conclusion: Aerosol treatment may be administered to young children using JN, VMN, or pMDI/VHC combined with resuscitator bag. Using pMDI/VHC with resuscitator bag is the best choice to deliver albuterol in spontaneously breathing children. Further studies are needed to determine the effectiveness of these aerosol generators with different type of resuscitator bag and different breathing parameters.
6
Hammer, Carrie L., and Matthew D. Bertsch. "In Vitro Effect of Nonconventional Accessory Devices on Throat Deposition and Respirable Mass." The University of Arizona, 2012. http://hdl.handle.net/10150/623585.
Full textAbstract:
Class of 2012 AbstractSpecific Aims: To evaluate the in vitro throat deposition and respirable mass of the QVAR® pressurized metered-dose inhaler (pMDI) alone or coupled to an accessory device, such as the AeroChamber Valved Holding ChamberTM or various nonconventional accessory devices. Methods: The performance of the AeroChamber and nonconventional accessory devices, including a toilet paper roll, paper towel roll, rolled paper, plastic bottle spacer, plastic bottle reverse-flow holding chamber, and nebulizer reservoir tubing, were compared to no accessory device. Throat deposition and respirable mass were evaluated using a United States Pharmacopeia (USP) inlet ("throat") coupled to instrumentation for particle size analysis. Each configuration was tested with three actuations and repeated in quadruplicate. The amount of drug deposition was quantified using high-performance liquid chromatography. The data were analyzed using multiple independent t-tests assuming unequal variances. An a priori α-threshold of 0.05 was used with a Bonferroni corrected α of 0.007. Main Results: Compared to the pMDI alone, all of the accessory devices had significantly lower throat deposition (p < 0.001) and significantly higher respirable fraction (p < 0.001). Differences in respirable mass were not significant for any accessory device (p ≥ 0.049), except the paper towel roll and the nebulizer reservoir tubing (p < 0.001). Conclusions: Under these testing circumstances, nonconventional accessory devices, such as the toilet paper roll, rolled paper, plastic bottle spacer, and plastic bottle reverse-flow holding chamber, effectively reduce throat deposition and maintain respirable mass compared to a QVAR pMDI alone. Therefore, they may be suitable alternatives to commercial spacers.
7
Alalwan, Mahmood A. "In Vitro Evaluation oF Aerosol Drug Delivery With And Without High Flow Nasal Cannula Using Pressurized Metered Dose Inhaler And Jet Nebulizer in Pediatrics." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/rt_theses/14.
Full textAbstract:
Background: HFNC system is a novel device used with aerosol therapy and seems to be rapidly accepted. Although there are some studies conducted on HFNC and vibrating mesh nebulizer, the effect of HFNC on aerosol delivery using jet nebulizer or pressurized metered-dose inhaler (pMDI) has not been reported. In an effort to examine the effect of HFNC on aerosol deposition, this study was conducted to quantify aerosol drug delivery with or without a HFNC using either pMDI or jet nebulizer.
Methodology: The SAINT model, attached to an absolute filter (Respirgard II, Vital Signs Colorado Inc., Englewood, CO, USA) for aerosol collection, was connected to a pediatric breathing simulator (Harvard Apparatus, Model 613, South Natick, MA, USA). To keep the filter and the SAINT model in upright position to collect aerosolized drug, an elbow adapter was connected between the absolute filter and the breathing simulator. An infant HFNC (Optiflow, Fisher & Paykel Healthcare LTD., Auckland, New Zealand) ran at 3 l/min O2 was attached to the nares of the SAINT model. Breathing parameters used in this study were Vt of 100 mL, RR of 30 breaths/min, and I:E ratio of 1: 1.4. Aerosol drug was administered using: 1) Misty-neb jet nebulizer (Allegiance Healthcare, McGaw Park, Illinois, USA) powered by air at 8 l/min using pediatric aerosol facemask (B&F Medical, Allied Healthcare Products, Saint Louis, MO, USA) to deliver albuterol sulfate (2.5 mg/3 mL NS), and 2) Four actuations of Ventolin HFA pMDI (90 μg/puff) (GlaxoSmithKline, Research Triangle Park, NC, USA) combined with VHC (AeroChamber plus with Flow-Vu, Monaghan Medical, Plattsburgh, NY, USA). Aerosol was administered to the model with and without the HFNC and another without (n=3). Drug was collected on an absolute filter, eluted and measured using spectrophotometry. Independent t tests were performed for data analysis. Statistical significance was determined with a p value of <0.05.
Results: The mean inhaled mass percent was greatest for pMDI with (p = 0.0001) or without HFNC (p = 0.003). Removing HFNC from the nares before aerosol treatment trended to increase drug delivery with the jet nebulizer (p = 0.024), and increased drug delivery by 6 fold with pMDI (p = 0.003).
Conclusions: Aerosol drug may be administered in pediatrics receiving HFNC therapy using either jet nebulizer or pMDI. However, using pMDI, either with or without HFNC, is the best option. When delivering medical aerosol by mask, whether by jet nebulizer or pMDI, removing HFNC led to an increase in inhaled mass percent. However, the benefit of increased aerosol delivery must be weighed against the risk of lung derecruitment when nasal prongs are removed.
8
Hammer, Carrie L., Matthew D. Bertsch, Paul B. Myrdal, and Poonam Sheth. "In Vitro Effect of Nonconventional Accessory Devices on Throat Deposition and Respirable Mass." The University of Arizona, 2012. http://hdl.handle.net/10150/614433.
Full textAbstract:
Class of 2012 AbstractSpecific Aims: To evaluate the in vitro throat deposition and respirable mass of the QVAR® pressurized metered-dose inhaler (pMDI) alone or coupled to an accessory device, such as the AeroChamber Valved Holding ChamberTM or various nonconventional accessory devices. Methods: The performance of the AeroChamber and nonconventional accessory devices, including a toilet paper roll, paper towel roll, rolled paper, plastic bottle spacer, plastic bottle reverse-flow holding chamber, and nebulizer reservoir tubing, were compared to no accessory device. Throat deposition and respirable mass were evaluated using a United States Pharmacopeia (USP) inlet ("throat") coupled to instrumentation for particle size analysis. Each configuration was tested with three actuations and repeated in quadruplicate. The amount of drug deposition was quantified using high-performance liquid chromatography. The data were analyzed using multiple independent t-tests assuming unequal variances. An a priori α-threshold of 0.05 was used with a Bonferroni corrected α of 0.007. Main Results: Compared to the pMDI alone, all of the accessory devices had significantly lower throat deposition (p < 0.001) and significantly higher respirable fraction (p < 0.001). Differences in respirable mass were not significant for any accessory device (p ≥ 0.049), except the paper towel roll and the nebulizer reservoir tubing (p < 0.001). Conclusions: Under these testing circumstances, nonconventional accessory devices, such as the toilet paper roll, rolled paper, plastic bottle spacer, and plastic bottle reverse-flow holding chamber, effectively reduce throat deposition and maintain respirable mass compared to a QVAR pMDI alone. Therefore, they may be suitable alternatives to commercial spacers.
9
Sheth, Poonam. "Theoretical and Experimental Behavior of Suspension Pressurized Metered Dose Inhalers." Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/325231.
Full textAbstract:
Pressurized metered dose inhalers (pMDIs) are widely utilized to manage diseases of the lungs, such as asthma and chronic obstructive pulmonary disease. They can be formulated such that the drug and/or nonvolatile excipients are dissolved or dispersed in the formulation, rendering a solution or suspension formulation, respectively. While the formulation process for solution pMDIs is well defined, the formulation process of pMDIs with any type of suspended entity can be lengthy and empirical. The use of suspended drug or the addition of a second drug or excipient in a suspension pMDI formulation may non-linearly impact the product performance of the drug of interest in the formulation; this requires iterative testing of a series of pMDIs in order to identify a formulation with the most potential for success. One of the primary attributes used to characterize the product performance and quality control of inhaled medications is the residual aerodynamic particle size distribution (APSD) of the aerosolized drug. Along with clinical factors, formulation and device parameters have a significant impact on APSD. In this study, a computational model was developed using the principles of statistics and physical chemistry to predict the residual APSD generated by suspension pMDIs based on formulation, device, and raw drug or excipient substance considerations. The formulations modeled and experimentally evaluated consist of a suspended drug or excipient with/without a dissolved drug or excipient in a cosolvent-propellant system. The in silico model enables modeling a process that is difficult to delineate experimentally and contributes to understanding the link between pMDI formulation and device to product performance. The ability to identify and understand the variables that affect atomization and/or aerosol disposition , such as initial droplet size, suspended micronized drug or excipient size, and drug or excipient concentration, facilitates defining the design space for suspension pMDIs during development and improves recognizing the sensitive of the APSD is on each hardware and formulation variable. This model can later be applied to limit batch-to-batch variation in the manufacturing process and selecting plausible suspension pMDI formulations with quality design as the end goal.
10
Dunbar, C. A. "An experimental and theoretical investigation of the spray issued from a pressurised metered-dose inhaler." Thesis, University of Manchester, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.587518.
Full textAbstract:
This research was concerned with the experimental and theoretical investigation of the spray issued from a pressurised metered-dose inhaler (pMDI) and has been motivated by the urgent need to find suitable replacements to the environmentally destructive Cf'Csbased propellants currently used and to extend the working knowledge of the device. The majority of the experimental work was conducted using phase-Doppler anemometry (PDA), a single particle light scattering technique which provides the simultaneous measurement of drop size, velocity and concentration, yielding the most detailed temporal and spatial analysis of the pMDI spray to date. The PDA analysis was complemented by a visual investigation of the near-orifice flow field in an attempt to obtain information on the primary atomization process. The theoretical investigation of the pMDI spray consisted of constructing a model of the fluid flow through the pMDI during a single actuation that was based on a quasi-steadystate separated flow analysis and included a qualitative and quantitative description of the primary atomization process. The construction of a model of the resultant spray was based on the solution of the multiphase transport equations using computational fluid dynamics (eFD) techniques, with the theoretical results being validated against the experimental data. The spray issued from a pMDI was found to be an unsteady, transient, threedimensional, multiphase fluid flow, generally characterised by high initial drop velocities with steep axial velocity radial gradients, small drop sizes, high levels of turbulence and a mean spray cone angle of approximately eleven degrees. The visualisation of the near-orifice flow field suggested that flash evaporation was the primary atomization mechanism, producing a finely pre-atomized spray. The pMDI spray was affected by attitude, it having been observed that the patternation of the spray was biased in the downward direction and this was a consequence of the asymmetric geometry of the actuator nozzle. The results predicted at the near-orifice measurement locations by the theoretical spray model suggested that the theoretical actuator flow model successfully simulated the fluid flow through the pMDI and the primary atomization process during a single actuation for a placebo hydrofluoroalkane formulation. However, the resultsproduced by the theoretical spray model could only be considered as preliminary until further numerical analysis is conducted.
Books on the topic "Pressurised metered dose inhaler (pMDI)"
1
Dhand, Rajiv, and Michael McCormack. Bronchodilators in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0033.
Full textAbstract:
Inhaled beta-agonists and anticholinergic agents, as well as systemically administered methylxanthines, are frequently employed to achieve bronchodilation in critically-ill patients. Inhaled agents are given by pressurized metered dose inhaler (pMDI), nebulizer, or dry powder inhaler. In ventilator-supported patients, aerosolized agents are generally only administered by pMDI or nebulizer. The ventilator circuit, artificial airway, and circuit humidity complicate the delivery of aerosolized agents, and there is a wide variability in drug delivery efficiency with various bench models of mechanical ventilation. Aerosolized drug by pMDI is affected by the use of spacer devices, synchronization of pMDI actuation and ventilator breath delivery, and appropriate priming of the pMDI device. The efficiency of aerosolized drug delivery by jet nebulization is also affected by device placement in the circuit, as well as by a number of other factors. Several investigators have demonstrated comparable efficiency of aerosol delivery with mechanically-ventilated and ambulatory patients when careful attention is given to the technique of administration. Appropriate administration of aerosolized bronchodilators in patients receiving invasive or non-invasive positive pressure ventilation produces significant therapeutic effects.
Conference papers on the topic "Pressurised metered dose inhaler (pMDI)"
1
Bell, David, Gill Mundin, Mark Lomax, Jo Woodward, Sanjeeva Dissanayake, and Tim Overend. "Relative pulmonary bioavailability (BA) of fluticasone propionate/formoterol (FP/FORM) via pressurised metered-dose inhaler (pMDI) and a novel breath-triggered inhaler (BTI)." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa523.
Full text
2
Silva, Lui´s F., Senhorinha Teixeira, Jose´ Carlos Teixeira, Rita Rebelo, Ricardo Oliveira, and Henedina Antunes. "Study and Development of Spacers for Pressurized Inhaler Devices: A Project Review." In ASME 2009 International Mechanical Engineering Congress and Exposition. ASMEDC, 2009. http://dx.doi.org/10.1115/imece2009-13171.
Full textAbstract:
In recent years, allergic diseases, particularly asthma, have been acquiring an increasing importance in the developed countries, due to the rising of its prevalence and morbidity and the economic burden associated, becoming a serious public health problem. Recent therapeutic approaches in asthma patients may help to prevent most of the crisis and remain free of symptoms. Several inhalation devices are available for drug delivery to the lungs, including metered-dose inhalers (MDIs), dry powder inhalers (PDIs) and nebulizers. Although this variety of devices used for drug delivery to the bronchial tree have shown encouraging results, a great amount of the drug does not reach the goal and remains in the mouth (less than 20% of the drug can reach the lungs) and higher airways. This causes not only a loss of drug but also increases costs and produces undesirable side effects. For better efficiency of the process, spacers, such as the Volumatic® used in the study herein reported, are used. This paper will describe and summarize part of the developments being carried out so far at the University of Minho in this domain, as well as the latest developments in order to understand the characteristics of the used spacer and the parameters affecting its performance. By using computational fluid Dynamics (CFD) techniques, the behavior of the drug flow inside the spacer, combined with a pressurized metered-dose inhaler (pMDI), the discrete phase model (DPM) flow inside the Volumatic® is also reported. The results obtained are also analyzed and discussed, using two different 3D grid types (Cooper and T-Grid). The insight provided by the detailed data of the flow patterns inside the Volumatic® provides possible options for new geometry possibilities for the spacer devices.
3
Suggett, J., M. Nagel, and A. Bracey. "P278 Assessing different valved holding chambers (vhc) with facemask for delivered mass to carina with inhaled corticosteroid by pressurised metered-dose inhaler (pmdi)." In British Thoracic Society Winter Meeting 2017, QEII Centre Broad Sanctuary Westminster London SW1P 3EE, 6 to 8 December 2017, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2017. http://dx.doi.org/10.1136/thoraxjnl-2017-210983.420.
Full text
4
Kim, KT, BQ Lanier, M. Goldman, P. Martin, and J. Zangrilli. "Effect of Adjustable-Dose (AD) Budesonide/Formoterol Pressurized Metered-Dose Inhaler (pMDI), Fixed-Dose (FD) Budesonide/Formoterol pMDI, and FD Fluticasone/Salmeterol Dry Powder Inhaler (DPI) on Predose FEF25–75%." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a2788.
Full text
5
Bell, David, Gill Mundin, Mark Lomax, Jo Woodward, Prashant Dalvi, and Sanjeeva Dissanayake. "Systemic bioavailability (BA) and pharmacodynamics (PD) of fluticasone propionate/formoterol (FP/FORM) via pressurised metered-dose inhaler (pMDI) or a novel breath-triggered inhaler (BTI)." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa3950.
Full text
6
Chen, Yingxue, Susanne Prothon, Ulf Eriksson, Henrik Forsman, Hong-lin Su, Mary Brown, Ajay Aggarwal, and Helen Jackson. "Pharmacokinetics (PK) of a single dose AZD7594 administered intravenously (IV), orally, and inhaled via two dry powder inhalers (DPI) and a pressurized metered-dose inhaler (pMDI)." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa531.
Full text
7
Agarwal, Sudhir K., and Saket Sharma. "Effect Of Fluticasone/Formoterol Pressurized Metered-Dose Inhaler (pMDI) In Early Management Of Acute Exacerbations Of Asthma." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5659.
Full text
8
Brown, Randall W., Tom Uryniak, and Kathy L. Lampl. "Differential Long-Term Pulmonary Function Outcomes Of Budesonide/Formoterol Pressurized Metered-Dose Inhaler PMDI And Budesonide PMDI In African-American Patients With Asthma." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a1293.
Full text
9
Suggett, J., M. Nagel, and A. Bracey. "M33 Assessing different valved holding chambers (VHC) with facemask for delivered mass to carina with inhaled corticosteroid by pressurized metered-dose inhaler (pMDI)." In British Thoracic Society Winter Meeting 2018, QEII Centre, Broad Sanctuary, Westminster, London SW1P 3EE, 5 to 7 December 2018, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2018. http://dx.doi.org/10.1136/thorax-2018-212555.453.
Full text
10
Vandewalker, M. "Dose-Ranging Effects of Extrafine Beclomethasone Dipropionate (BDP) Delivered Via a Pressurized Metered-Dose Inhaler (PMDI) in Patients with Asthma: The Beam Study." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5636.
Full text