scholarly journals Modern inhalation drug delivery devices for treatment of chronic obstructive pulmonary disease

2015 ◽  
Vol 25 (4) ◽  
pp. 477-482
Author(s):  
N. T. Vatutin ◽  
A. S. Smirnova ◽  
G. G. Taradin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inhalation Drug Delivery ◽  
Drug Delivery Devices

Advances in drug delivery: is triple therapy the future for the treatment of chronic obstructive pulmonary disease?

2011 ◽  
Vol 12 (12) ◽  
pp. 1913-1932 ◽  
Author(s):  
Rania O Salama ◽  
Paul M Young ◽  
Philippe Rogueda ◽  
Arthur Lallement ◽  
Ilian Iliev ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Triple Therapy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Future

scholarly journals Risks associated with tiotropium in chronic obstructive pulmonary disease: overview of the evidence to date

2012 ◽  
Vol 3 (3) ◽  
pp. 123-131 ◽  
Author(s):  
Yoon K. Loke ◽  
Sonal Singh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Adverse Effects ◽  
Pulmonary Disease ◽  
Urinary Retention ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Increased Risk

Tiotropium is a long-acting inhaled anticholinergic agent that is widely used in the treatment of chronic obstructive pulmonary disease (COPD). It was initially launched as the tiotropium HandiHaler formulation, but this was followed by a newer version based on a potentially more efficient drug delivery device, known as Respimat. This Respimat formulation is available worldwide but has not yet succeeded in gaining regulatory approval in the USA. In the past few years, the adverse effects profile of tiotropium has come under close scrutiny owing to concerns about the possibility of urinary and cardiovascular adverse effects. These concerns appeared to have been alleviated following the publication of data from the Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT) trial, which was a large trial of 4 years’ duration. This trial did not show any excess myocardial infarction, renal or urinary adverse events with tiotropium compared with placebo. However, the risk of urinary retention has been in the spotlight again following publication of two observational studies reporting a significantly increased risk of urinary retention in men recently started on inhaled anticholinergics, especially when prostatic hyperplasia coexists. More recently, a meta-analysis of mortality data for the tiotropium Respimat formulation raised the possibility of an increased risk of death, including death from cardiovascular causes. It is unclear if the more efficient drug delivery offered by the Respimat device is hitting a different part of the dose-toxicity curve. In the absence of any evidence of superior clinical efficacy with tiotropium Respimat compared with tiotropium HandiHaler, some experts have argued that there is no compelling reason to choose the Respimat formulation given the new uncertainties about its safety profile.

scholarly journals Aerosol delivery aspects within a high flow therapy system in chronic obstructive pulmonary disease patients

2020 ◽  
pp. 00422-2020 ◽  
Author(s):  
Yasmin M. Madney ◽  
Nabila Ibrahim Laz ◽  
Ahmed A. Elberry ◽  
Hoda Rabea ◽  
Mohamed E.A. Abdelrahim
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Face Mask ◽  
High Flow ◽  
Nasal Cannula ◽  
Chronic Obstructive ◽  
Aerosol Delivery ◽  
Obstructive Pulmonary Disease

There is a lack of information about the influence of patient interfaces like facemask or mouthpiece on the effective dose of aerosolized drugs while using high flow therapy in a clinical setting. These interfaces can improve pulmonary drug delivery over nasal cannula but patient preference and comfort should also be considered.The present work was to determine the effect of three different interfaces (nasal cannula, valved face mask, and mouthpiece) when combined with titrated oxygen flow on aerosol delivery in chronic obstructive pulmonary disease (COPD) patients hospitalised due to acute exacerbation.The variations between these interfaces were addressed in terms of change in lung function measurements pre-and post-inhalation, the delivered salbutamol dose, and patient tolerance to each interface.High flow nasal cannula was the most comfortable interface used. However, its pulmonary drug delivery was significantly lower than both the valved face mask and mouthpiece (p<0.05). Although drug delivery was different with the three tested interfaces, the lung function improvements were similar.

scholarly journals Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients

2016 ◽  
Vol 49 (2) ◽  
pp. 1601794 ◽  
Author(s):  
Mathieu Molimard ◽  
Chantal Raherison ◽  
Severine Lignot ◽  
Aurelie Balestra ◽  
Stephanie Lamarque ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Pulmonary Disease ◽  
Real Life ◽  
Life Assessment ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Inhaler Device ◽  
Severe Copd

Acute exacerbations of chronic obstructive pulmonary disease (COPD) can be prevented by inhaled treatment. Errors in inhaler handling, not taken into account in clinical trials, could impact drug delivery and minimise treatment benefit. We aimed to assess real-life inhaler device handling in COPD patients and its association with COPD exacerbations.To this end, 212 general practitioners and 50 pulmonologists assessed the handling of 3393 devices used for continuous treatment of COPD in 2935 patients. Handling errors were observed in over 50% of handlings, regardless of the device used. Critical errors compromising drug delivery were respectively made in 15.4%, 21.2%, 29.3%, 43.8%, 46.9% and 32.1% of inhalation assessment tests with Breezhaler® (n=876), Diskus® (n=452), Handihaler® (n=598), pressurised metered-dose inhaler (pMDI) (n=422), Respimat® (n=625) and Turbuhaler® (n=420).The proportion of patients requiring hospitalisation or emergency room visits in the past 3 months for severe COPD exacerbation was 3.3% (95% CI 2.0–4.5) in the absence of error and 6.9% (95% CI 5.3–8.5) in the presence of critical error (OR 1.86, 95% CI 1.14–3.04, p<0.05).Handling errors of inhaler devices are underestimated in real life and are associated with an increased rate of severe COPD exacerbation. Training in inhaler use is an integral part of COPD management.

scholarly journals Novel drug delivery systems targeting oxidative stress in chronic obstructive pulmonary disease: a review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
You Xu ◽  
Hongmei Liu ◽  
Lei Song
Keyword(s):  
Oxidative Stress ◽  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Pulmonary Disease ◽  
Drug Delivery Systems ◽  
Current Knowledge ◽  
Delivery Systems ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Novel Drug

Abstract Oxidative stress is significantly involved in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD). Combining antioxidant drugs or nutrients results in a noteworthy therapeutic value in animal models of COPD. However, the benefits have not been reproduced in clinical applications, this may be attributed to the limited absorption, concentration, and half-life of exogenous antioxidants. Therefore, novel drug delivery systems to combat oxidative stress in COPD are needed. This review presents a brief insight into the current knowledge on the role of oxidative stress and highlights the recent trends in novel drug delivery carriers that could aid in combating oxidative stress in COPD. The introduction of nanotechnology has enabled researchers to overcome several problems and improve the pharmacokinetics and bioavailability of drugs. Large porous microparticles, and porous nanoparticle-encapsulated microparticles are the most promising carriers for achieving effective pulmonary deposition of inhaled medication and obtaining controlled drug release. However, translating drug delivery systems for administration in pulmonary clinical settings is still in its initial phases.

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