Chest
Volume 114, Issue 6, December 1998, Pages 1676-1680
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Laboratory and Animal Investigations
In Vitro Comparison of Beclomethasone and Salbutamol Metered-Dose Inhaler Aerosols Inhaled During Pediatric Tidal Breathing From Four Valved Holding Chambers

https://doi.org/10.1378/chest.114.6.1676Get rights and content

Study objectives

To determine the amount of salbutamol or beclomethasone delivered from metered-dose inhalers (MDIs) in particle sizes appropriate for inhalational treatment with four common holding chambers (AeroChamber, OptiChamber, Space Chamber, E-Z Spacer) when used under simulated pediatric tidal breathing conditions.

Design

Five devices of each type were tested with salbutamol (100 μg, Glaxo-Wellcome) and beclomethasone (50 μg, Glaxo-Wellcome) MDIs. Each device was connected to face replicas representative of 7-month-old (infant), 2-year-old (toddler), and 4-year-old (child) children and aerosol inhaled into a cascade impactor (Anderson) using a valve system and simulated tidal breathing patterns representative of children of these ages.

Measurements and results

Amounts of drug inhaled in fine particles varied significantly between devices and ages (p < 0.01), eg, for beclomethasone, from 4 μg (infant, Space Chamber) to 8 μg (toddler, OptiChamber), and for salbutamol, from 18 to 36 μg. The AeroChamber and OptiChamber behaved quite similarly, delivering more drug in the fine particles than the other two devices, and having insignificant variations in these amounts with age (p > 0.05).

Conclusions

Amounts of drug inhaled in fine particles during pediatric tidal breathing from valved holding chambers are dependent on the holding chamber model, the drug used, and the breathing pattern, although dependence on the breathing pattern is relatively small for some of the devices tested.

Section snippets

Materials and Methods

The apparatus shown in Figure 1, and described in reference 9, was used to allow a simulated tidal breathing pattern to occur through each holding chamber while the “inhaled” aerosol was collected at a constant flow rate of 28.3 L/min into a cascade impactor (Anderson Mark II cascade impactor; Graseby Anderson; Smyrna, GA). Finlay9 has shown that connecting the cascade impactor directly to the holding chamber and “inhaling” into the impactor at a flow rate of 28.3 L/min gives significantly more

Results

Amounts of drug collected in various locations are shown in Table 1 for beclomethasone and in Table 2 for salbutamol.

Amounts collected on the face replicas and in the cylindrical metal inserts connecting the “nostrils” to the impactor airstream were small (together averaging 1.9% of the label claim). For all ages, significantly more beclomethasone deposited on the face with the E-Z Spacer than any of the other devices (p < 0.01).

None of the differences in the total amount collected are

Discussion

Our results show that during pediatric tidal breathing, the Optichamber and AeroChamber behaved similarly (differing from each other on average by <6% in the amount of either beclomethasone or salbutamol inhaled in particles with diameters 1.1 to 4.7 μm or 1.1 to 3.3 μm), and both generally delivered more drug in particle sizes considered appropriate for inhalation treatment when compared with the EZ-Spacer or Space Chamber. The difference between the OptiChamber or AeroChamber and the other

Conclusions

Particle size measurements of the aerosol inhaled from four valved holding chamber types used with salbutamol or beclomethasone MDIs during simulated pediatric tidal breathing indicates that more drug is delivered in fine particles (1.1 to 4.7 μm or 1.1 to 3.3 μm) when using the AeroChamber and OptiChamber holding chambers compared with the Space Chamber or EZ-Spacer. In addition, the AeroChamber and OptiChamber showed less age/breathing pattern dependence to the fine particle dose compared to

Acknowledgments

The laboratory help of H. Orszanska is gratefully acknowledged.

References (12)

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Supported in part by the Alberta Lung Association.

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