Mohamed E.A. Abdelrahim1, Basma M.E. Mohamed1, Marwa Mohsen1, Ahmed M. AbdleFattah2, & Ahmed H.M. Sobh3
1Clinical Pharmacy department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
2 Clinical Pharmacy Department, Faculty of Pharmacy, King Salman International University (KSIU)
3Clinical Pharmacy Department, Faculty of Pharmacy, University of Mashreq, Baghdad, Iraq
Summary
We aimed to compare the performance of pressurized metered dose inhalers (pMDIs) alone, and connected to AeroChamber2go and MDI PLUS. The study was three parts: in-vitro using the Anderson cascade impactor to assess aerodynamic characteristics of delivered aerosol (salbutamol, Ventolin, GSK, 100µg/puff, 5puffs) each time at inhalation flow 28.3L/min; in-vivo, where a cohort of 20 patients with asthma (10 females) with a mean±SD age of 45.3±8.7 years were enrolled in the study. The subjects received 500 μg (5 puffs, 100 μg each) of salbutamol using pMDI alone, and with AeroChamber2go and MDI PLUS. Urine samples were collected from subjects at 30 minutes and cumulatively over 24 hours post-inhalation, serving as indices of relative lung deposition and systemic bioavailability, respectively. We also measured the ex-vivo delivered dose by placing an inhalation filter between the patient and the pMDI-spacer combination in the washout days. Finally, we tested the ease of use of pMDI alone and combined with either the AeroChamber2go or the MDI PLUS. The study demonstrated that pMDI alone produced a significantly higher total emitted dose and systemic bioavailability index, as well as higher exvivo values, but lower fine particle dose, fine particle fraction, and lung bioavailability index compared with pMDI combined with the AeroChamber2go® or the MDI PLUS® (p<0.05). In sum, using either of the two spacers showed better drug delivery compared to using the pMDI alone. This could be translated into better health outcomes for asthmatic patients.