Journal of Allergy and Clinical Immunology
Choosing the metered-dose inhaler spacer or holding chamber that matches the patient's need: Evidence that the specific drug being delivered is an important consideration☆,☆☆
Section snippets
Procedure
We studied a total of five conditions with each of four MDI drug preparations. Conditions were as follows: (1) the MDI alone, (2) the MDI plus the OptiHaler, (3) the MDI plus the AeroChamber, (4) the MDI plus the InspirEase, and (5) the MDI plus the Ace holding chamber. The four commercially available MDIs studied were albuterol, 90 μg per actuation (Proventil), bitolterol, 370 μg per actuation (Tornalate), flunisolide, 250 μg per actuation (Aerobid), and beclomethasone, 42 μg per actuation
RESULTS
Each of the four chambers tested significantly reduced the quantity of each of the four drugs deposited in the throat intake port compared with the MDI alone (Table II). The quantity of albuterol delivered to the cascade impactor was not altered by any of the four chambers. Bitolterol delivery to the impactor was significantly reduced by the Ace and the OptiHaler. Similarly, the quantity of flunisolide reaching the impactor was significantly reduced by the Ace, OptiHaler, and the InspirEase.
DISCUSSION
All four of the holding chambers we tested dramatically reduced the drug deposited in the “throat” intake port of the in vitro testing apparatus, regardless of the drug used. This suggests that each chamber will be effective in reducing oropharyngeal drug deposition in patients. However, the effect of each holding chamber on delivery of drug beyond the “throat” in particles small enough to have a high probability of reaching the respiratory tract (sometimes called the “respirable” or “fine
Acknowledgements
We thank Donna Reihman for assistance with preparation of this manuscript, Peter Bertling for his technical assistance, and the Dura Corporation for funding a portion of this project.
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Spacers and Valved Holding Chambers
2023, Inhaled Delivery Systems for the Treatment of Asthma and COPD
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From the College of Medicine, Department of Pediatrics, and The Department of Preventive Medicine and Environmental Health, Division of Biostatistics, The University of Iowa.
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