Influence of particle size and patient dosing technique on lung deposition of HFA-beclomethasone from a metered dose inhaler
Influence of particle size and patient dosing technique on lung deposition of HFA-beclomethasone from a metered dose inhaler
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DOI：
10.1089/jam.2005.18.379
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发表时间：
2005-12-01
期刊：
影响因子：
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通讯作者：
Boudreau, RJ
中科院分区：
文献类型：
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作者：
Leach, CL;Davidson, PJ;Boudreau, RJ
本研究的目的是确定呼吸激活吸入器（QVAR（TM）Autohaler（TM））与适当和不适当的按压和呼吸（QVAR（TM）P&B）定量吸入器（MDI）技术相比的HFA-134 a-二丙酸倍氯米松（HFA-BDP）的肺部递送。假设HFA-BDP中较小的BDP颗粒在患者吸入空气中悬浮的时间更长，从而减少吸入器失调的有害影响。本研究是一项开放标签、四阶段、交叉设计。使用有哮喘症状史、FEV-1> 70%正常预测值、β激动剂可逆性>= 12%的哮喘患者（n = 7）。用锝-99 m放射性标记BDP，并从QVAR Autohaler或QVAR P&B装置输送给接受过可重复使用协调和不协调P&B MDI技术培训的患者。使用Autohaler MDI的患者显示60%的BDP肺沉积。使用P&B MDI协调技术的患者显示59%的肺沉积。在吸入前接受持续启动P&B MDI训练的患者显示出37%的肺沉积。接受培训的患者在吸气后期持续启动P&B MDI（即，1.5吸入3秒）显示50%的肺沉积。总之，呼吸激活的Autohaler自动提供了60%的最佳BDP肺沉积。具有良好P&B MDI技术的患者也获得了59%的最佳肺沉积。当患者表现出较差的吸入器技术时，肺沉积程度降低。然而，技术较差的患者仍然接受大剂量的BDP肺给药（即，>= 37%），相比之下，先前发表并在本研究中证实的CFC-BDP计量吸入器的肺沉积值为4-7%。
The objective of this study was to determine the lung delivery of HFA-134a-beclomethasone dipropionate (HFA-BDP) from a breath-activated inhaler (QVAR (TM) Autohaler (TM)) compared with proper and improper press and breathe (QVAR (TM) P&B) metered dose inhaler (MDI) technique. The hypothesis was that that the smaller particles of BDP from HFA-BDP would stay suspended longer in the inspiratory air of patients and thus reduce the deleterious eff- ects of inhaler disco ordination. The study was an open label, four period, cross-over design. Asthmatic patients (n = 7) with a history of asthma symptoms, an FEV-1 of > 70% of predicted normal, and a history of reversibility to a beta-agonist of >= 12% were utilized. BDP was radiolabeled with technetium-99m and delivered from the QVAR Autohaler or QVAR P&B device in patients trained to reproducibly utilize coordinated and discoordinated P&B MDI technique. Patients using Autohaler MDI exhibited 60% lung deposition of BDP. Patients using coordinated technique with the P&B MDI exhibited 59% lung deposition. Patients trained to consistently actuate the P&B MDI before inhaling exhibited 37% lung deposition. Patients trained to consistently actuate the P&B MDI late in the inspiration (i.e., 1.5 sec into a 3-sec inspiration) exhibited 50% lung deposition. In conclusion, the breath-activated Autohaler automatically provided optimal BDP lung deposition of 60%. Patients with good P&B MDI technique also received optimal lung deposition of 59%. The degree of lung deposition was decreased as patients demonstrated poor inhaler technique. However patients with poor technique still received a large lung dose of BDP (i.e., >= 37%) compared with lung deposition values of 4-7% for CFC-BDP MDIs previously published and confirmed in this study.