Bisphenol A (BPA) is a controversial chemical that is used to enhance the clarity and durability of some clear, plastic products. The use of BPA is the subject of discussion, research and public scrutiny as it may lead to negative health effects.1
Though current findings indicate low health risks from exposure to BPA, experts have been unable to come to an agreement regarding appropriate safe levels for consumer products.2 Nevertheless, the Government of Canada has taken steps to ban the use of BPA in baby bottles to reduce newborn and infant exposure.
Trudell Medical International has chosen to be proactive and manufacture the AeroChamber Plus* chambers with Flow-Vu* indicator without any BPA to eliminate any possible patient risk. The medications taken with our chambers are critical to your health and it is our responsibility to lead in the development of innovative, consumer friendly products.
The AeroChamber Plus* chamber with Flow-Vu* indicator may have either a mask or mouthpiece – and will hold the medication for a short time until you are ready to inhale it. Without a chamber, medication may get trapped in your mouth or throat, which can leave a bad taste and often means that some of the medication isn't reaching your lungs.
Why use the AeroChamber Plus* Chamber with Flow-Vu* Indicator?
To be most effective, the inhaler should be pressed during inhalation to optimize the medication delivery to the deepest part of the lungs. Effective delivery of the medication to the lungs is difficult because inhalers deliver the medication dose at a very high rate of speed. The AeroChamber Plus* chamber with Flow-Vu* indicator slows the speed of medication for optimal inhalation that helps ensure medication particles are delivered deep into the lungs.
1 Okada H, Tokunaga T, Liu X, Takayanagi S, Matsushima A, Shimohigashi Y. Direct evidence revealing structural elements essential for the high binding ability of Bisphenol A to human estrogen-related receptor-gamma. Environ. Health Perspect.2008;116(1):32-38. 2 Lang IA, Galloway TS, Scarlett A; et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008;300(11): 1303-1310.
The Flow-Vu* Indicator helps to:
- Confirm a good mask/mouthpiece seal to eliminate medication leakage
- Count the number of breaths taken through the chamber
- Find the right time to press the puffer at the start of inhalation to ensure medication reaches the deepest part of the lungs
- Confirm that the patient is performing the inspiratory maneuver
Video Length: 1:50 mins
complete chamber instructions
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Different valved holding chambers can deliver different amounts of inhaled medication. When prescribing a valved holding chamber it is important to give due consideration to the chamber that is listed on the Metered Dose Inhaler Summary of Product Characteristics (where specified by name).2
The AeroChamber Plus* Brand of Chamber is listed on the following leading metered dose inhaler’s companies’ Summary of Product Characteristics:
- Airomir† – IVAX Pharmaceuticals UK
- Alvesco† 40, 80 and 160 – Nycomed, UK
- Atrovent† Inhaler CFC-Free – Boehringer Ingelheim , UK
- Flovent† HFA 44/110/ 220 – GlaxoSmithKline US
- Fostair† 100 – Chiesi Ltd, EU
- Qvar† 50/100 – IVAX Pharmaceuticals UK
- Sabumalin† 100 – Aeropharm GmbH, EU
- Seretide† Evohaler† 44 / 110 / 220 – GlaxoSmithKline, EU
- Ventolin† Evohaler† – GlaxoSmithKline US, UK
- Zenhale† – Merck Canada Inc.
Improper mask fit or design can lead to gaps – as small as ½ cm – which may allow ambient air to enter the mask and reduce medication delivery to the lungs by more than 50%.2
The anatomically designed ComfortSeal* Masks minimize the amount of dead space (the space between the valve and the patient). Patients find this comfortable as it requires less pressure to form a secure seal. In addition, the EZ Flow Exhalation Valve, Flow-Vu* Indicator and Alignment Feature all help parents and caregivers ensure that the chamber is assembled and applied to the face correctly.
A recent study tested 7 commonly used facemasks and found the ComfortSeal* Masks incorporated in our Valved Holding Chambers have the lowest dead space volume3 resulting in improved aerosol delivery efficiency. This is due in part to the integrated Exhalation Valve that minimizes re-breathing and directs exhaled flow away from the patient's face.
To ensure your patient is using a properly fitted mask, please download our custom Mask Sizer (see left hand column).
- Any child under the age of 6 that uses an inhaler
- Anyone taking inhaled corticosteroids
- Elderly patients that use an inhaler
- Anyone who has difficulty coordinating actuation of their inhaler with inhalation
Video Length: 1:23 mins
Video Length: 1:50 mins
Video Length: 2:12 mins
1 P. Barnes, J.C. Virchow, J. Sanchis, T. Welte and S. Pedersen. Asthma management: important issues. European Respiratory Review, Volume 14, Number 97: 147-151. 2 Esposito - Festen et al. Effect of a Facemask Leak on Aerosol Delivery from a pMDI - Spacer System. JAM 2004; 17 (1): 1-6. 3 Shah SA, Berlinski AB, Rubin BK. Force-Dependent Static Dead Space of Face Masks Used with Holding Chambers. Respiratory Care, Feb 2006, Vol 51, No 2.
Getting the medication to your patients’ lungs is priority one - the AeroChamber Plus* Valved Holding Chamber with Flow-Vu* Indicator is designed to do just that.
- Proven dosing performance across a wide range of formulations
- The only full line of aerosol delivery devices designed specifically for each patient
- Most recommended chamber by leading metered dose inhaler manufacturers
- Small volume chamber is portable and easy to use with equivalent performance to larger devices4
Free from Bisphenol A (BPA)
- BPA is an endocrine disruptor, which can mimic the body's own hormones and may lead to negative health effects2
- Use of BPA in products continues to be a subject of discussion, research and public scrutiny - with experts unable to agree on 'safe' levels of exposure3
- Health Canada has moved to ban the use of BPA in baby bottles
- Trudell Medical International has chosen to protect patients and provide BPA free technology to eliminate any risk that may be present
- Mouthpiece Cap
Protects the mouthpiece from dirt and debris when the device is not in use.
- Exhalation Valve
Valve closes upon exhalation to retain any medication inside the chamber for the next breath.
- Flow-Vu* Indicator
Moves with respiration and helps confirm proper inhalation technique.
- Alignment Feature
Helps align the Backpiece for proper assembly after cleaning.
- FlowSignal* Whistle
Provides audible feedback when the patient is inhaling too rapidly.
- Universal Backpiece
Can be used with all commonly prescribed pressurized Metered Dose Inhalers.
- Inhalation Valve
Valve is responsive to very low inspiratory efforts, ensuring medication is delivered during acute exacerbations when flow rates can be significantly reduced. Special 'low-flow' valves in pediatric chambers.
- ComfortSeal* Masks
The anatomically designed ComfortSeal* Masks have a flexible, curved lip to ensure a reliable seal with as little as 0.7 kg applied force5 (gentle). Exhalation valves mean the chamber can remain in place so patients do not have to remove the device to exhale.
Targeting drugs to the airways: the role of spacer devices
AIM: Spacer devices are inhalation aids of varying dimension and complexity, specifically designed to overcome problems with the use of pressurised metered dose inhalers (pMDIs). The aim of this review is to examine the current understanding about these inhalation devices and discuss their advantages and disadvantages. METHODS: The pertinent literature concerning the characteristics and effects of spacers on delivery and lung deposition of inhaled medications, as well as their clinical efficacy in patients with reversible airway obstruction, is examined. RESULTS: Spacers minimise problems of poor inhalation technique with pMDI, reduce oropharyngeal deposition and increase lung deposition. Spacers improve the clinical effect of inhaled medications, especially in patients unable to use a pMDI properly. Compared to both pMDIs and dry-powder inhalers, spacers may increase the response to beta-adrenergic bronchodilators, even in patients with correct inhalation technique. A pMDI plus spacer has proven to be viable lower cost alternative to the use of a nebuliser for delivering large bronchodilator doses in patients with severe acute asthma or chronic obstructive pulmonary disease. CONCLUSION: pMDIs may be routinely fitted with a spacer, especially in situations where correct pMDI use is unlikely. Lavorini F, Fontana GA. Expert Opin Drug Deliv 2009; 6(1):91-102.
Medication Delivery Via Infant and Child Valved Holding Chambers (VHCs) with Facemask is Aided with Inhalation Flow Indicator
This study investigated movement of an integrated inspiratory flow indicator (IFI), number of inhalations and mass of medication delivered using simulations of infant (tidal volume (Vt)=50-ml; 25%-duty cycle; 30-cycles/min) and small child (Vt=155-ml; 33%-duty cycle; 25-cycles/min) tidal breathing. AeroChamberPlus* VHCs incorporating the IFI feature, with infant or child facemask (n=5/group) were coupled to a breathing simulator. Aerosol capture took place using a filter positioned where the mouth of a user would be located. The dead volume in each facemask was 12-ml (infant) and 25-ml (child). 1-actuation of a beta-2 adrenergic agonist (Ventolin-HFA; GSK Inc.) was delivered via metered dose inhaler to the VHC and the filter removed after 1 inhalation. This procedure was repeated, but removing the filter after 2, 3, 4, 5 and 6 inhalations. Total mass of salbutamol (mean ± SD, μg) for the ’infant’ condition was 15.5±2.4 mg (1-inhalation); 26.2±2.9 (2-inhalations); 33.9±3.1 (3-inhalations); 34.2±4.4 (4-inhalations); 35.2±3.5 (5-inhalations); 33.0±3.9 (6-inhalations). Equivalent data for the ’child’ condition were 40.0±3.9 mg (1-inhalation); 50.3±4.7 (2-inhalations); 54.0±3.2 (3-inhalations); 48.0±4.3 (4-inhalations); 52.2±3.8 (5-inhalations); 51.2±5.6 (6-inhalations). The IFI moved in synchrony with valve opening. At least 3 successive inhalations were required to achieve consistent medication delivery under the optimum test conditions that reflect perfect coordination by the user. The IFI is an important new feature confirming the number of inhalations that take place, thereby optimizing medication delivery. Mark Nagel, Valentina Avvakoumova, Heather Mackay, Jolyon Mitchell, Jamie Malpass. Medical Aerosol Laboratory, Trudell Medical International, London, ON,Canada.
study summaries and technical information
1 P. Barnes, J.C. Virchow, J. Sanchis, T. Welte and S. Pedersen. Asthma management: important issues. European Respiratory Review, Volume 14, Number 97: 147-151. 2 Okada H, Tokunaga T, Liu X, Takayanagi S, Matsushima A, Shimohigashi Y. Direct evidence revealing structural elements essential for the high binding ability of Bisphenol A to human estrogen-related receptor-gamma. Environ. Health Perspect.2008;116(1):32-38. 3 Lang IA, Galloway TS, Scarlett A; et al. Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008;300(11): 1303-1310. 4 TMI Aerosol Lab, Data on File. 5 Shah SA et al. Force-Dependent Static Dead Space of Face Masks Used With Holding Chambers. Respiratory Care, February 2006, Vol 51; No 2.