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Abstract: Poster Presentations |

COMPARATIVE EVALUATION OF CARDBOARD VERSUS RIGID SMALL VOLUME VALVED HOLDING CHAMBERS FOR THE DELIVERY OF A BETA-2 AGONIST FORMULATION: DELIVERY TO THE UNCOORDINATED USER FREE TO VIEW

Dominic Coppolo, RRT*; Jolyon Mitchell, PhD; Kimberly Wiersema, BA; Valentina Avvakoumova, BSc; Mark Nagel, BSc
Author and Funding Information

Monaghan Medical Corp., Syracuse, NY


Chest


Chest. 2005;128(4_MeetingAbstracts):246S. doi:10.1378/chest.128.4_MeetingAbstracts.246S-b
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Abstract

PURPOSE:  VHCs are prescribed for patients that have difficulty coordinating pressurized metered-dose inhaler (pMDI) use, frequently resulting in delayed inhalation following inhaler actuation. Our study introduced a realistic 2-second delay, comparing delivery of a beta-2 agonist via VHCs of similar size (n=5/group), one manufactured from cardboard (LiteAire™, Thayer Medical, Tucson, AZ –160-ml) the other from rigid polymer (AeroChamber Plus®, Monaghan Medical Corp., Syracuse, NY –150-ml).

METHODS:  The AeroChamber Plus® VHCs were pretreated by washing in water containing a mild ionic detergent, rinsed and drip-dried, as recommended prior to use. The LiteAire™ VHCs were assembled and used in accordance with manufacturer’s instructions. Each VHC was tested using an Andersen 8-stage impactor with USP Induction Port operated at 28.3±0.5 L/min, representative of flow rates seen with adult patients. A shutter that interfaced between the VHC mouthpiece and induction port entrance was used to simulate a 2-s delay interval between pMDI actuation and the onset of sampling. The shutter moved to allow flow from the VHC to the impactor only after the defined delay. 5-actuations of albuterol (Ratiopharm, Mississauga, Canada, 100 μg/dose albuterol base equivalent ex metering valve) were delivered from a pre-primed and shaken pMDI canister at 30-s intervals. The induction port and stages of the impactor were subsequently assayed for albuterol by HPLC-UV spectrophotometry. Benchmark measurements were also made with the pMDI alone.

RESULTS:  Fine particle mass/actuation ((FPM) <4.7 μm aerodynamic diameter (mean (95% CI)) was 27.8 (4.2) μg (pMDI alone), 21.7 (5.0) μg (AeroChamber Plus® VHC) and 13.9 (4.2) μg (LiteAire™ VHC).

CONCLUSION:  FPM(pMDI-alone) represents delivery with perfect inhaler technique. The AeroChamber Plus® VHC delivered nearly 80% FPM(pMDI-alone) with a 2-s delay, but the corresponding delivery via the LiteAire™ VHC was only 50% FPM(pMDI-alone).

CLINICAL IMPLICATIONS:  Dosing may have to be adjusted to take into account the poorer efficiency of the cardboard VHC, considering the likelihood of imperfect coordination.

DISCLOSURE:  Dominic Coppolo, Employee All of the authors are employees of companies in the Trudell Medical Group. These companies manufacture the AeroChamber Plus® VHC

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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