The Bioavailability of Salbutamol in Urine via Volumatic and Nonvolumatic Valved Holding Chambers

World Allergy Organization Journal

Mohammadreza Masjedi⁷  Shadi Baniasadi⁶  Hamid Mahboobi Pour⁸  Azita Hajhossein Talasaz¹  Pegah Abdolahi⁵  Atefeh Fakharian²  Jamshid Salamzadeh⁵  Farzad Kobarfard³  Fanak Fahimi⁴ 

[1] Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran;Department of Pulmonology, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Department of Medicinal Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Department of Pharmaceutical Care, Chronic Respiratory Disease Research Center, TB and Lung Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Virology Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Chronic Respiratory Disease Research Center, TB and Lung Disease Research Center, NRITLD, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Hepatology and Gasteroenterology, Gastrointestinal Department, Karaj University of Medical Sciences, Karaj, Iran

关键词: spirometry;    salbutamol;    urinary concentration;    valved holding chamber;    asthma;   

Others  :  1145535
DOI  :  10.1097/WOX.0b013e31823890f6

【 摘 要 】

Purpose

Pressurized metered dose inhalers are commonly used in patients with asthma. However, the need to coordinate inhalation with inhaler actuation means that they are not suitable for use per se. Valved holding chamber devices were developed to overcome some of the problems of pressurized metered dose inhalers. Several types of holding chambers of different sizes are available in Iran. This study was designed to compare the effects of 2 commonly used valved holding chambers (Asthm Yar and Dam Yar) in Iran on bioavailability of salbutamol spray and also spirometric parameters in asthmatic patients.

Methods

This was a comparative experimental crossover study. Patients with mild to moderate asthma were entered in this study. Lung function was assessed using a portable spirometer (Spirolab, Progetti, Italy). Spirometric parameters of forced expiratory flow (FEF)_50%, FEF_25-75%, peak expiratory flow (PEF), forced expiratory volume in the first second of expiration (FEV₁), forced vital capacity (FVC), and FEV₁/FVC were measured. Urinary concentration of salbutamol as an index of pulmonary bioavailability was assayed with high-performance liquid chromatography.

Results

Forty patients (25 women and 15 men) with the mean age of 43.10 ± 12.99 years were studied. Mean ± SD changes of spirometric parameters before and after using Asthm Yar were not significantly different from those of Dam Yar. The relative bioavailability after inhalation with Asthm Yar was significantly higher than after inhalation with Dam Yar (P = 0.002).

Conclusions

Although the results indicate that relative bioavailability to the lung after inhalation with Asthm Yar was significantly higher than after inhalation with Dam Yar, its clinical importance should be tested.

【 授权许可】

   
2011 World Allergy Organization; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Rubin BK: Air and soul: the science and application of aerosol therapy. Respir Care 2010, 55:911-921.
• [2]Berger W: Aerosol devices and asthma therapy. Curr Drug Deliv 2009, 6:38-49.
• [3]Hess DR: Aerosol delivery devices in the treatment of asthma. Respir Care 2008, 53:699-723.
• [4]Bisgaard H: Aerosol treatment of young children. Eur Respir Rev 1994, 4:15-20.
• [5]Connett GJ, Warde C, Wooler E, Lenny W: Use of budenoside in severe asthmatic aged 1-3 years. Arch Dis Child 1993, 69:351-355.
• [6]Halloworth GW, Swarbrick J, Boylan JC: Metered dose inhalers pressurized systems. In Encyclopedia of Pharmaceutical Technology. Volume 9. New York: Marcel Dekker; 1994::299-329.
• [7]Tal A, Golan H, Grauer N, Aviram M, Albin D, Quastel MR: Deposition pattern of radiolabeled salbutamol inhaled from a metered dose inhaler by means of a spacer with mask in young children with airway obstruction. J Pediatr 1996, 128:479-484.
• [8]Konig P: Spacer devices used with metered dose inhalers. Breakthrough or gimmick? Chest 1985, 88:276-284.
• [9]Newman SP, Millar AB, Lennard-Jones TR, Moren F, Clarke SW: Improvement of pressurized aerosol deposition with Nebuhaler spacer device. Thorax 1984, 39:935-941.
• [10]Hindle M, Chrystyn H: Relative bioavailability of salbutamol to the lung following inhalation using metered dose inhalation methods and spacer devices. Thorax 1994, 49:549-553.
• [11]Nagel MW, Wiersema KJ, Bates SL, Mitchell JP: Performance of large- and small-volume valved holding chambers with a new combination long-term bronchodilator/anti-inflammatory formulation delivered by pressurized metered dose inhaler. Aerosol Med 2002, 15:427-433.
• [12]Mazhar SR, Chrystyn H: Salbutamol relative lung and systemic bioavailability of large and small spacers. J Pharm Pharmacol 2008, 60:1609-1613.
• [13]Tomlinson HS, Corllet SA, Allen MB, Chrystyn H: Assessment of different methods of inhalation from salbutamol metered dose inhalers by urinary drug excretion and methacholine challenge. Br J Clin Pharmacol 2005, 60:605-610.
• [14]Hindle M, Chrystyn H: Determination of the relative bioavailability of salbutamol to the lung following inhalation. Br J Clin Pharm 1992, 34:311-315.
• [15]Global Initiative for Asthma (GINA): Global Strategy for Asthma Management and Prevention. NHLBI/WHO Workshop Report. National Institutes of Health, National Heart, Lung and Blood Institute: 1995. National Institutes of Health publication. Available at: http://www.ginasthma.org/Guidelines/guidelines-gina-report-global-strategy-for-asthma.html webcite. Accessed October 30, 2011
• [16]Chrystyn H, Hindle M: Investigation of an optimal inhaler technique with the use of urinary salbutamol excretion as a measure of relative bioavailability to the lung. Thorax 1993, 48:607-610.
• [17]Paul M, Hogan J, Krikorian J: A comparison of bronchodilator therapy delivered by nebulization and metered-dose inhaler in mechanically ventilated patients. Chest 1999, 115:1653-1657.
• [18]Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A: Standardization of spirometry. Eur Respir J 2005, 26:319-338.
• [19]Syndor LR, Krikland I: Introduction to Modern Liquid Chromatography. 2nd edition. Chichester, United Kingdom: John Willey & sons; 1970:83-165.
• [20]Walker SL, Owen J: The effect of inhalation technique, spacer, volume and training on aerosol delivery from spacers in children. In Presented at: American Thoracic Society Conference; May 20-25, 2005. San Diego, CA;
• [21]Chrystyn H, Allen MD, Corlett SA, Tomlinson HS: Simultaneous measurement of pharmacodynamic and pharmacokinetics parameters which can be used to evaluate the equivalence of inhaled salbutamol. Am J Respir Crit Care Med 1998, 157:A636.
• [22]Tomlinson HS, Corlett SA, Chrystyn H: Dose-response relationship and reproducibility of urinary salbutamol excretion during the first 30 min after an inhalation. Br J Clin Pharmacol 2003, 56:225-227.
• [23]Wildhaber JH, Devadason SG, Hayden MJ, James R, Dufty AP, Fox RA, Summers QA, LeSouëf PN: Electrostatic charge on a plastic spacer device influences the delivery of salbutamol. Eur Respir J 1996, 9:1943-1946.
• [24]Wildhaber JH, Devadason SG, Eber E, Hayden MJ, Everard ML, et al.: Effect of electrostatic charge, flow, delay and multiple actuations on the in vitro delivery of salbutamol from different small volume spacers for infants. Thorax 1996, 51:985-988.
• [25]Chuffart AA, Sennhauser FH, Wildhaber JH: Factors affecting the efficiency of aerosol therapy with pressurized metered-dose inhalers through plastic spacers. Swiss Med Wkly 2001, 131:14-18.
• [26]Lipworth BJ, Clark DJ: Early drug absorption profile of non-CFC salbutamol via small and large volume plastic spacer devices. Br J Clin Pharmacol 1998, 46:45-48.