Work

Evaluation of Preliminary Bronchodilation Effect on Aerosol Delivery from a Dry Powder Inhaler for Patients with Chronic Obstructive Pulmonary Disease with Suboptimal Peak Inspiratory Flow Rate

Year: 2025

Type: article

Abstract: Suboptimal peak inspiratory flow rates (PIFR) are common in patients with chronic obstructive pulmonary disease (COPD), hindering effective medication dispersion and aerosol delivery. This study aimed to assess whether administering a preliminary bronchodilator dose via a pressurized metered-dose inhaler (pMDI) improves aerosol drug delivery via dry powder inhaler (DPI) in patients with COPD with suboptimal PIFR (< 60 L/min), compared with those with optimal PIFR (≥ 60 L/min). Overall, 24 patients with COPD were evaluated. PIFR was measured using the In-Check Dial © G16, dividing patients into optimal and suboptimal groups. All patients received a 200 µg dose of salbutamol via Diskus ® DPI. Patients with COPD with suboptimal PIFR received two puffs (100 µg each) preceded by a preliminary salbutamol dose administered via pMDI ® . Urine salbutamol levels (USAL30) and salbutamol that was eluted from filters (SALF) were measured after 30 min to assess lung deposition through high-performance liquid chromatography (HPLC). Patients with COPD with suboptimal PIFR without a preliminary dose had significantly lower USAL30 than the optimal group (4.99% versus 6.18%, p = 0.013). A preliminary dose improved USAL30 in the suboptimal group but did not reach statistical significance (5.45% versus 4.99%, p = 0.071). A significant difference in aerosol drug delivery was observed between optimal and suboptimal groups without a preliminary dose, suggesting that inhaler selection in patients with COPD may need to be individualized on the basis of inspiratory flow capability. Administering a preliminary dose of pMDI ® before using a DPI minimally affects the suboptimal inhalation through DPI.

Source: Clinical Pharmacokinetics

DOI: 10.1007/s40262-025-01560-x

Authors: Mohamed Ismail Hassan, Nabila Ibrahim Laz, Yasmin M. Madney, Mohamed E. A. Abdelrahim, Hadeer S. Harb

Institutions: Sinai University, Beni-Suef University

Language: English

Topic: Inhalation and Respiratory Drug Delivery

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,990