Turbuhaler

Turbuhaler management of chronic asthma in adults and children over age 6 ... 

Patients should also be educated to keep track of inhaler use. Many DPIs have a built-in counter or device to notify the patient of how many doses are remaining (e.g., Diskus and Twisthaler ) or that the inhaler is approaching empty (e.g., Turbuhaler ). 

Figure 5 shows examples of two dry powder inhalers, the Turbuhaler and the Diskus, currently marketed in the United States for the delivery of the steroids, budesonide and fluticosone, respectively. Table 6 shows the major elements of a number of passive dry powder inhalers. In addition to the commercially available passive inhalation products, a number of active dispersion systems are under development the key characteristics of selected devices are shown in Table 7. 

Turbuhaler - 200 Reservoir Shear force, capillary Shear Force... 

KIL Wetterlin. Turbuhaler a new powder inhaler for administration of drugs to the airways. Pharm Res 5 506-508, 1988. 

Newman, S.P., Moren, F., Trofast, E., Talaee, N., and Clarke, S.W., Deposition and clinical efficacy of terbutaline sulphate from Turbuhaler, a new multi-dose powder inhaler, Eur. Resp. J., 2 247-252 (1989). 

Devadason, S.G., Everard, M.L., MacEarlan, C., Roller, C., Summers, Q.A., Swift P., Borgs-trom, L., and Le Souef, P.N., Lung deposition from the Turbuhaler in children with cystic... 

Pulmicort Turbuhaler 19 Pyrazinamide 58 Pyrethrin 81 Pyridium 55 Pyridoxine 58 irndhamine 59, 75... 

For nebulizers and MDIs, the external resistance (Re) is quite low. Different approaches have been made to describe the external airflow resistance of DPIs. Olsson and Asking [99] derived an empirical relationship between flow rate () and pressure drop (AR), AR = for a number of inhalers (such as Rotahaler , Spinhaler and Turbuhaler ) in which they define the proportionality coefficient (C) as the airflow resistance. This relationship differs only slightly from the general (theoretical) equation for orifice types of flow constrictions ... 

It has been shown that the maximal in vitro FPF of most marketed devices is between approximately 20 and 50% of the nominal dose, but the maxima are achieved at different flow rates [109,110]. Lung depositions from a great number of DPI studies, summarized in two review articles [112,135], show that most systems have the same efficacy as MDIs (between 5 and 20% of the metered dose) with a few exceptions, such as the Easyhaler , Turbuhaler and Novolizer , which yield lung depositions between 20 and 30% of the dose, or even higher [135-137]. 

Powder Each actuation delivers 160 meg Rx) Pulmicort Turbuhaler (AstraZeneca)... 

Budesonide turbuhaler- In all patients, it is desirable to titrate to the lowest effective dose once asthma stability is achieved. 

ICS flow is device dependent with or without SHC but some may have delivery >MDI (e.g. Turbuhaler). 

Brand Name(s) Entocort EC, Pulmicort Respules, Pulmicort Turbuhaler, Rhinocort, Rhinocort Aqua... 

Aerosol powder (Turbuhaler) 160 mcg/activation Inhalation suspension (Respules) 0.25, 0.5 mg/2 mL Flunisolide (AeroBid, Aerospan)... 

Petersson, G., and Wiren, J. E. (1980), The brochodilator response from inhaled terbu-taline is influenced by the mass of small particles A study on a dry powder inhaler (Turbuhaler), Eur. Respir. 2, 253-256. 

Turbuhaler AstraZeneca Passive None Reservoir Multidose 200... 

The available studies suggest that fluticasone is more effective than beclomethasone, triamcinolone, or budesonide. However, budesonide delivered by Turbuhaler has equivalent efficacy to fluticasone delivered by metered-dose inhaler or Diskhaler, and is more effective than beclomethasone. When comparative safety is considered, budesonide and triamcinolone delivered by metered-dose inhaler have less systemic activity than fluticasone. Beclomethasone and fluticasone delivered by metered-dose inhaler are equivalent. Budesonide delivered by... 

Turbuhaler has less systemic activity than fluticasone delivered by Diskhaler (17). 

In a randomized, double-blind study, adult asthmatic patients took budesonide 800 micrograms/day over 12 weeks either by Easyhaler (n = 103) or by Turbuhaler (n = 58) dry powder inhaler. The Easyhaler was equivalent to the Turbuhaler with regard to safety and efficacy, but was more acceptable to the patients (23). 

Aaronson D, Kaiser H, Dockhorn R, Findlay S, Korenblat P, Thorsson L, Kallen A. Effects of budesonide by means of the Turbuhaler on the hypothalmic-pituitary-adrenal axis in asthmatic subjects a dose-response study. J Allergy Clin Immunol 1998 101(3) 312-9. 

Johnell O, Pauwels R, Lofdahl CG, Laitinen LA, Postma DS, Pride NB, Ohlsson SV. Bone mineral density in patients with chronic obstructive pulmonary disease treated with budesonide Turbuhaler. Eur Respir J 2002 19(6) 1058-63. 

Thorsson L, Edsbacker S, Kallen A, Lofdahl CG. Pharmacokinetics and systemic activity of fluticasone via Diskus and pMDI, and of budesonide via Turbuhaler. Br J Clin Pharmacol 2001 52(5) 529-38. 

Reservoir-type multiple-dose devices. Acompletely different approach was first introduced by AstraZeneca with the Turbuhaler (or Turbohaler in some countries), a powder reservoir from which the device meters each dose by the patient turning the knob at the bottom side of the device (Fig. 8.8). 

Since the device itself meters the dose, it must contain a precisely working measuring mechanism to ensure dose accuracy and consistency. The metering unit of the Turbuhaler consists of groups of truncated... 

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