EFFICIENT DELIVERY TO THE LUNGS OF FLUNISOLIDE AEROSOL FROM A NEW PORTABLE HAND-HELD MULTIDOSE NEBULIZER

In order to provide asthmatic patients with an inhaler that does not u se chlorofluorocarbon propellants, a novel multidose hand-held nebuliz er (RESPIMAT, Boehringer Ingelheim Ltd.) has been developed. This devi ce delivers 200 x 15 mu L metered doses of drug solution, but does not use propellants of any kind. In this study of 10 healthy volunteers, the deposition pattern in the lungs and oropharynx of an ethanolic sol ution of flunisolide delivered via a prototype III multidose nebulizer has been determined by gamma scintigraphy. A comparison was made with the same dose (250 mu g) of flunisolide delivered by a pressurized me tered dose inhaler (MDI) and MDI plus Inhacort spacer. Mean (SD) whole lung deposition from the multidose nebulizer (39.7 (9.9) % of the met ered dose) was significantly higher than that from either MDI (15.3 (5 .1) %, P < 0.01) or NIDI plus spacer (28.0 (7.0) %, P = 0.01). A mean 10.4% of the dose was recovered from an exhaled air filter for the mul tidose nebulizer, but less than 2% of the dose for MDI or MDI plus spa cer. Oropharyngeal deposition was significantly reduced for the multid ose nebulizer 139.9 (9.4) %) compared to MDI (66.9 (7.1) %), but was r educed further for the MDI plus spacer (27.3 (11.3) %). The multidose nebulizer delivers an unusually high percentage of an aerosol dose to the lungs, and it ''targets'' flunisolide to the lungs more effectivel y than the MDI, The multidose nebulizer could constitute a viable alte rnative to MDIs in asthma maintenance therapy.