Inhalation drug delivery devices

An asthma inhaler is an example of a product that contains both a drug and a drug delivery device. Such a product would be regulated primarily as a drug as it achieves its medical purpose by pharmaceutical means. The inhaler would additionally have to satisfy the requirements of a device. 

Educate patients on the use of inhaled drug delivery devices, peak flow monitors, and asthma education plans. 

The first commercially available DPI system appeared on the market in 1949, developed and marketed by Abbott under the name Aerohaler. Like all early pulmonary drug-delivery devices, it delivered small-molecule compoimds (bronchodilators or inhaled corticosteroids) to the airways (not necessarily the deep limg) for the treatment of asthma or chronic obstructive pulmonary disease. Table 6 lists some of the early DPI systems used for asthma and COPD the energy somces in these devices were mechanical and patient inspiration. 

Administration Iloprost is intended for inhalation administration only via the Prodose AAD system, a pulmonary drug delivery device. It has not been studied with any other nebulizers. 

As reported later in Chapter 9.9 of this book, active-ingredient-containing polymeric micro-particles are widely used in technological and medical applications. For example, these particles are suitable as drug-delivery devices and can control the pharmaceutical release-rate over time. The particle size is absolutely important when dealing with drug-delivery devices. Very small particles can be inhaled, while larger ones can be injected into the blood stream. Therefore, it is important to control the microparticle size in the production. 

There are several ways to categorize drug delivery devices. The inhalation drug delivery devices discussed in this article are categorized according to their operating principles or fundamental mechanism of generating aerosols. 

The metered solution inhaler (MSI), under development by Sheffield Pharmaceuticals, uses the same aerosolization principle as the AeroDose. The MSI is a portable, hand-held drug delivery device, as shown in Fig. 13. Using a motorized pump, drug solution is delivered to the surface of a ultrasonic horn powered... 

The pMDI will continue to be one of the most popniar drug delivery devices for inhaled antiasthma drugs. The inaeasing number of modifications to the standard inhaler should improve drug dehvery. 

Pulmonary drug delivery devices are reviewed with respect to recent advances and future needs. The paper provides an introduction to inhaled delivery techniques, the requirements of such delivery devices, a review of the various designs available, new materials and areas of applications, followed by a gap analysis, a discussion of future needs and examples. 

Patients switched from an MDI to a DPI should be counseled that the DPI requires a rapid and forceful inhalation as compared to the slow inhalation used for an MDI. Patients using a DPI should also be counseled not to exhale into the device, as it will cause a loss of dose or decreased drug delivery. Because delivery technique with inhalers deteriorates over time, the health care provider should take every opportunity to reinforce appropriate inhaler technique. 

Devices used for delivery of the drug (such as inhalers) are another area requiring an integrated clinical and pharmaceutical assessment for their performance, ease of use, and implications for safety and efficacy. 

Labiris NR, Dolovich MB. Pulmonary drug delivery. Part II the role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol 2003 56(6) 600-12. 

Geriatric Considerations - Summary Ensure that the older adult can adequately use the inhalation device. A spacer maybe beneficial in fhose unable fo coordinate device operation and inhalation. Spacer devices improve drug delivery to the lungs, therefore monitor closely as the patient may also experience increased systemic side effects with improved exposure to albuterol. Monitor cardiac status. 

Intimately related to these factors is the design of the device, formulation, and the interface with the patient. Much of the discussion below will focus on the implications of excipients on formulation challenges for inhaled aerosol products. This chapter summarizes excipients for pulmonary formulations from several perspectives (i) excipient selection based on principles of delivery, (ii) physicochemical requirements for excipients, and (iii) specific challenges for formulations faced with aerosol drug delivery systems, including (a) biological aspects, (b) microbiological aspects, (c) analytical issues, and (d) future prospects. 

Wilkes W, Fink J, Dhand R. Selecting an accessory device with a metered-dose inhaler variable influence of accessory devices on fine particle dose, throat deposition, and drug delivery with asynchronous actuation from a metered-dose inhaler. J Aerosol Med 2001 14(3)251-360. 

The systemic availability of an inhaled glucocorticoid represents the additive and complex combination of pulmonary and gastrointestinal drug absorption. Absorption is influenced by many factors, including delivery device, the use of a spacer, the particle size of the inhaled drug, and the absorption and metabolism of the swallowed drug (1). 

---