Nicola Mina, Soliman Youssef M A, Hussein Raghda, Saeed Haitham, Abdelrahim Mohamed
Dept of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Dept of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt.
ERJ Open Res. 2020 Oct 13;6(4). doi: 10.1183/23120541.00073-2020. eCollection 2020 Oct.
Add-on devices that are attached to metered-dose inhalers (MDIs) were introduced to improve aerosol delivery. The objective of this study was to determine the efficacy of drug delivery from an MDI when attached to different add-on devices at different inhalation volumes. The total emitted dose (TED) of salbutamol was estimated for the MDI alone and the MDI connected to five different add-on devices (Able valved holding chamber, Tips-haler valved holding chamber, Aerochamber plus flow Vu valved holding chamber, Dolphin chamber, and a handmade water bottle spacer), at inhalation flow of 28.3 L·min with flow volume of 1, 2 and 4 L, assuming young child (aged <6 years), old child (>6 years) and adult inhalation volumes, respectively. The TED% ranged between 84.1% and 87.2% at all inhalation volumes from the MDI alone, which was significantly greater than all MDI add-on device combinations (p<0.05). The TED% delivered to MDI sampling apparatus by a homemade water bottle spacer and Dolphin chamber, as non-antistatic add-on devices, ranged between 30.5% and 35.3%. However, washing these non-antistatic add-on devices with a light detergent before use improved their TED to range between 47.6% and 51.2%. Non-antistatic add-on devices had significantly lower TED (p<0.05) than that delivered by most antistatic add-on devices, which ranged from 51.3% to 71.6%. This study suggests that antistatic add-on devices delivered much more aerosol than non-antistatic add-on devices. However, it may be advised to still use a non-antistatic add-on device, for the sake of solving the coordination problem, and wash it with light detergent before use to improve TED.
为改善气雾剂递送效果，人们引入了附加在定量吸入器（MDIs）上的装置。本研究的目的是确定在不同吸入量下，MDI连接不同附加装置时的药物递送效果。分别假设儿童（<6岁）、大龄儿童（>6岁）和成人的吸入量，在吸入流速为28.3 L·min、流量为1 L、2 L和4 L的情况下，估算了单独MDI以及连接五种不同附加装置（Able带阀储雾罐、Tips-haler带阀储雾罐、Aerochamber plus flow Vu带阀储雾罐、Dolphin储雾罐和自制水瓶间隔器）的MDI中沙丁胺醇的总喷出剂量（TED）。单独MDI在所有吸入量下的TED%在84.1%至87.2%之间，显著高于所有MDI附加装置组合（p<0.05）。作为非抗静电附加装置的自制水瓶间隔器和Dolphin储雾罐递送至MDI采样装置的TED%在30.5%至35.3%之间。然而，在使用前用轻度洗涤剂清洗这些非抗静电附加装置可将其TED提高至47.6%至51.2%之间。非抗静电附加装置的TED显著低于大多数抗静电附加装置（p<0.05），后者的TED范围为51.3%至71.6%。本研究表明，抗静电附加装置递送的气雾剂比非抗静电附加装置多得多。然而，为了解决配合问题，仍建议使用非抗静电附加装置，并在使用前用轻度洗涤剂清洗以提高TED。
