Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices

Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered do...

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Main Author: Pierre Ernst
Format: Article
Language:English
Published: Wiley 1998-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/1998/802829
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author Pierre Ernst
author_facet Pierre Ernst
author_sort Pierre Ernst
collection DOAJ
description Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI); its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs) as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs) are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.
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spelling doaj-art-7b18a636ea874dd3b3b3e13189f36a4b2025-02-03T00:58:59ZengWileyCanadian Respiratory Journal1198-22411998-01-015318018310.1155/1998/802829Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler DevicesPierre Ernst0Respiratory Division, Montreal General Hospital, McGill University, Montreal, Quebec, CanadaDirect delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI); its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs) as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs) are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.http://dx.doi.org/10.1155/1998/802829
spellingShingle Pierre Ernst
Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
Canadian Respiratory Journal
title Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
title_full Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
title_fullStr Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
title_full_unstemmed Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
title_short Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices
title_sort inhaled drug delivery a practical guide to prescribing inhaler devices
url http://dx.doi.org/10.1155/1998/802829
work_keys_str_mv AT pierreernst inhaleddrugdeliveryapracticalguidetoprescribinginhalerdevices