The role of disposable inhalers in pulmonary drug delivery

Abstract

Prerequisites for the use of disposable inhalers, particularly dry powder inhalers, in applications such as childhood vaccination and for preventing or stopping pandemic outbreaks of highly infectious diseases (like influenza, bird flu, SARS) are that they are simple, cheap and effective. Not only do the devices have to be simple in design, but the drug formulations should also be cheap. This may require a different approach as the formulation may not need to be adapted to improve the inhaler must be designed to enhance formulation dispersion.

Dry powder inhalation: past, present and future

“…However, inhaled vaccination as one-off administration depends on a high reliability regarding delivered fine particle dose on the target area. This requires highly efficient inhaler technology which also needs to be disposable, simple, and cheap to facilitate mass vaccination programs in developing countries [172]. It may also be of utmost importance to develop reusable instruction and feedback systems for such disposable inhalers in order to practice the inhalation maneuver and check correct inhalation during vaccine delivery.…”

“…It may also be of utmost importance to develop reusable instruction and feedback systems for such disposable inhalers in order to practice the inhalation maneuver and check correct inhalation during vaccine delivery. Disposable DPIs are furthermore recommended for hygroscopic drug formulations and antibiotics [172]. For a realistic future expectation, it may be wise not to think too much in terms of feasible applications, however, but rather in terms of DPI technique itself and what is possible with this technique.…”

“…For future applications (e.g. hygroscopic formulations), it also has to be considered whether disposable or reusable inhalers are the best option [172]. Finally, new inhaler technology should enable training of the proper inhalation technique by providing feedback about the inhalation maneuver during drug administration to the patient or the health-care professional during inhalation [186].…”

Reply to the comment by de Boer and Hoppentocht on: Inhaled Antimicrobial therapy – Barriers to effective treatment, by J. Weers, Adv. Drug Deliv. Rev. (2015), http://dx.doi.org/10.1016/j.addr.2014.08.013

“…Beyond their arguments regarding the Twincer device, de Boer and Hoppentocht have also made several misleading comments in the literature, not backed by experimental data, with respect to the use of capsule-based inhalers for the delivery of inhaled antibiotics, and in particular the TOBI Podhaler drug product [11,12,23]. Some of these comments expressed as direct quotations are addressed below:…”

“…"Aminoglycosides are prone to adhere onto inhaler walls and build up huge deposits that after exposure to high relative humidity transfer into a viscous syrup. This is fatal for further inhalations from the same inhaler" [23] -There are specific design features in the device that minimize the impact of humidity on functionality [21]. The delivered dose for the TOBI Podhaler drug product is high (N 90% of the nominal dose), thereby minimizing powder retention in the device.…”