Comparison of the bronchodilator effects of salbutamol delivered via a metered-dose inhaler with spacer, a dry-powder inhaler, and a jet nebulizer inpatients with chronic obstructive pulmonary disease
A. Ikeda et al., Comparison of the bronchodilator effects of salbutamol delivered via a metered-dose inhaler with spacer, a dry-powder inhaler, and a jet nebulizer inpatients with chronic obstructive pulmonary disease, RESPIRATION, 66(2), 1999, pp. 119-123
The aim of this study was to compare the bronchodilator effects of salbutam
ol delivered via three different devices: a dry-powder inhaler (DPI), a met
ered-dose inhaler (MDI) with a large-volume spacer and a jet nebulizer (NEB
) in patients with stable chronic obstructive pulmonary disease (COPD). Ten
male patients with stable COPD [age: 67.2 +/- 3.8 years, forced expiratory
volume in 1 s (FEV1): 1.56 +/- 0.32 liters] were studied in a randomized,
double-blind and crossover manner. Each patient received 200 or 1,000 mu g
salbutamol via an MDI with an InspirEase(TM) spacer, a Rotahaler(TM), or a
DeVilbiss 646(TM) nebulizer (NEB), or matching placebo on 7 separate days.
Spirometry was performed before and 15, 30, 60, 90, 120, and 240 min after
inhalation. With the 200-mu g dose, only DPI produced a small but greater r
esponse in maximum FEV1 and in area under the time-response curve (AUC-FEV1
) compared with placebo. With the 1,000-mu g dose, DPI and MDI produced equ
ally greater improvements in both maximum FEV1 and AUC-FEV1 than NEB. An eq
ual bronchodilating effect can be obtained using either DPI or MDI with a s
pacer device, whereas the NEB was less effective when the same dose was adm
inistered.