S. Chodosh et al., Effective delivery of particles with the HandiHaler (R) dry powder inhalation system over a range of chronic obstructive pulmonary disease severity, J AEROSOL M, 14(3), 2001, pp. 309-315
Citations number
19
Categorie Soggetti
Envirnomentale Medicine & Public Health
Journal title
JOURNAL OF AEROSOL MEDICINE-DEPOSITION CLEARANCE AND EFFECTS IN THE LUNG
The HandiHaler((R)) is a dry powder breath activated inhaler system develop
ed for inhalation therapy for patients with airway disease. Its operation i
s based on the evacuation of powder from a pierced capsule. We sought to do
cument the inspiratory flow rates attained by patients inspiring through th
e HandiHaler((R)) with various degrees of airflow limitation. Subjects with
stable chronic obstructive pulmonary disease (COPD) were the study's popul
ation. An in vitro study of fine particle dose was conducted using an Ander
sen Cascade Impactor to assess medication delivery at low inspiratory flow
rates. Subsequently, an in vivo study was conducted to determine inspirator
y flow rates in patients with COPD as measured through a pneumotach with a
custom coupler device with and without the HandiHaler (R). Patients were cl
assified into three approximately equal groups of spirometric severity rang
ing from mild (46-65% predicted normal forced expiratory volume in 1 sec [F
EV1]), to moderate (28-45%) to severe (less than or equal to 27%). The in v
itro study indicated delivery of medication at flow rates as low as 20 L/mi
n. Twenty-six men completed the in vivo study (age 66.9 +/- 10.9 years, FEV
1 = 1.02 +/- 0.45 1.). The median peak inspiratory flow rates attained in t
he mild (n = 8), moderate (n = 10), and severe (n = 8) categories were 45,
45.6, and 35.4 L/min respectively. The minimum peak inspiratory flow rates
in the three groups were 28.2, 21.6 and 20.4 L/min. The HandiHaler((R)) dev
ice effectively delivers particles to the lung over a wide range of airflow
limitation in patients with COPD.