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.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Clinical Pharmacokinetics Pub Date : 2025-08-29 DOI:10.1007/s40262-025-01560-x

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

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引用次数: 0

Abstract

Background: 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).

Methods: 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).

Results: 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).

Conclusions: 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.

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干粉吸入器对慢性阻塞性肺疾病呼吸流量峰值次优患者气溶胶输送支气管扩张效果的初步评价

背景：慢性阻塞性肺疾病（COPD）患者中常见的吸气流量峰值（PIFR），阻碍了有效的药物分散和气溶胶递送。本研究旨在评估与PIFR（≥60l /min）较优的COPD患者相比，通过加压计量吸入器（pMDI）给予支气管扩张剂初步剂量是否能改善PIFR （< 60l /min）次优COPD患者通过干粉吸入器（DPI）雾化给药。方法：对24例慢性阻塞性肺病患者进行评估。采用In-Check Dial©G16测量PIFR，将患者分为最优组和次优组。所有患者均通过Diskus®DPI接受200µg剂量的沙丁胺醇。PIFR不理想的COPD患者接受两次抽吸（每次100µg），然后通过pMDI®给药初步剂量的沙丁胺醇。30 min后测定尿液沙丁胺醇水平（USAL30）和从过滤器中洗脱的沙丁胺醇（SALF），通过高效液相色谱（HPLC）评估肺沉积。结果：未初始剂量的次优PIFR COPD患者USAL30显著低于最佳组（4.99% vs 6.18%, p = 0.013）。初步剂量改善了次优组的USAL30，但未达到统计学意义（5.45%比4.99%,p = 0.071）。结论：在没有初始剂量的情况下，最优组和次优组在雾化给药方面存在显著差异，提示COPD患者吸入器的选择可能需要根据吸气流量能力进行个体化。在使用DPI之前给予初步剂量的pMDI®对通过DPI的次优吸入的影响最小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Pharmacokinetics 医学-药学

CiteScore

8.80

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Pharmacokinetics promotes the continuing development of clinical pharmacokinetics and pharmacodynamics for the improvement of drug therapy, and for furthering postgraduate education in clinical pharmacology and therapeutics. Pharmacokinetics, the study of drug disposition in the body, is an integral part of drug development and rational use. Knowledge and application of pharmacokinetic principles leads to accelerated drug development, cost effective drug use and a reduced frequency of adverse effects and drug interactions.