China
Africa
Explore chapters and articles related to this topic
Emerging Technologies for Particle Engineering
Published in Dilip M. Parikh, Handbook of Pharmaceutical Granulation Technology, 2021
Spray drying has been used over the past 30 years to produce particles for inhalation applications. Particle size is crucial for pulmonary delivery because particles that are too large (> 5 microns) will not go deep into the lungs and those that are too small (< 1 micron) may be exhaled. Spray drying can be used to engineer particles with specific densities and particle sizes. Because the process uses heat, it is not suitable for some thermally sensitive materials. The most common means of delivering inhalation particles to the lungs are dry powder inhalers or DPI. Emulsion, supercritical antisolvent, and spray drying are three examples of particle engineering systems adopted for the generation of inhalation powder [108].A detailed discussion of spray drying is presented in Chapter 6 of this book.
Respiratory, endocrine, cardiac, and renal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Inhaled drugs are preferred because of their high therapeutic-toxic ratio, i.e. high concentrations of drug are delivered directly to the airways, with potent therapeutic effects and few systemic side effects. Several systems for inhalation exist: metered dose inhaler, dry powder inhaler or nebuliser. The use of a spacer, which facilitates the use of a metered dose inhaler, increases the deposition and decreases the side effects. For these reasons, a spacer is the treatment of choice in children below the age of 4 years. In infants and young children a spacer with a mask is indicated. Several factors will guide the choice of a spacer. Spacer and metered dose inhaler should fit properly, but also the mask or mouth piece should fit to the child. The volume of the spacer should be adapted to the lung volume of the patient and the child should be capable of moving the valves of the spacer. For children aged from 4 to 6 years, dry powder inhalers can be used, depending on the cooperation and inspiratory effort of the child. During attacks, since inspiratory effort is decreased, bronchodilators can be administered using metered dose inhaler and spacer, or using a nebuliser.
General Conclusions
Published in Anthony J. Hickey, Sandro R.P. da Rocha, Pharmaceutical Inhalation Aerosol Technology, 2019
Anthony J. Hickey, Sandro R.P. da Rocha
Dry powder inhalers most frequently use the inspiratory flow of the patient to disperse the aerosol. The extent of dispersion may depend on the formulation, pressure-drop, and flow rate generated by the patient in response to the resistance of the device.
The use of puzzles in inhaler technique training
Published in Journal of Asthma, 2022
When patients misuse inhalers, the medicine does not reach the lungs properly (1,5). In addition, incorrect inhaler techniques may result in increased use of systemic steroids and higher hospitalization rates (6). Furthermore, using incorrect inhaler techniques may pose a problem for children even after they are given proper inhaler technique training (7,8). In a previous study, only 83% of the children could demonstrate all inhaler technique steps correctly, while 7% made at least one error. Moreover, 4.2% of the children made errors in all the steps (7). Thus, some asthmatic patients do not know the optimal inhaler technique and should be trained by healthcare professionals at the time of diagnosis, as recommended in the guidelines. In addition, the inhaler technique should be reviewed at each follow-up visit (9–12). In our country, different inhaler devices such as MDIs and dry powder inhalers (Discus, Inhaler capsules, Turbuhalers, etc.) are approved for children. Further, in line with the recommendations of the guidelines, we routinely prefer spacers for all children who use metered dose inhalers.
Stability test of novel combined formulated dry powder inhalation system containing antibiotic: physical characterization and in vitro–in silico lung deposition results
Published in Drug Development and Industrial Pharmacy, 2019
Edit Benke, Árpád Farkas, Imre Balásházy, Piroska Szabó-Révész, Rita Ambrus
Drugs (e.g. antibiotics) can be delivered via the pulmonary route for the purpose of achieving local and systemic effects. This type of drug delivery has many advantages. For example, it should be noted that by circumventing the gastrointestinal tract, the drugs reach the Cmax value in the blood within approximately 1–3 min [15]. By avoiding the first-pass effect of the liver and the enzymatic inactivation of the gastrointestinal system as metabolic pathways, the use of lower doses of active agents is sufficient to induce the same therapeutic effect. Thus, the side effects profile could be modified. In addition, pulmonary drug delivery is a noninvasive therapeutic procedure, which does not cause pain or tissue damage [16,17]. However, at present, only three inhaled antibiotics (tobramycin, aztreonam, and colistimethate (sodium)) are on the market [18]. The use of the dry powder inhalers (DPIs) offers outstandingly many benefits: propellant-free, easy to use, portability, increased stability, less need for patient coordination, etc. [19–21].
Asthma patient satisfaction with different dry powder inhalers
Published in Expert Review of Respiratory Medicine, 2019
Antonio Valero, Paula Ribó, Luis Maíz, Esther Barbero, Myriam Calle, Carlos Campo, Paula Rytilä, Jordi Giner, Vicente Plaza
Physicians should keep in mind patient satisfaction with asthma therapy, and especially specific satisfaction with the inhaler.Dry powder inhalers (DPIs) present different features that may have clinical implications.EasyhalerTM has been shown to have advantages over older DPIs in prior studies.In a homogeneous population of patients with moderate to severe asthma, specific satisfaction with inhaler (measured with the FSI-10 questionnaire) was statistically significantly higher with EasyhalerTM (43.8 ± 7.1) compared with TurbuhalerTM or DiskusTM (AccuhalerTM) (41.3 ± 7.6) (p < 0.01).Moreover, high satisfaction with inhaler was statistically significantly higher with EasyhalerTM (62.4% of patients) than with TurbuhalerTM or DiskusTM (AccuhalerTM) (43% of patients) (p = 0.01).This preference for EH has been found in other studies in patients with asthma.