In Vitro Evaluation of Optimal Inhalation Flow Patterns for Commercial Dry Powder Inhalers and Pressurized Metered Dose Inhalers With Human Inhalation Flow Pattern Simulator

Numerous patients with chronic obstructive pulmonary disease (COPD) and asthma do not use inhaler devices properly, which can contribute to poor disease control. The objective of this study is to assess the technical and safety use of dry powder inhalers (DPIs) versus pressurized metered-dose inhalers (MDIs) in adult patients with COPD or asthma in Lebanon. A concurrent, prospective comparative observational study was conducted at one hospital and 15 community pharmacies in Lebanon. Over a period of 18 months, 246 questionnaires were filled. Patients included were adults with COPD or asthma. Answers were entered into the Statistical Package for Social Sciences software and excel sheet. T-test and correlation were used to analyze the results; 67.8% and 38.4% of those using DPIs and MDIs, respectively, performed the exact technical steps adequately ( p = 0.003, relative risk: 2.134, 95% confidence interval: 0.910–4.842). When compared to MDI, a higher percentage of DPI users found their devices easy to use. Moreover, 81.4% of the MDI users found difficulty in coordinating between pressing the canister and inhaling. Rates of exacerbations were significantly higher in MDIs vs. DPI users (59.4% vs. 21.7%). Overall, 44.31% of patients did not receive education from their healthcare professionals about the devices. A significant number of COPD/asthma adult patients do not use their devices properly. Even though DPIs were significantly easier to use, proper education on the technical use of all types of inhalers is needed.

Download Full-text

Considerations for Designing In Vitro Bioequivalence (IVBE) Studies for Pressurized Metered Dose Inhalers (pMDIs) with Spacer or Valved Holding Chamber (S/VHC) Add-on Devices

Journal of Aerosol Medicine and Pulmonary Drug Delivery ◽

10.1089/jamp.2014.1150 ◽

2015 ◽

Vol 28 (3) ◽

pp. 156-181 ◽

Cited By ~ 1

Author(s):

Dennis Sandell ◽

Jolyon P. Mitchell

Keyword(s):

Metered Dose Inhalers ◽

Metered Dose ◽

Pressurized Metered Dose Inhalers

Download Full-text

In vitro evaluation of dry powder inhalers I: drug deposition of commonly used devices

International Journal of Pharmaceutics ◽

10.1016/s0378-5173(97)00113-0 ◽

1997 ◽

Vol 154 (1) ◽

pp. 19-29 ◽

Cited By ~ 66

Author(s):

Hartwig Steckel ◽

Bernd W. Müller

Keyword(s):

Dry Powder Inhalers ◽

Dry Powder ◽

In Vitro Evaluation ◽

Drug Deposition

Download Full-text

Medication Administration With Inhalers or Nebulizers

Canadian Journal of Health Technologies ◽

10.51731/cjht.2021.192 ◽

2021 ◽

Vol 1 (11) ◽

Author(s):

Khai Than ◽

Aleksandra Grobelna

Keyword(s):

Clinical Effectiveness ◽

Medication Administration ◽

Chronic Obstructive ◽

Dry Powder Inhalers ◽

Metered Dose Inhalers ◽

Dry Powder ◽

Obstructive Pulmonary Disease ◽

Metered Dose ◽

The Cost ◽

Evidence Based Guidelines

Delivery of medication via metered-dose inhalers to children or adults with asthma, or adults with chronic obstructive pulmonary disease at emergency departments or intensive care units, may be as effective as nebulizers in terms of clinical parameters and health care resource use. Limited data on adverse events showed no significant differences between metered-dose inhalers and nebulizers. No evidence was found on the clinical effectiveness of dry powder inhalers in comparison with nebulizers or metered-dose inhalers. No evidence was found on the cost-effectiveness of medication administration via metered-dose inhalers, nebulizers, or dry powder inhalers in comparison with each other. No evidence-based guidelines with recommendations regarding the comparative use of metered-dose inhalers, dry powder inhalers, or nebulizers for administration of medication were identified.

Download Full-text