scholarly journals REVIEW ON DRY POWDER INHALERS: CURRENT ADVANCES AND LIMITATIONS

2021 ◽  
pp. 63-67
Author(s):  
A. V. Badarinath ◽  
S A Sreenivas ◽  
M. Suresh Babu
Keyword(s):  
Clinical Practice ◽  
Focal Point ◽  
Dry Powder Inhaler ◽  
Dry Powder Inhalers ◽  
Clinical Use ◽  
Expected Loss ◽  
Dry Powder ◽  
Everyday Clinical Practice ◽  
Innovative Work

Inhalers are the focal point of quickened innovative work as a result of the possibility to deliver greatest medication to the site of pathology in the lungs. Among the accessible conveyance choices, the dry powder inhaler (DPI) is the favoured gadget for the treatment of an undeniably different scope of ailments. Advancement of DPI frameworks that focus on the conveyance of fine medication particles to the more profound aviation routes in the lungs utilizing a mix of improved medication definitions and upgraded conveyance gadget advances implies that every one of these variables adds to in general execution of the vaporized framework. There are enormous scopes of gadgets for clinical use, anyway no individual gadget shows prevalent clinical viability. A significant worry that is pertinent in everyday clinical practice is the between and intra-understanding fluctuation of the medication measurements conveyed to the profound lungs from the inward breath gadgets, where the degree of changeability relies upon the medication definition, the gadget plan, and patient's breath profile. This fluctuation may result in under-dosing of medication to the patient and expected loss of pharmacological viability. This article audits ongoing advances in container based DPI innovation and the presentation of the 'dispensable' DPI gadget.

scholarly journals Development of an adaptive bypass element for passive entrainment flow control in dry powder inhalers

2019 ◽  
Vol 233 (15) ◽  
pp. 5201-5213
Author(s):  
Thomas Kopsch ◽  
Darragh Murnane ◽  
Digby Symons
Keyword(s):  
Drug Delivery ◽  
Dry Powder Inhaler ◽  
Experimental Methods ◽  
Dry Powder Inhalers ◽  
Total Flow ◽  
Dry Powder ◽  
Flow Rates ◽  
Inhaler Device ◽  
Flow Resistances ◽  
Flap Valve

The release of drug from dry powder inhalers is strongly dependent on the patient's inhalation profile. To maximise the effect of the treatment, it is necessary to optimise dry powder inhalers to achieve drug delivery that (A) is independent of the inhalation manoeuvre and (B) is targeted to the correct site in the lung. The purpose of this study is to develop a dry powder inhaler with an adaptive bypass element that achieves desired drug delivery behaviour. Computational and experimental methods are used. First, the effect of a generic variable bypass element on entrainment behaviour is modelled. This is done by modelling a dry powder inhaler as a network of flow. Second, the behaviour of a potential variable bypass element, a flap valve, is studied both computationally and experimentally. Third, the flow resistances are optimised to achieve consistent and desired entrainment behaviour for patients with very different inhalation manoeuvres. A simulated dry powder inhaler device design was found that achieves an approximately constant entrainment flow rate of 12 L/min when total flow rates larger than 20 L/min are applied. The developed dry powder inhaler is predicted to accurately deliver drug for patients with highly different inhalation manoeuvres.

A Preference Study of Two Placebo Dry Powder Inhalers in Adults with COPD: ELLIPTA® Dry Powder Inhaler (DPI) versus DISKUS® DPI

2015 ◽  
Vol 13 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Suyong Yun Kirby ◽  
Chang-Qing Zhu ◽  
Edward M. Kerwin ◽  
Richard H. Stanford ◽  
George Georges
Keyword(s):  
Dry Powder Inhaler ◽  
Dry Powder Inhalers ◽  
Dry Powder ◽  
Preference Study

scholarly journals The Use of Video Instructions in Patient Education Promoting Correct Technique for Dry Powder Inhalers: An Investigation on Inhaler-Naïve Individuals

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 106 ◽  
Author(s):  
Sofia von Schantz ◽  
Nina Katajavuori ◽  
Anne Juppo
Keyword(s):  
Disease Management ◽  
Dry Powder Inhaler ◽  
Dry Powder Inhalers ◽  
Inhaler Technique ◽  
Dry Powder ◽  
Educational Method ◽  
Inhaler Device ◽  
Correct Technique ◽  
Study Participants ◽  
To Receive

Introduction: The correct use of a prescribed inhaler device is crucial for achieving successful disease management in asthma. This study investigates non-verbal, demonstrational videos as a method of teaching inhaler naïve individuals how to use a dry powder inhaler (DPI). Methods: Video instructions for four DPIs were examined using a mixed methodology; 31 inhaler-naïve individuals participated in the study. Participants were each shown a demonstrational video of one the four inhalers, after each video the participant demonstrated how they would use the inhaler. After demonstrating the use, participants crossed over to the next inhaler. The demonstrations were videotaped. A common questionnaire was filled at the beginning of the study and four inhaler-specific questionnaires which were filled out by the participant after each inhaler demonstration. Results: The frequency of participant error varied between inhalers. When asked about how they perceived the video instructions, participants often stated they would have liked to receive feedback on their performance. The importance of feedback was further highlighted by the fact that participants tended to overestimate their own inhaler technique. Conclusion: Non-verbal videos may be more efficient for some DPIs than for others as a method for providing inhaler instructions. Lack of feedback on the participants’ inhaler performance emerged as a clear shortcoming of this educational method. Some steps in the inhalation process may be harder for individuals to remember and therefore require extra emphasis in order to achieve correct inhaler technique.

Patient Handling of a Dry-Powder Inhaler in Clinical Practice

CHEST Journal ◽  
2001 ◽  
Vol 120 (5) ◽  
pp. 1480-1484 ◽  
Author(s):  
Stanley Epstein ◽  
Ari Maidenberg ◽  
David Hallett ◽  
Kay Khan ◽  
Kenneth R. Chapman
Keyword(s):  
Clinical Practice ◽  
Dry Powder Inhaler ◽  
Dry Powder ◽  
Patient Handling

scholarly journals The Global Usability Score Short-Form for the simplified assessment of dry powder inhalers (DPIs) usability

2020 ◽  
Vol 15 ◽  
Author(s):  
Massimiliano Povero ◽  
Paola Turco ◽  
Luca Bonadiman ◽  
Roberto W. Dal Negro
Keyword(s):  
Clinical Practice ◽  
Short Form ◽  
Objective Assessment ◽  
Indirect Comparison ◽  
Real Life ◽  
Dry Powder Inhaler ◽  
High Specificity ◽  
Lasso Regression ◽  
Dry Powder ◽  
Specificity And Sensitivity

Background: The choice of the Dry Powder Inhaler (DPI) to prescribe is a critical issue. The estimation of DPIs usability depends on the objective assessment of several indices related to both subjective and objective determinants. The Global Usability Score (GUS) Questionnaire is a comprehensive tool usable for checking, comparing, and ranking inhalers’ usability objectively in real life, but it takes some time to fill.Aim: The aim of this study was to favour the quicker check of DPIs usability in clinical practice by means of a simplified short-form GUS (S-GUS) Questionnaire, while maintaining the high specificity and sensitivity of the original, extended version of the Questionnaire (O-GUS questionnaire).Methods: The usability of the six most prescribed DPIs was assessed in 222 patients with persistent airway obstruction and needing long-term inhalation treatments. LASSO regression and multicollinearity test were used to select the subset of questions of the O-GUS questionnaire, with the highest information power. Each item was then scored using the corresponding coefficient in the linear regression (normalized at 50 as the O-GUS score). Agreement between the original and the short-form questionnaire was evaluated using the Cohen’s kappa statistic (κ). The overall S-GUS values obtained for each DPI were then compared to those from the O-GUS, in the same patients, using a Bayesian indirect comparison (IC) model.Results: After the statistical selection of the items mostly contributing to the overall score, the novel S-GUS questionnaire consists of twelve items only. Nine items are related to patients’ opinion before DPIs handling, and three to the nurse’s assessment after DPIs practicality. O-GUS and S-GUS score were strongly correlated (R2=0.9843, p<0.0001) and the usability score calculated for each DPI by means of the O- and of S- GUS overlapped almost completely (κ=84.5%, 95% CI 81.3% to 89.2%). Furthermore, S-GUS was much faster to complete than O-GUS (mean time 6.1 vs 23.4 minutes, p<0.001). Estimates of S-GUS, obtained from the IC model, allowed to propose a simple classification of usability: “good” by GUS values >25; “pretty good” by values ≤25≥15, and “insufficient” by values <15.Conclusions: The S-GUS proves as much specific and suitable as the extended O-GUS questionnaire in measuring DPIs usability, while maintaining the same high sensitivity. As the time required for its use is quite shorter, S-GUS is also particularly suitable and helpful in current clinical practice.

Reproducibility of Bronchodilator Response for a Reservoir Dry Powder Inhaler Following Routine Clinical Use

2000 ◽  
Vol 37 (1) ◽  
pp. 81-87 ◽  
Author(s):  
A. H. Morice ◽  
M. D. Peake ◽  
M. B. Allen ◽  
J. C. Campbell ◽  
M. Parry-billings
Keyword(s):  
Dry Powder Inhaler ◽  
Clinical Use ◽  
Dry Powder ◽  
Bronchodilator Response

Delivery of Dry Powders to the Lungs: Influence of Particle Attributes from a Biological and Technological Point of View

2019 ◽  
Vol 16 (3) ◽  
pp. 180-194 ◽  
Author(s):  
Sarah Zellnitz ◽  
Eva Roblegg ◽  
Joana Pinto ◽  
Eleonore Fröhlich
Keyword(s):  
Solid State ◽  
Dry Powder Inhaler ◽  
Point Of View ◽  
Dry Powder Inhalers ◽  
Dry Powder ◽  
Dry Powders ◽  
Pharmaceutical Ingredients ◽  
Technical Requirements ◽  
Particle Characteristics ◽  
Epithelial Cell Layer

Dry powder inhalers are medical devices used to deliver powder formulations of active pharmaceutical ingredients via oral inhalation to the lungs. Drug particles, from a biological perspective, should reach the targeted site, dissolve and permeate through the epithelial cell layer in order to deliver a therapeutic effect. However, drug particle attributes that lead to a biological activity are not always consistent with the technical requirements necessary for formulation design. For example, small cohesive drug particles may interact with neighbouring particles, resulting in large aggregates or even agglomerates that show poor flowability, solubility and permeability. To circumvent these hurdles, most dry powder inhalers currently on the market are carrier-based formulations. These formulations comprise drug particles, which are blended with larger carrier particles that need to detach again from the carrier during inhalation. Apart from blending process parameters, inhaler type used and patient’s inspiratory force, drug detachment strongly depends on the drug and carrier particle characteristics such as size, shape, solid-state and morphology as well as their interdependency. This review discusses critical particle characteristics. We consider size of the drug (1-5 &#181;m in order to reach the lung), solid-state (crystalline to guarantee stability versus amorphous to improve dissolution), shape (spherical drug particles to avoid macrophage clearance) and surface morphology of the carrier (regular shaped smooth or nano-rough carrier surfaces for improved drug detachment.) that need to be considered in dry powder inhaler development taking into account the lung as biological barrier.

scholarly journals A Critical Review on Emerging Trends in Dry Powder Inhaler Formulation for the Treatment of Pulmonary Aspergillosis

Pharmaceutics ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 1161
Author(s):  
Shen Nam Cheng ◽  
Zhi Guang Tan ◽  
Manisha Pandey ◽  
Teerapol Srichana ◽  
Mallikarjuna Rao Pichika ◽  
...  
Keyword(s):  
Antifungal Agents ◽  
Therapeutic Potential ◽  
Focal Point ◽  
Dry Powder Inhaler ◽  
Systemic Exposure ◽  
Pulmonary Delivery ◽  
Dry Powder ◽  
Pulmonary Aspergillosis ◽  
Emerging Trends ◽  
Insight Into

Pulmonary aspergillosis (PA), a pulmonary fungal infection caused by Aspergillus spp., is a concern for immunocompromised populations. Despite substantial research efforts, conventional treatments of PA using antifungal agents are associated with limitations such as excessive systemic exposure, serious side effects and limited availability of the therapeutics in the lungs for an adequate duration. To overcome the limitations associated with the conventional regimens, pulmonary delivery of antifungal agents has become a focal point of research because of the superiority of local and targeted drug delivery. Dry powder inhalers and nebulized formulations of antifungal agents have been developed and evaluated for their capability to effectively deliver antifungal agents to the lungs. Moreover, progress in nanotechnology and the utilization of nanocarriers in the development of pulmonary delivery formulations has allowed further augmentation of treatment capability and efficiency. Thus, the following review provides an insight into the advantages and therapeutic potential of the utilization of nanocarriers in pulmonary delivery of antifungal agents for the treatment of PA. In addition, discussions on formulation aspects and safety concerns together with the clinical and regulatory aspects of the formulations are presented, which suggest the possibility and desirability of utilization of nanocarriers in the treatment of PA.

scholarly journals The environmental impact of inhalers for asthma; a green challenge and a golden opportunity

2021 ◽  
Author(s):  
Alex Wilkinson ◽  
Ashley Woodcock
Keyword(s):  
Greenhouse Gas Emissions ◽  
Greenhouse Gas ◽  
Asthma Control ◽  
Carbon Footprint ◽  
Dry Powder Inhaler ◽  
Dry Powder Inhalers ◽  
Dry Powder ◽  
Gas Emissions ◽  
Inhaled Steroids ◽  
The Uk

The propellants used in metered-dose inhalers (MDIs) are powerful greenhouse gases, which account for approximately 13% of the NHS’s carbon footprint related to the delivery of care. Most MDI use is in salbutamol relievers in patients with poorly controlled disease. The UK lags behind in this regard with greater reliance on salbutamol MDI and correspondingly greater greenhouse gas emissions; roughly treble our European neighbours’. There has been a broad switch towards MDIs in the UK over the last 20 years to reduce financial costs such that two-thirds of asthma patients in the UK are on treatment dominated by salbutamol MDI. Strategies that replace overuse of reliever MDIs with regimes emphasising inhaled corticosteroids have the potential to improve asthma control alongside significant reductions in greenhouse gas emissions. Real-world evidence shows that once-daily long-acting combination dry-powder inhalers can improve compliance, asthma control and reduce the carbon footprint of care. Similarly, maintenance and reliever therapy (MART) which uses combination reliever and inhaled steroids in one device (usually a dry-powder inhaler) can simplify therapy, improve asthma control and reduce greenhouse gas emissions. Both treatment strategies are popular with patients, most of whom are willing to change treatment to reduce their carbon footprint. By focussing on patients who are currently using high amounts of salbutamol MDI, and prioritising inhaled steroids via dry-powder inhalers, there are golden opportunities to make asthma care more effective, safer and greener.

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