Lung deposition of inhaled tobramycin with eFlow rapid/LC Plus jet nebuliser in healthy and cystic fibrosis subjects

Lenney, Warren; Edenborough, Frank; Kho, Pearl; Kovarik, John M.

doi:10.1016/j.jcf.2010.08.019

Cited by 68 publications

(51 citation statements)

References 23 publications

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“…Indeed, the proportion of the dose reaching the lungs was high compared with the classical nondrug targeting nebulizers. 25,26 It is consistent with a previous study with 6 subjects with ␣1-penetration index deficiency. 27 This improved efficiency is probably related to the electronically guided inspiration 25 and to the low breathing frequency 15 generated by the Akita, which are known to be beneficial for lung deposition and to target the peripheral lung as a region of interest.…”

Section: Discussionsupporting

confidence: 92%

Effect of Drug Targeting Nebulization on Lung Deposition: A Randomized Crossover Scintigraphic Comparison Between Central and Peripheral Delivery

et al. 2014

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BACKGROUND: Recent technological advances in nebulization permit researchers to target specific parts of the lungs by modifying delivery method. The aim of this study was to compare the central and peripheral targeted modalities of administration. METHODS: Lung and regional deposition of inhaled technetium-99m diethylene triamine penta-acetic was measured by scintigraphy after peripheral and central targeted modalities of administration with an Akita device in 6 healthy subjects. RESULTS: Drug targeting nebulization delivered a large amount of drug into the peripheral part of the lung independent of the modality (outer-to-inner deposition ratio of 1.24 ؎ 0.21 vs 1.22 ؎ 0.14 for central and peripheral modalities, respectively), but there was no difference in lung deposition (whole-body deposition, 83.3 ؎ 6.5% vs 82.8 ؎ 7.3%, P ‫؍‬ .86) or regional deposition (P ‫؍‬ .77) between both modalities. The extrathoracic deposition was < 20% of the wholebody deposition, without a difference between modalities (P ‫؍‬ .86). CONCLUSIONS: This study shows for the first time that choosing 2 different specific drug targeting nebulization modes does not influence the amount of drug delivered into the lung in healthy male subjects. Moreover, the modes do not modify the site of deposition under the conditions of our study.

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Section: Discussionsupporting

confidence: 92%

Effect of Drug Targeting Nebulization on Lung Deposition: A Randomized Crossover Scintigraphic Comparison Between Central and Peripheral Delivery

et al. 2014

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“…Mesh nebulizers were compared with conventional jet nebulizers with mains-powered compressors in Figure 1. The results of the in vivo studies in Figure 1 [44,[50][51][52][53][54][55][56][57] suggest that lung deposition is also similar for both types of nebulizers. For instance, when an aerosol with a mass median diameter (MMD) of 3 μm was produced by both a mesh nebulizer and a jet nebulizer, the lung deposition was 80% of the delivered dose.…”

Section: Mesh Nebulizers Versus Jet Nebulizers In Vivomentioning

confidence: 99%

Mesh Nebulizers have Become the First Choice for New Nebulized Pharmaceutical Drug Developments

Pritchard

Hatley

Denyer³

et al. 2018

Ther. Deliv.

109

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In the 24 years since first being marketed, the mesh nebulizer has been developed by five main manufacturers into a viable solution for the delivery of high-value nebulized drugs. Mesh nebulizers provide increased portability, convenience and energy efficiency along with similar lung deposition and increased ease of use compared with jet nebulizers. An analysis of EU and US clinical trial databases has shown that mesh nebulizers are now preferred over jet nebulizers for clinical trials sponsored by pharmaceutical companies. The results show a strong preference for the use of mesh nebulizers in trials involving high cost and niche therapy areas. Built-in capability to optimize the way patients use their mesh nebulizer and manage their disease will further increase uptake. [Formula: see text]

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“…It is a highly efficient nebulizer that provides approximately 90% of the nominal dose in a short treatment duration. Recent studies showed that the eFlow can improve patient compliance due to short nebulization time (33). Also, the eFlow has a range of optimal fill volumes up to 4 ml and can be used with a variety of drug formulations, such as highly viscous fluids, proteins, peptides, suspensions, and surfactants.…”

Section: Active Mesh Nebulizersmentioning

confidence: 99%

Jet, Ultrasonic, and Mesh Nebulizers: An Evaluation of Nebulizers for Better Clinical Outcomes

Ari

2014

Eurasian J Pulmonol

145

110

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For over a century, nebulizers have been commonly used to deliver aerosolized medications in the treatment of patients with pulmonary diseases. They are the aerosol device of choice when patients can not coordinate inhalation and actuation needed for the use of the pressurized metered-dose inhalers (pMDIs) or are not able to provide the necessary inspiratory flow required by the dry powder inhaler (DPI) for effective aerosol drug delivery. Three types of nebulizers exist: (1) jet nebulizers, (2) ultrasonic nebulizers, and (3) mesh nebulizers. The purpose of this paper is to explain the types of nebulizers available on the market and to evaluate their efficiencies in aerosol drug delivery while suggesting strategies for the optimal treatment of patients with pulmonary diseases. Keywords: Nebulizers, aerosols, inhalation therapyDelivery of aerosolized drugs was revolutionized in the 1950s with the development of nebulizers and pressurized metered-dose inhalers. Nebulizers transform liquid formulations and suspension into medical aerosol. In the past few years, there have been advances in the development of new nebulizers that hold the promise to improve aerosol drug delivery to patients with pulmonary diseases. Nebulizers are divided into three categories: (1) jet nebulizers, (2) ultrasonic nebulizers, and (3) mesh nebulizers. While jet nebulizers are commonly used for the treatment of patients with pulmonary diseases, they are bulky and require a power source. Due to aerosolized droplets and solvent vapor that saturates the outgoing air, jet nebulizers cool the drug solution in the nebulizer and increase solute concentration in the residual volume. Although ultrasonic nebulizers are more efficient and compact than jet nebulizers, they can not be used to deliver proteins or suspensions. With the development of mesh nebulizers that use lower-frequency waves, heating issues that denature proteins during aerosol therapy are eliminated. Also, it has been shown that mesh nebulizers are suitable for delivery of suspensions, liposomes, and nucleic acids (1-5). Since there is a large number of nebulizers in each category that have been introduced to the market, the purpose of this paper is to explain the types of nebulizers available and to evaluate their efficiencies in aerosol drug delivery. In addition, strategies for optimal inhalation treatment of patients with pulmonary diseases will be investigated. JET NEBULIZERSTraditionally, jet nebulizers have been used for the treatment of pulmonary diseases. These nebulizers require 2 to 10 L/min of pressurized gas to draw medication up through a capillary tube from the nebulizer reservoir in order to generate a wide range of particle sizes that are blasted into one or more baffles, which take larger particles out of suspension and return them to the reservoir.Jet nebulizers are effective in delivering formulations that can not be delivered with pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs). For instance, antibiotics, mucolytics, liposomal f...

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Lung deposition of inhaled tobramycin with eFlow rapid/LC Plus jet nebuliser in healthy and cystic fibrosis subjects

Abstract: eFlow rapid reduces the nebulisation time of tobramycin and can potentially improved compliance in patients with CF.

Cited by 68 publications

References 23 publications

Effect of Drug Targeting Nebulization on Lung Deposition: A Randomized Crossover Scintigraphic Comparison Between Central and Peripheral Delivery

Effect of Drug Targeting Nebulization on Lung Deposition: A Randomized Crossover Scintigraphic Comparison Between Central and Peripheral Delivery

Mesh Nebulizers have Become the First Choice for New Nebulized Pharmaceutical Drug Developments

Jet, Ultrasonic, and Mesh Nebulizers: An Evaluation of Nebulizers for Better Clinical Outcomes

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