Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt.
Pharmaceutics and Industrial Pharmacy Department, Beni-suef University, Beni-suef, Egypt.
Respir Care. 2020 Mar;65(3):320-325. doi: 10.4187/respcare.06835. Epub 2019 Aug 27.
The use of accessory devices with pressurized metered-dose inhalers (pMDIs) enhances aerosol delivery and helps overcome any lack of patient coordination when using the pMDI. The use of accessory devices could be influenced by the efficacy, availability, and cost of these devices. The aim of this study was to compare drug delivery with the pMDI alone and with non-antistatic and antistatic accessory devices.
The total emitted dose and aerodynamic characterization of salbutamol particles were measured for the pMDI alone and for the pMDI combined with 4 different accessory devices: a homemade spacer, the Dolphin spacer, the DispozABLE paper spacer, and the AeroChamber Plus valved holding chamber. Aerodynamic characterization was analyzed with an Andersen cascade impactor at an inhalation flow of 28.3 L/min, and drug deposition was measured with high-performance liquid chromatography.
The mean ± SD total emitted dose from the pMDI alone, 155.2 ± 20.5 μg, was the greatest of all modalities, and the difference was significant ( < .001). The homemade and Dolphin spacers had the highest mean ± SD deposited amounts of salbutamol remaining on their walls (ie, 124.1 ± 11.1 μg and 131.5 ± 11.8 μg, respectively). The mean ± SD total emitted doses with the AeroChamber Plus valved holding chamber (61.9 ± 8.9 μg) and the DispozABLE paper spacer (76.4 ± 8.6 μg) were significantly higher than the emitted doses with the other devices. The mean ± SD fine-particle doses emitted with the AeroChamber plus valved holding chamber (51.4 ± 4.7 μg) and the DispozABLE paper spacer (39.7 ± 5.6 μg) were significantly higher than those with the other devices. The AeroChamber Plus valved holding chamber had the lowest mass median aerodynamic diameter (MMAD) values, but there were no statistically significant differences in MMAD between any of the combinations of pMDI and accessory device.
The valved holding chamber and the paper spacer had better aerodynamic characteristics than the other devices tested. We consider the antistatic devices to be the optimum devices for aerosol delivery due to their high efficacy compared to non-antistatic devices.
使用带压力定量吸入器（pMDI）的辅助设备可以增强气溶胶输送，并帮助克服患者在使用 pMDI 时协调能力不足的问题。辅助设备的使用可能受到这些设备的疗效、可用性和成本的影响。本研究的目的是比较单独使用 pMDI 以及使用非静电和静电辅助设备时的药物输送情况。
单独使用 pMDI 以及与 4 种不同的辅助设备（自制间隔器、海豚间隔器、可处置纸间隔器和 AerChamber Plus 活瓣保持室）联合使用时，测量沙丁胺醇颗粒的总发射剂量和空气动力学特性。在 28.3 L/min 的吸气流量下，用 Andersen 级联冲击器进行空气动力学特性分析，并用高效液相色谱法测量药物沉积量。
单独使用 pMDI 时的总发射剂量（155.2±20.5μg）为所有模式中最高，差异有统计学意义（<.001）。自制和海豚间隔器上的沙丁胺醇沉积量最高（分别为 124.1±11.1μg 和 131.5±11.8μg）。带活瓣保持室的 AerChamber Plus （61.9±8.9μg）和可处置纸间隔器（76.4±8.6μg）的总发射剂量明显高于其他装置。带活瓣保持室的 AerChamber Plus （51.4±4.7μg）和可处置纸间隔器（39.7±5.6μg）的精细颗粒剂量明显高于其他装置。带活瓣保持室的 AerChamber Plus 的质量中值空气动力学直径（MMAD）值最低，但 pMDI 与辅助装置的任何组合之间的 MMAD 差异均无统计学意义。
活瓣保持室和纸间隔器比其他测试设备具有更好的空气动力学特性。与非静电设备相比，我们认为静电设备在气溶胶输送方面具有更高的疗效，是最佳的设备。
