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


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

[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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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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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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[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

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

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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Comment on "Optimizing the Delivery of Inhaled Medication for Respiratory Patients: The Role of Valved Holding Chambers".

Can Respir J 2019;2019:6475651. Epub 2019 Jul 25.

Pediatric Department, University of Alberta, Edmonton, AB T6G2C6, Canada.

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Effect of Oxygen Flow on Aerosol Delivery From a Nebulizer With a Holding Chamber.

Respir Care 2019 Dec 6;64(12):1508-1515. Epub 2019 Aug 6.

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

Background: A new holding chamber was designed to be used with a vibrating mesh nebulizer to increase the total inhalable dose for patients. It facilitates intermittent and continuous nebulization as well as the optional supply of supplemental oxygen via a T-piece with a mouthpiece adapter. This study aimed to evaluate the effect of oxygen introduction in the new holding chamber on aerosol delivery using a vibrating mesh nebulizer. Read More

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December 2019

Metered-dose inhaler therapy with spacers: Are newborns capable of using this system correctly?

Pediatr Pulmonol 2019 09 8;54(9):1417-1421. Epub 2019 Jul 8.

Department of Pediatrics, UFCSPA, Porto Alegre, RS, Brazil.

Introduction: Aerosol therapy using a metered-dose inhaler (MDI) coupled to a spacer chamber is the most widely used long-term treatment modality for chronic lung disease of prematurity. However, its use in neonates is based on data obtained from other age groups. Proper use of maintenance treatment is essential for the long-term stability of these patients. Read More

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September 2019

In vitro drug delivery performance of five valved holding chambers with and without facemasks.

Pediatr Pulmonol 2019 09 29;54(9):1457-1465. Epub 2019 Jun 29.

Allergy Centre, Tampere University Hospital, Tampere, Finland.

Background: Valved holding chambers (VHCs) are essential for efficient pulmonary delivery of inhaled medication in preschool children. The numerous devices in the market vary in material, aerodynamic characteristics, volume, valve properties, and mask design. Drug delivery is affected by the VHC characteristics as well as by the age and breathing pattern of the child. Read More

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September 2019

Bioavailability of Beclometasone From Two HFA-BDP Formulations With a Spacer.

Respir Care 2019 Oct 28;64(10):1222-1230. Epub 2019 May 28.

Inhalation Consultancy Limited, Leeds, United Kingdom.

Background: The drug delivery characteristics of each inhaler/spacer combination are unique. The spacer size as well as the presence of electrostatic charge greatly influence the inhaler dose emission and in vivo delivery. Using a previously developed urinary pharmacokinetic method, we have measured the relative lung and systemic bioavailability of beclometasone dipropionate (BDP) after inhalation from 2 hydrofluroalkane-beclometasone dipropionate (HFA-BDP) formulations when used with a spacer. Read More

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October 2019

Comparison of adverse events associated with different spacers used with non-extrafine beclometasone dipropionate for asthma.

NPJ Prim Care Respir Med 2019 02 8;29(1). Epub 2019 Feb 8.

Observational and Pragmatic Research Institute, Singapore, Singapore.

Co-prescription of Aerochamber spacer with non-extrafine beclometasone diproprionate (non-EF BDP) is common but unlicensed. We report a comparison of inhaled corticosteroid (ICS)-related adverse events between patients co-prescribed Aerochamber compared to the licensed Volumatic spacer. We utilised two historical cohorts: questionnaire-based and electronic medical record (EMR)-based, to assess patient-reported and EMR-recorded adverse events in patients with asthma prescribed non-EF BDP. Read More

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February 2019

Salbutamol and ipratropium by inhaler is superior to nebulizer in children with severe acute asthma exacerbation: Randomized clinical trial.

Pediatr Pulmonol 2019 04 22;54(4):372-377. Epub 2019 Jan 22.

Division of Pediatrics, Emergency Department, Clinical Hospital, National University of Asunción, Asunción, Paraguay.

Introduction: In moderate-severe asthma exacerbation, salbutamol by inhaler (MDI) is superior to salbutamol delivered by nebulizer (NEB); however, to our knowledge, no studies in children with exclusively severe exacerbations were performed.

Objective: To compare the efficacy of salbutamol and ipratropium bromide by MDI versus by NEB in severe asthma exacerbations.

Methods: We performed a clinical trial enrolling 103 children (2-14 years of age) with severe asthma exacerbations (defined by the Pulmonary Score ≥ 7) seen at the emergency room in Asuncion, Paraguay. Read More

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Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma.

Can Respir J 2018 3;2018:3095647. Epub 2018 Sep 3.

Respiratory Center, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.

Background: In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma.

Objective: To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Read More

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Efficient Nose-to-Lung Aerosol Delivery with an Inline DPI Requiring Low Actuation Air Volume.

Pharm Res 2018 Aug 21;35(10):194. Epub 2018 Aug 21.

Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015 Richmond, Virginia, 23284-3015, USA.

Purpose: To demonstrate efficient aerosol delivery through an in vitro nasal model using a dry powder inhaler (DPI) requiring low actuation air volumes (LV) applied during low-flow nasal cannula (LFNC) therapy.

Methods: A previously developed LV-DPI was connected to a LFNC system with 4 mm diameter tubing. System connections and the nasal cannula interface were replaced with streamlined components. Read More

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Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation.

Respir Care 2018 Nov 7;63(11):1360-1369. Epub 2018 Aug 7.

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

Background: Predosing patients with COPD with salbutamol by using a pressurized metered-dose-inhaler (pMDI) as a bronchodilator was hypothesized to improve the distribution of the subsequent nebulized dose. This study determined the effect of a pMDI preliminary bronchodilator dose on the aerosol delivered by a mesh nebulizer during single-limb noninvasive ventilation.

Methods: Twelve subjects with COPD who received noninvasive ventilation were enrolled in a randomized, open-label, urinary pharmacokinetic study. Read More

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November 2018

Effect of a spacer on total systemic and lung bioavailability in healthy volunteers and in vitro performance of the Symbicort (budesonide/formoterol) pressurized metered dose inhaler.

Pulm Pharmacol Ther 2018 10 2;52:7-17. Epub 2018 Aug 2.

AstraZeneca, Pepparedsleden 1, 431 50, Mölndal, Gothenburg, Sweden. Electronic address:

Introduction: Many patients with chronic obstructive pulmonary disease or asthma experience difficulties in coordinating inhalation with pressurized metered-dose inhaler (pMDI) actuation. The use of a spacer device can improve drug delivery in these patients. The aim of this study was to establish the relative bioavailability of single doses of Symbicort (budesonide/formoterol) pMDI 160/4. Read More

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October 2018

Optimizing the Delivery of Inhaled Medication for Respiratory Patients: The Role of Valved Holding Chambers.

Can Respir J 2018 4;2018:5076259. Epub 2018 Apr 4.

Family Physician Airways Group of Canada, Richmond Hill, ON, Canada.

Valved holding chambers (VHCs) have been used with pressurized metered-dose inhalers since the early 1980s. They have been shown to increase fine particle delivery to the lungs, decrease oropharyngeal deposition, and reduce side effects such as throat irritation, dysphonia, and oral candidiasis that are common with use of pressurized metered-dose inhalers (pMDIs) alone. VHCs act as aerosol reservoirs, allowing the user to actuate the pMDI device and then inhale the medication in a two-step process that helps users overcome challenges in coordinating pMDI actuation with inhalation. Read More

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Effect of a Nebulizer Holding Chamber on Aerosol Delivery.

Respir Care 2018 Sep 22;63(9):1125-1131. Epub 2018 May 22.

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

Background: A new holding chamber was designed to be used with the Aerogen Solo nebulizer to increase the aerosol emitted that reach the patient. The aim of this study was to evaluate the efficacy of this holding chamber with the nebulizer and determine its usability with other nebulizers.

Methods: The study was divided into 2 parts. Read More

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September 2018

Application of an inline dry powder inhaler to deliver high dose pharmaceutical aerosols during low flow nasal cannula therapy.

Int J Pharm 2018 Jul 5;546(1-2):1-9. Epub 2018 May 5.

Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, United States; Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, United States. Electronic address:

Inline dry powder inhalers (DPIs) offer a potentially effective option to deliver high dose inhaled medications simultaneously with mechanical ventilation. The objective of this study was to develop an inline DPI that is actuated using a low volume of air (LV-DPI) to efficiently deliver pharmaceutical aerosols during low flow nasal cannula (LFNC) therapy. A characteristic feature of the new inline LV-DPIs was the use of hollow capillary tubes that both pierced the capsule and provided a pathway for inlet air and exiting aerosol. Read More

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