As current MDIs contain hydrofluorocarbon propellants, it would be beneficial to find ways to reduce carbon emissions without compromising patient safety.

This lab study investigated a way to optimize the modelled lung dose per actuation while at the same time minimizing the carbon emissions from the MDI

Does Spacer/Adapter Device Choice Affect Delivery of a Pressurized Metered Dose Inhaler (pMDI) through a Humidified Circuit to a Simulated Patient on Mecha

Asthma control and global warming are important issues that have significant impacts on human health and the environment.

It is critical however to ensure that maintaining or improving the patient’s asthma control goes hand in hand with environmental actions.

This lab study investigated how to optimize the modelled lung delivery while at the same time minimizing the carbon emissions from the MDI.

This study was presented at the Drug Delivery to the Lungs, 2022.

Short-acting beta2 agonist (SABA) monotherapy is typically required to provide as needed short term relief of bronchoconstriction. The salbutamol EasyHaler† DPI has recently become available in the UK as an alternative to delivery by pressurized metered-dose inhaler. Our study evaluated delivery from this DPI at different inhalation flow rates.

This study was presented at the Drug Delivery to the Lungs Conference, 2022.

• The FRI deposition profiles highlight that the MDI/AeroChamber Plus* Flow-Vu* VHC delivered a significantly greater percentage of drug to the lung region than either of the two DPIs, irrespective of flow rate.
• This was reflected in much higher modelled oropharyngeal deposition for the two DPIs.
• The influence of inhalation flow profile was significant for one of the DPIs.

RDD 2020 - E-Poster Presentation

COPD is a chronic and progressive disease that requires regular self-administration of inhaled medications. However, as the disease progresses, reduced respiratory muscle strength may prevent patients from generating sufficient inspiratory effort to effectively use dry-powder inhalers (DPIs) [1, 2]. In contrast, patients can inhale slowly or breathe tidally from a pMDI with VHC without the need to coordinate with inhaler actuation [3].

PRESENTED AT VIRTUAL ATS 2020

• Evaluations of inhaler use have demonstrated that mishandling of MDIs is commonplace.
• One of the most common errors is the failure to coordinate inhalation with actuation of the inhaler
• One of the reasons why VHCs are often prescribed, is to reduce the severity of this error
• This Functional Respiratory Imaging (FRI) based study assessed the likely severity of a short inhalation delay (from actuation) with an MDI alone and how it contrasted to the use with a VHC

Summary:

Presented at DDL 2017 in Edinburgh

• Valved holding chambers are widely prescribed to assist patients receiving inhaled medications by avoiding losses caused by imperfect coordination of inhalation and actuation and also to reduce oropharyngeal deposition.
• Regardless of whether using a solution based formulation (like Qvar) or a suspension formulation (Flovent), the use of a valved holding chamber reduced the amount of medication deposited in the mouth (oropharynx) and increased the potential for lung delivery
• This study can be used to help demonstrate the value of using a valved holding chamber for both solution and suspension formulated metered dose inhalers and for all patient populations, including adults

Conclusions:

• The most efficient and effective delivery method remains that recommended in the device IFU (one actuation inhaled at a time, as well inhalation as soon as possible after actuation)
• However, this laboratory-based study has indicated that a modified common-canister protocol with an anti-static VHC as the aerosol transfer vehicle has the potential to be a viable ‘off-label’ proposition in hospital situations where there is an urgent need to conserve pMDI medication as well as avoid cross-contamination from pathogenic viruses or bacteria

CONCLUSIONS

• A systematic review of nebulizer use highlighted a few different potential mechanisms for fugitive emissions. Differences in nebulizer design had an impact in the amount and type of fugitive emissions emitted.
• Through the choice of an appropriate nebulizer, the natural risk can be greatly reduced, and through selection of appropriate mitigation strategies, the risk can be almost eliminated.

• A systematic review of nebulizer use highlighted a few different potential mechanisms for fugitive emissions. Differences in nebulizer design had an impact in the amount and type of fugitive emissions emitted.
• Through the choice of an appropriate nebulizer, the natural risk can be greatly reduced, and through selection of appropriate mitigation strategies, the risk can be almost eliminated.

The FRI deposition profiles highlighted significant differences between the VHCs on test, with intrathoracic delivery for the AeroChamber Plus* Flow-Vu* VHC system being almost double that of the other two VHC systems and being similar to the MDI alone with perfect coordination