LUNG DEPOSITION OF BUDESONIDE IN ASTHMATICS - A COMPARISON OF DIFFERENT FORMULATIONS

Lung deposition of budesonide administered from a pressurized metered dose inhaler (pMDI), with and without a large volume spacer (Nebuhaler (R)) attached, and from Turbuhaler(R), were compared in an open, cross over, randomized study in eight asthmatic patients under optimum inhal ation conditions using a Tc-99m-tracer and scintigraphic imaging. The total and regional deposition of aerosol in the lungs as well as the o ropharyngeal deposition was determined. The percentage of dose in the whole lung was 11.9 +/- 5.0% (mean +/- S.D.) from a pMDI, 38.4 +/- 10. 2% from a pMDI with Nebuhaler and 26.1 +/- 10.5% from Turbuhaler. The mean lung deposition from Turbuhaler was significantly greater (p = 0. 0005) than that from a pMDI alone, and a pMDI with Nebuhaler gave sign ificantly greater lung deposition compared with a pMDI (p<0.0001) and Turbuhaler (p = 0.02). No significant difference was observed in centr al lung deposition between Turbuhaler and Nebuhaler administrations, w hereas Nebuhaler gave a greater intermediate and peripheral lung depos ition. Administrations via pMDI and pMDI with Nebuhaler gave higher pe ripheral/central ratios (similar to 1.2) vs 0.64 with Turbuhaler. The total lung deposition of budesonide via a pMDI and Turbuhaler in asthm atic patients in the present study was comparable with that previously found in healthy subjects. (C) 1998 Elsevier Science B.V. All rights reserved.