Advertisement
Regular Article| Volume 95, ISSUE 12, P949-953, December 2001

Download started.

Ok

The efficacy of a new salbutamol metered-dose powder inhaler in comparison with two other inhaler devices

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      An open cross-over and randomized study was carried out in order to compare the efficacy and safety of inhaled salbutamol delivered from a new 50 μ g dose−1metered-dose dry powder inhaler Taifun®, and a commercially available 50 μ g dose−1dry powder inhaler Turbuhaler®, and a conventional 100 μ g dose−1pressurized metered-dose inhaler with a spacer (pMDI+S). Twenty-one patients, aged 21–70 years, with stable asthma and with demonstrated reversibility upon inhalation of salbutamol were included in the study. On three separate study days, the patients received a total dose of 400μ g of salbutamol from the dry powder inhalers and a dose of 800 μ g from the pMDI+S in a cumulative fashion: 1, 1, 2 and 4 doses at 30 min intervals. The per cent change in forced expiratory volume in 1 sec (FEV1), was used as the primary efficacy variable. Salbutamol inhaled via the Taifun®produced greater bronchodilation than the other devices. The difference in percent change in FEV1between the Taifun®and the other devices was statistically significant at the two first dose levels, but diminished towards the higher doses when the plateau of the dose–response curve was reached. The estimated relative dose potency of the Taifun®was approximately 1·9- and 2·8-fold compared to the Turbuhaler®and the pMDI+S, respectively. The Taifun®caused a slight, but clinically insignificant, decrease in serum potassium concentration. There were no significant changes in the other safety parameters (blood pressure, heart rate and electrocardiogram recordings) with any of the used devices. In conclusion, this study indicates that salbutamol inhaled via the Taifun®is more potent than salbutamol inhaled from the other devices tested. In practise, a smaller total dose of salbutamol from the Taifun®is needed to produce a similar bronchodilatory response. All treatments were equally well tolerated.

      Keywords

      References

      REFERENCES

      1. Global initiative for asthma: global strategy for asthma management and prevention, Bethesda, MD, National Heart, Lung and Blood Institute, 1995

        • Newman SP
        Metered dose pressurized aerosols and the ozone layer.
        Eur Respir J. 1990; 3: 495-497
        • Selroos O
        • Löfroos AB
        • Pietinalho A
        • Riska H
        Comparison of terbutaline and placebo from a pressurised metered dose inhaler and a dry powder inhaler in a subgroup of patients with asthma.
        Thorax. 1994; 49: 1228-1230
        • Lahdensuo A
        • Muittari A
        Bronchodilator effects of a fenoterol metered dose inhaler and fenoterol powder in asthmatics with poor inhaler technique.
        Eur J Respir Dis. 1986; 68: 332-335
        • Pitcairn GR
        • Lankinen T
        • Valkila E
        • Newman SP
        Lung deposition of salbutamol from the Leiras metered dose powder inhaler.
        J Aerosol Med. 1995; 8: 307-311
        • Seppälä OP
        • Kari E
        • Elo J
        • Löyttyniemi E
        • Kunkel G
        Comparison of the bronchodilating effects of a novel salbutamol metered dose powder inhaler and a pressurized metered dose aerosol with a spacer.
        Drug Res. 1998; 9: 919-923
        • Seppälä OP
        • Herrala J
        • Hedman J
        • Alanko K
        • Liippo K
        • Terho EO
        • Pietinalho A
        • Nyholm JE
        • Nieminen MM
        The bronchoprotective efficacy of salbutamol inhaled from a new metered dose powder inhaler compared with a conventional pressurized metered-dose inhaler connected to a spacer.
        Respir Med. 1998; 92: 578-583
        • Smolensky MH
        • Reinberg A
        • Queng JT
        The chronobiology and chronopharmacology of allergy.
        Ann Allergy. 1981; 47: 234-252
        • Selroos O
        • Pietinalho A
        • Riska H
        Delivery devices for inhaled asthma medication. Clinical implications of differences in effectiveness.
        Clin Immunother. 1996; 6: 273-299
        • Pawels R
        • Newman S
        • Borgström L
        Airway deposition and airway effects of antiasthma drugs delivered from metered dose inhalers.
        Eur Respir J. 1997; 10: 2127-2138
        • Borgström L
        • Newman S
        • Weisz A
        • Moren F
        Pulmonary deposition of inhaled terbutaline: a comparison of two methods: scanning gamma camera and urinary excretion.
        J Pharm Sci. 1992; 81: 1-3
        • Borgström L
        • Newman SP
        Total and regional lung deposition of terbutaline sulphate inhaled via a pressurised MDI or via Turbuhaler.
        Int J Pharm. 1993; 97: 47-53
        • Carlsson AL
        • Arweström E
        • Friberg K
        • Källen A
        • Lunde H
        • Löfdahl CG
        Efficacy of cumulative doses of salbutamol administered via Turbuhaler or Diskhaler in patients with reversible airway obstruction.
        Allergy. 1998; 53: 712-715
        • Mahadewsingh JV
        • Hamersma W BGJ
        • Schreurs A JM
        Relative efficacy of three different inhalers containing salbutamol in patients with asthma.
        Eur J Clin Pharmacol. 1996; 50: 467-469
        • Bondesson E
        • Friberg K
        • Soliman S
        • Löfdahl CG
        Safety and efficacy of a high cumulative dose of salbutamol inhaled via Turbuhaler or via a pressurized metered dose inhaler in patients with asthma.
        Respir Med. 1998; 92: 325-330
        • Lipworth BJ
        • McDevitt DG
        • Struthers AD
        Systemic β -adrenoceptor responses to salbutamol given by metered-dose inhaler alone and with pear shaped spacer attachment: comparison of electrocardiographic, hypokalaemic and haemodynamic effects.
        Br J Clin Pharmacol. 1989; 27: 837-842
        • Lipworth BJ
        • Tregaskis BF
        • McDevitt DG
        β-adrenoceptor responses to inhaled salbutamol in the elderly.
        Br J Clin Pharmacol. 1989; 28: 725-729