A Concise Overview on Recent Advances in Pharmaceutical Aerosols and Their Commercial Applications

2021 ◽  
Vol 14 ◽  
Author(s):  
Raghav Mishra ◽  
Radhika Agarwal
Keyword(s):  
Pharmaceutical Products ◽  
Chronic Obstructive ◽  
Pharmaceutical Aerosols ◽  
Obstructive Pulmonary Disease ◽  
Therapy Termination ◽  
Rising Incidence ◽  
Commercial Applications ◽  
Pharmaceutical Aerosol ◽  
Localized Drug Delivery ◽  
Inhaler Devices

Background: Localized drug delivery to the respiratory system has become an increasingly successful and essential treatment strategy for several pulmonary diseases, including asthma, chronic abstractive disease, pneumonia, bronchitis, and cystic fibrosis. The rising incidence of respiratory diseases is a significant factor driving the worldwide market for respiratory inhaler devices. Objective: The objective of this article is to present various aspects of pharmaceutical aerosols, including their types, components, fundamentals, in-process and finished product quality control tests based on pharmacopeial standards and specifications, and commercial utility considering the pharmaceutical aerosol dosage forms that have been patented from 2000 to 2020, along with a list of marketed pharmaceutical products. Method: Aerosol, collectively referred to as a pressurized device, operates by triggering an appropriate valve system with a continuous or metered dosage of tiny mist spray. It is used not only in the treatment of asthma and chronic obstructive pulmonary disease but also in the treatment of cancer, diabetes, migraine, angina pectoris, acute lung injury, bone disorders, tuberculosis, and many more. A multitude of different variables, including types and properties of propellants, active substances, containers, valves, actuators, spray patterns, valve crimping efficiency, and particle size of the aerosols, influence the therapeutic effectiveness of pharmaceutical aerosols. Conclusion: Based on the current findings, distinct characteristics such as the elimination of firstpass metabolism, quick drug absorption, ease of therapy termination, as well as a larger surface area have attributed to the success of pharmaceutical aerosols.

scholarly journals Matching Inhaler Devices with Patients: The Role of the Primary Care Physician

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alan Kaplan ◽  
David Price
Keyword(s):  
Primary Care ◽  
Treatment Success ◽  
Primary Care Providers ◽  
Care Physician ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Care Providers ◽  
Obstructive Pulmonary Disease ◽  
Inhaler Devices

Poor inhaler technique and nonadherence impair the efficacy of medications for asthma and chronic obstructive pulmonary disease (COPD). A range of factors, including age, dexterity, inspiratory capacity, cognitive ability, health literacy, and ethnicity, can impact a patient’s ability and intention to use their device. Treatment success can also be influenced by patient preferences and perceptions. Therefore, it is important that healthcare professionals effectively match inhaler devices to individual patients’ needs and abilities and empower patients by including them in treatment decisions. Physicians must, therefore, fully understand the characteristics of each device, as well as their patients’ demographic characteristics and comorbidities. Following device selection, patient training and education, including a physical demonstration of the device, are key to eliminate any critical errors that may impact on health outcomes. Inhaler technique should be frequently rechecked. This review will examine the important role of primary care providers in the selection of appropriate inhaler devices and provision of training for patients with COPD and asthma to optimize correct inhaler use and adherence. An overview of the key features of available devices and of the factors to consider when selecting devices will be provided in the context of current asthma and COPD guidelines.

scholarly journals CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis

2021 ◽  
Vol 10 (5) ◽  
pp. 936
Author(s):  
Jean-Louis Pépin ◽  
Sébastien Bailly ◽  
Pierre Rinder ◽  
Dan Adler ◽  
Daniel Szeftel ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Real Life ◽  
Sleep Apnoea ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Therapy Termination ◽  
Insurance Reimbursement ◽  
Obstructive Sleep ◽  
System Data

The nationwide claims data lake for sleep apnoea (ALASKA)—real-life data for understanding and increasing obstructive sleep apnea (OSA) quality of care study—investigated long-term continuous positive airway pressure (CPAP) termination rates, focusing on the contribution of comorbidities. The French national health insurance reimbursement system data for new CPAP users aged ≥18 years were analyzed. Innovative algorithms were used to determine the presence of specific comorbidities (hypertension, diabetes and chronic obstructive pulmonary disease (COPD)). Therapy termination was defined as cessation of CPAP reimbursements. A total of 480,000 patients were included (mean age 59.3 ± 13.6 years, 65.4% male). An amount of 50.7, 24.4 and 4.3% of patients, respectively, had hypertension, diabetes and COPD. Overall CPAP termination rates after 1, 2 and 3 years were 23.1, 37.1 and 47.7%, respectively. On multivariable analysis, age categories, female sex (1.09 (1.08–1.10) and COPD (1.12 (1.10–1.13)) and diabetes (1.18 (1.16–1.19)) were significantly associated with higher CPAP termination risk; patients with hypertension were more likely to continue using CPAP (hazard ratio 0.96 (95% confidence interval 0.95–0.97)). Therapy termination rates were highest in younger or older patients with ≥1 comorbidity. Comorbidities have an important influence on long-term CPAP continuation in patients with OSA.

Inhalotherapy in Noninvasive Ventilation

2020 ◽  
pp. 180-192
Author(s):  
Mónica Helena Correia Pereira ◽  
João Miguel Bettencourt Sena Carvalho ◽  
Paula Maria Gonçalves Pinto ◽  
Maria do Carmo Oliveira Cordeiro
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Noninvasive Positive Pressure Ventilation ◽  
Standard Of Care ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Invasive Ventilation ◽  
Pharmaceutical Aerosols ◽  
Obstructive Pulmonary Disease ◽  
Acute Cardiogenic Pulmonary Edema

The use of non-invasive ventilation (NIV) has markedly increased over the last decades, and NIV has now become an important alternative to invasive ventilation and has gained popularity particularly as treatment option for patients with obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), and acute respiratory failure. The most prominent forms of NIV are noninvasive positive pressure ventilation (NPPV) and the recently introduced high-flow nasal cannula (HFNC) therapy. Many patients who received NIV may also benefit from the administration of pharmaceutical aerosols, typically bronchodilators, which are best delivered without interrupting respiratory support. For example, nowadays, the use of NIV is considered the standard of care for some forms of acute respiratory failure such as COPD exacerbation and acute cardiogenic pulmonary edema. Patients with COPD exacerbation also benefit from inhaled bronchodilator therapy.

scholarly journals Critical inhaler technique errors in Swedish patients with COPD: a cross-sectional study analysing video-recorded demonstrations

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Johanna Sulku ◽  
Kristina Bröms ◽  
Marieann Högman ◽  
Christer Janson ◽  
Karin Lisspers ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Inhaler Device ◽  
Device Model ◽  
Copd Patients ◽  
Critical Error ◽  
Inhaler Devices

AbstractA correct use of inhaler devices is essential in chronic obstructive pulmonary disease (COPD) treatment. Critical errors were studied by analysing 659 video-recorded demonstrations of inhaler technique from 364 COPD patients using six different inhaler device models. The majority of the included patients used two (55%) or more (20%) device models. Overall, 66% of the patients made ≥1 critical error with at least one device model. The corresponding numbers for patients using 1, 2 and ≥3 device models were 43%, 70% and 86%, respectively. The only factor associated with making ≥1 critical error was simultaneous use of two (adjusted odds ratios (aOR) 3.17, 95% confidence interval (95% CI) 1.81, 5.64) or three or more (aOR 8.97, 95% CI 3.93, 22.1) device models. In conclusion, the proportion of patients making critical errors in inhaler technique was substantial, particularly in those using several different device models. To obtain optimal COPD treatment, it is important to assess a patient’s inhaler technique and to minimise the number of inhaler device models.

scholarly journals A randomised open-label cross-over study of inhaler errors, preference and time to achieve correct inhaler use in patients with COPD or asthma: comparison of ELLIPTA with other inhaler devices

2016 ◽  
Vol 26 (1) ◽  
Author(s):  
Job van der Palen ◽  
Mike Thomas ◽  
Henry Chrystyn ◽  
Raj K Sharma ◽  
Paul DLPM van der Valk ◽  
...  
Keyword(s):  
Dose Inhaler ◽  
Chronic Obstructive ◽  
Information Leaflet ◽  
Metered Dose Inhaler ◽  
Open Label ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Metered Dose ◽  
Asthma Patients ◽  
Inhaler Devices

Abstract Errors in the use of different inhalers were investigated in patients naive to the devices under investigation in a multicentre, single-visit, randomised, open-label, cross-over study. Patients with chronic obstructive pulmonary disease (COPD) or asthma were assigned to ELLIPTA vs DISKUS (Accuhaler), metered-dose inhaler (MDI) or Turbuhaler. Patients with COPD were also assigned to ELLIPTA vs Handihaler or Breezhaler. Patients demonstrated inhaler use after reading the patient information leaflet (PIL). A trained investigator assessed critical errors (i.e., those likely to result in the inhalation of significantly reduced, minimal or no medication). If the patient made errors, the investigator demonstrated the correct use of the inhaler, and the patient demonstrated inhaler use again. Fewer COPD patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS, 9/171 (5%) vs 75/171 (44%); MDI, 10/80 (13%) vs 48/80 (60%); Turbuhaler, 8/100 (8%) vs 44/100 (44%); Handihaler, 17/118 (14%) vs 57/118 (48%); Breezhaler, 13/98 (13%) vs 45/98 (46%; all P<0.001). Most patients (57–70%) made no errors using ELLIPTA and did not require investigator instruction. Instruction was required for DISKUS (65%), MDI (85%), Turbuhaler (71%), Handihaler (62%) and Breezhaler (56%). Fewer asthma patients made critical errors with ELLIPTA after reading the PIL vs: DISKUS (3/70 (4%) vs 9/70 (13%), P=0.221); MDI (2/32 (6%) vs 8/32 (25%), P=0.074) and significantly fewer vs Turbuhaler (3/60 (5%) vs 20/60 (33%), P<0.001). More asthma and COPD patients preferred ELLIPTA over the other devices (all P⩽0.002). Significantly, fewer COPD patients using ELLIPTA made critical errors after reading the PIL vs other inhalers. More asthma and COPD patients preferred ELLIPTA over comparator inhalers.

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