324 results match your criteria Use of Metered Dose Inhalers Spacers and Nebulizers


Turning green: the impact of changing to more eco-friendly respiratory healthcare - a carbon and cost analysis of Dutch prescription data.

BMJ Open 2022 Jun 14;12(6):e055546. Epub 2022 Jun 14.

National Health Care Institute, Diemen, The Netherlands

Objectives: Dry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurised metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO equivalents when replacing pMDIs by non-propellant inhalers (NPIs) in Dutch respiratory healthcare and estimated the associated cost.

Design: We performed a descriptive analysis of prescription data from two national databases of two independent governmental bodies. Read More

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Advanced counselling using training device and smartphone application on inhalation technique from metered-dose inhaler with spacer equipped with different interfaces in asthmatic children.

Int J Clin Pract 2021 Sep 4;75(9):e14413. Epub 2021 Jun 4.

Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.

Background: Spacers are equipped with either facemask or mouthpiece as an interface through which patient inhale their dose. The present study aimed to evaluate the effect of advanced counselling using training devices and smartphone applications on inhalation techniques from the metered-dose inhaler (MDI) with a spacer equipped with different interfaces.

Methods: 100 paediatric asthmatic children (8-18 years) were divided into two groups. Read More

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September 2021

Optimal administration of bronchodilators with valved holding chambers in preschool children: a review of literature.

Eur J Pediatr 2021 Oct 20;180(10):3101-3109. Epub 2021 Apr 20.

Allergy Centre, Tampere University Hospital, Tampere, Finland.

Our aim was to synthesize the published literature on factors that potentially affect the delivery of bronchodilators using valved holding chambers (VHC) in preschool children. We also aimed to identify those attributes that are not yet incorporated or clearly stated in the guidelines and those topics that are still lacking sufficient data. There is strong evidence supporting several recommendations in current guidelines. Read More

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October 2021

Effect of different accessory devices on the dose delivered from pressurised metred-dose inhalers.

Int J Clin Pract 2021 Jun 30;75(6):e14157. Epub 2021 Mar 30.

Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.

Introductions: Improved aerosol delivery of bronchodilators to chronic obstructive pulmonary disease (COPD) subjects is a cornerstone in the treatment approach. Drug delivery and response are improved with the use of accessory devices [spacers and valved holding chambers (VHCs)] with metred-dose inhalers (pMDIs). However, different accessory devices are available in the market with different properties that could affect aerosol delivery. Read More

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Pressurized Metered Dose Inhaler Aerosol Delivery Within Nasal High-Flow Circuits: A Bench Study.

J Aerosol Med Pulm Drug Deliv 2021 09 24;34(5):303-310. Epub 2021 Mar 24.

INSERM, Centre d'Étude des Pathologies Respiratoires (CEPR) UMR 1100, Université de Tours, Tours, France.

Obstructive patients may benefit from nasal high-flow (NHF) therapy, but the use of pressurized metered-dose inhalers (pMDIs) has not been evaluated in this situation. Using an adult circuit and medium-sized cannula, we have tested different NHF rates, pMDI positions, breathing patterns, spacers, and spacer orientation. First, we evaluated albuterol delivery at the nasal cannula outlet. Read More

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September 2021

Spacer microbial contamination and asthma outcomes: case series.

J Asthma 2022 Apr 10;59(4):755-756. Epub 2021 Feb 10.

Wake Forest School of Medicine, Physician Assistant Studies, Winston-Salem, NC, USA.

Objective: The primary method of drug delivery to treat asthma is through pressurized metered dose inhalers (pMDI). Asthma guidelines recommend that providers prescribe a spacer for all patients using pMDI. The objective of this study was to examine whether microbial contamination of spacer devices is associated with poor asthma outcomes. Read More

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Utility of a Mask with a Spacer to Deliver the Contents of a Metered Dose Inhaler.

Ann Am Thorac Soc 2021 03;18(3):553

Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Puducherry, India.

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Homemade valved holding chambers for children with airway hyperresponsiveness: A randomized crossover trial.

Pediatr Pulmonol 2021 01 4;56(1):49-56. Epub 2020 Nov 4.

Nursing Affairs, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Background: During the COVID-19 pandemic, a metered-dose inhaler (MDI) with a valved holding chamber (VHC) is a preferred route of bronchodilator delivery. We have developed a new homemade VHC, made of a paper coffee cup, and a drinking water bottle. This study was conducted to compare the bronchodilator response in children with airway hyperresponsiveness after the use of our homemade VHC and that of a standard commercial one. Read More

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January 2021

Mask Use with Spacers/Valved Holding Chambers and Metered Dose Inhalers among Children with Asthma.

Ann Am Thorac Soc 2021 01;18(1):17-22

Department of Medicine and.

Inhaler misuse is highly prevalent and associated with high morbidity and costs. For metered dose inhalers, proper use can be supported with devices such as spacers/valved holding chambers (VHCs) and masks to effectively deliver inhaled medication to the lungs. However, guidelines are vague about which children with asthma should use spacers/VHCs with masks to deliver medication from metered dose inhalers as well as when they should transition to spacers/VHCs with mouthpieces. Read More

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January 2021

Effectiveness of Spacer Devices on Preventing Undesirable Cardiovascular Effects of Inhaled Salbutamol.

J Aerosol Med Pulm Drug Deliv 2021 08 8;34(4):217-222. Epub 2020 Oct 8.

Respsono Clinic, São Bernardo do Campo, São Paulo, Brazil.

Currently, there are no regulatory guidelines indicating spacer devices/valved holding chamber (VHC) should be used routinely during pulmonary function tests, and few studies evaluated if spacer devices reduce beta-agonist bronchodilators' side effects. A prospective study compared salbutamol's cardiovascular effects and bronchodilation response during spirometry tests with and without a spacer device/VHC. Heart rate (HR), the corrected QT interval (QTc), and systolic and diastolic blood pressure were measured 10 minutes after the first spirometry test, before the drug administration, and 20 minutes after inhalation in both groups. Read More

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[Evaluation of Valved Holding Chambers Simulating Repurposing Use of Ciclesonide Metered-dose Inhaler by Patients with Pneumonia].

Yakugaku Zasshi 2020 Dec 25;140(12):1495-1500. Epub 2020 Sep 25.

Division of Drugs, National Institute of Health Sciences.

Achieving appropriate inhalation in patients with coronavirus disease 2019 (COVID-19) is a common challenge in the use of repurposed metered-dose inhaler (MDI) formulations. The purpose of this study was to evaluate the effect of five valved holding chambers (VHCs) on the inhalation of ciclesonide from Alvesco MDI. The aerodynamic particle size distribution of ciclesonide discharged from Alvesco MDI was evaluated using a Next Generation Impactor in the presence and absence of VHCs. Read More

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December 2020

Nebulized Therapies in COPD: Past, Present, and the Future.

Int J Chron Obstruct Pulmon Dis 2020 12;15:1665-1677. Epub 2020 Jul 12.

Williamson Medical Center, Franklin, TN, USA.

Current guidelines recommend inhalation therapy as the preferred route of drug administration for treating patients with chronic obstructive pulmonary disease (COPD). Inhalation devices consist of nebulizers and handheld inhalers, such as dry-powder inhalers (DPIs), pressurized metered-dose inhalers (pMDIs), and soft mist inhalers (SMIs). Although pMDIs, DPIs and SMIs may be appropriate for most patients with COPD, certain patient populations may have challenges with these devices. Read More

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Commercial valved spacers versus home-made spacers for delivering bronchodilator therapy in pediatric acute asthma: a cost-effectiveness analysis.

J Asthma 2021 10 27;58(10):1340-1347. Epub 2020 Jun 27.

Respiratory Department, Alder Hey Childrens Hospital Liverpool, Liverpool, UK.

Objective: Although valved spacers are the preferred method for administering metered-dose inhaler bronchodilators such as albuterol in pediatric acute asthma, their high cost and their lack of availability have limited their use, especially in low- and middle-income countries (LMICs). Because of this, it is a common practice to use home-made spacers, although a formal analysis evaluating their cost-effectiveness is lacking. Therefore, the objective of this study was to analyze the cost-effectiveness of home-made spacers compared to commercial valved spacers for delivering bronchodilator therapy in pediatric acute asthma. Read More

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October 2021

Comparative pharmacokinetics of salbutamol inhaled from a pressurized metered dose inhaler either alone or connected to a newly enhanced spacer design.

Eur J Pharm Sci 2020 Apr 9;147:105304. Epub 2020 Mar 9.

Clement Clarke International Limited, Harlow, United Kingdom.

Background: Coordination between actuation of a pressurized metered dose inhaler (pMDI) and inhalation is a critical manoeuvre that many patients fail to perform correctly. pMDIs connected to spacers do not require hand-lung coordination. This study evaluated the relative lung and systemic bioavailability and oropharyngeal deposition of salbutamol post-inhalation from Ventolin® Evohaler® (GlaxoSmithKline) either alone following verbal inhaler technique counselling (VC) or connected to a newly improved Able Spacer® (AS). Read More

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Reply.

J Allergy Clin Immunol Pract 2020 03;8(3):1166-1167

Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands; PureIMS B.V., Roden, the Netherlands. Electronic address:

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Relative lung dose from antistatic valved holding chambers.

J Allergy Clin Immunol Pract 2020 03;8(3):1166

Scottish Centre for Respiratory Research, Ninewells Hospital and Medical School, University of Dundee, Scotland, United Kingdom.

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Inhalation therapy devices for the treatment of obstructive lung diseases: the history of inhalers towards the ideal inhaler.

Eur J Intern Med 2020 05 26;75:15-18. Epub 2020 Feb 26.

Division of Respiratory Medicine, Department PROMISE, "Giaccone" University Hospital, University of Palermo, Italy.

Inhalation therapy allows conveying drugs directly into the airways. The devices used to administer inhaled drugs play a crucial role in the management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). To ensure high bronchial deposition of the drug, a device should deliver a high proportion of fine particles, be easy to use, and provide constant and accurate doses of the active substance. Read More

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Real-Time Analysis of the Respiratory Flow Through a Valved Holding Chamber.

J Aerosol Med Pulm Drug Deliv 2020 08 26;33(4):205-213. Epub 2020 Feb 26.

Department of Pediatrics, Virginia Commonwealth University School of Medicine and the Children's Hospital of Richmond, Richmond, Virginia.

The ability of patients to take, correctly and regularly, aerosol treatments is a key for good control of asthma and chronic obstructive pulmonary disease. Devices that help to improve inhalation technique could train the patient to take their medication properly, reducing risk of exacerbations. In this study we evaluate a new device that by recording real-time respiratory flow into the valved holding chamber (VHC) mouthpiece, could be used to improve patient technique. Read More

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The pharmacists' ability to use pressurized metered-dose inhalers with a spacer device and factors affecting it.

J Asthma 2021 05 27;58(5):659-664. Epub 2020 Feb 27.

Department of Pediatric Allergy and Immunology, İnönü University Faculty of Medicine, Malatya, Turkey.

The aim of this study is to evaluate the pharmacists' ability to use pMDIs with a spacer device and the factors that affect this ability. Face to face interviews were conducted with the pharmacists. A nine item questionnaire was completed and the checklist for how to use pMDIs with a spacer device was filled out. Read More

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Left to Their Own Devices: A Glance Into the Byzantine World of Obtaining Asthma Spacing Devices.

Clin Pediatr (Phila) 2020 05 20;59(4-5):337-339. Epub 2020 Jan 20.

Boston Children's Health Physicians, Valhalla, NY, USA.

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Spacers and Valved Holding Chambers-The Risk of Switching to Different Chambers.

J Allergy Clin Immunol Pract 2020 05 9;8(5):1569-1573. Epub 2020 Jan 9.

Imperial College London & Royal Brompton Hospital, London, United Kingdom.

Spacers are pressurized metered-dose inhaler (pMDI) accessory devices developed to reduce problems of poor inhaler technique with pMDIs. Spacers that feature a 1-way inspiratory valve are termed valved holding chambers (VHCs); they act as aerosol reservoirs, allowing the user to actuate the pMDI device and then inhale the medication in a 2-step process that helps users overcome challenges in coordinating pMDI actuation with inhalation. Both spacers and VHCs have been shown to increase fine particle delivery to the lungs, decrease oropharyngeal deposition, and reduce corticosteroid-related side effects such as throat irritation, dysphonia, and oral candidiasis commonly seen with the use of pMDIs alone. Read More

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[Spacer, Aerosol Therapy through Space and Time].

Laryngorhinootologie 2019 Dec 6;98(12):845-860. Epub 2019 Dec 6.

Mundipharma GmbH.

Aim Of The Literature Review: Within this review, results of a literature analysis on the application of spacers with pressurized metered dose inhalers (pMDI) are described and evaluated.

Methods: Next to an extensive revision on effects of spacers, the impacts of current guidelines and the conditions for product authorisations on the use of spacers are described which result from the interplay of characteristics from dose inhalers with a spacer.

Results: Spacers are generally useful to avoid coordination problems concerning the actuation of a pMDI at the beginning of an inhalation. Read More

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December 2019

What to consider before prescribing inhaled medications: a pragmatic approach for evaluating the current inhaler landscape.

Ther Adv Respir Dis 2019 Jan-Dec;13:1753466619884532

Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus C, Denmark.

Inhaled therapies are the cornerstone of treatment in asthma and chronic obstructive pulmonary disease, and there are a multitude of devices available. There is, however, a distinct lack of evidence-based guidance for healthcare providers on how to choose an appropriate inhaler. This review aims to summarise recent updates on topics related to inhaler choice, and to offer practical considerations for healthcare providers regarding currently marketed devices. Read More

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Antistatic treatment and salbutamol dosing have variable effect on drug delivery of valved holding chambers.

Pulm Pharmacol Ther 2019 12 31;59:101857. Epub 2019 Oct 31.

Allergy Centre, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Aims: Our aim was to evaluate whether the number of puffs or antistatic treatment have significant effect on drug delivery of six different valved holding chambers (VHCs).

Methods: We used simulated paediatric breathing pattern with 25/min frequency and 200 ml tidal volume. When comparing the effect of antistatic treatment, we used 100 μg of salbutamol (one puff Ventolin Evohaler 100 μg/dos) actuated into each VHC before and after detergent wash. Read More

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December 2019

Adapting the Aerogen Mesh Nebulizer for Dried Aerosol Exposures Using the PreciseInhale Platform.

J Aerosol Med Pulm Drug Deliv 2020 04 15;33(2):116-126. Epub 2019 Oct 15.

Inhalation Sciences Sweden AB, Huddinge, Sweden.

Many substances used in inhalation research are water soluble and can be administered as nebulized solutions. Typical examples are therapeutic, small-molecular agents, or macromolecules. Another category is a number of water-soluble agents used for airway diagnostics or disease modeling. Read More

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A comparative analysis of changes in pMDI drug dose delivery before and after detergent coating using five antistatic valved holding chambers.

J Allergy Clin Immunol Pract 2020 Mar 5;8(3):1124-1125.e4. Epub 2019 Oct 5.

Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, the Netherlands; PureIMS B.V., Roden, the Netherlands. Electronic address:

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Effects of modifying visual inhaler spacer usage instructions on correct usage rate of untrained users.

Int Forum Allergy Rhinol 2020 01 1;10(1):69-74. Epub 2019 Oct 1.

Pediatric Allergy and Immunology Department, GOP Taksim Education and Research Hospital, İstanbul, Turkey.

Background: Pressurized metered-dose inhalers (pMDIs) used with spacers are considered the method of choice for delivery of inhaled drugs in preschool-age children. The aim of this study was to determine the effects of modifying the visual inhaler spacer usage guidelines on the correct usage rate.

Methods: The parents and caregivers of patients <6 years old who were prescribed inhalers with spacers for the first time were included in our study. Read More

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January 2020

Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings.

J Asthma 2021 02 17;58(2):190-196. Epub 2019 Oct 17.

Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Correct technique with a pressurized metered-dose inhaler (pMDI) equipped with a valved holding chamber (VHC) or spacer provides an important advantage for adequate control of asthma and virus-induced wheezing in young children. The aim of this study was to assess the ability and knowledge of physicians and nurses to use a pMDI with a masked VHC in two pediatric emergency units. Study design: Two-center observational study. Read More

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February 2021

Evaluation of Disposable and Traditional Accessory Devices for Use With a Pressurized Metered-Dose Inhaler.

Respir Care 2020 Mar 27;65(3):320-325. Epub 2019 Aug 27.

Pharmaceutics and Industrial Pharmacy Department, Beni-suef University, Beni-suef, Egypt.

Background: The use of accessory devices with pressurized metered-dose inhalers (pMDIs) enhances aerosol delivery and helps overcome any lack of patient coordination when using the pMDI. The use of accessory devices could be influenced by the efficacy, availability, and cost of these devices. The aim of this study was to compare drug delivery with the pMDI alone and with non-antistatic and antistatic accessory devices. Read More

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