Incorrect Holding Angle of Dry Powder Inhaler during the Drug-Loading Step Significantly Decreases Output Efficiency

• Suenaga Kana

  College of Pharmaceutical Sciences, Ritsumeikan University

• Hira Daiki

  College of Pharmaceutical Sciences, Ritsumeikan University Department of Pharmacy, Shiga University of Medical Science Hospital

• Ishido Eri

  College of Pharmaceutical Sciences, Ritsumeikan University

• Koide Hiroyoshi

  Department of Pharmacy, Shiga University of Medical Science Hospital

• Ueshima Satoshi

  College of Pharmaceutical Sciences, Ritsumeikan University

• Okuda Tomoyuki

  Faculty of Pharmacy, Meijo University

• Yamaguchi Masafumi

  Department of Respiratory Medicine, Shiga University of Medical Science

• Morita Shin-ya

  Department of Pharmacy, Shiga University of Medical Science Hospital

• Okamoto Hirokazu

  Faculty of Pharmacy, Meijo University

• Okano Tomonobu

  College of Pharmaceutical Sciences, Ritsumeikan University

• Nakano Yasutaka

  Department of Respiratory Medicine, Shiga University of Medical Science

• Terada Tomohiro

  Department of Pharmacy, Shiga University of Medical Science Hospital

• Kakumoto Mikio

  College of Pharmaceutical Sciences, Ritsumeikan University

抄録

It is well known that correct use of inhalers plays a critical role in optimal inhalation therapy, but the impact of incorrect inhaler use on pulmonary drug delivery has not been quantitatively evaluated. The aim of this study was to investigate the frequency of holding inhalers at incorrect angles during the drug-loading step while using Turbuhaler^® and to quantify the influence of the inhaler angle on in vitro pulmonary delivery. Thirty patients prescribed Turbuhaler^® at Shiga University of Medical Science Hospital were enrolled. During inhalation, the participants’ inhalation techniques were assessed by clinical pharmacists. Additionally, the influence of the inhaler angle on pulmonary delivery of budesonide via Symbicort^® Turbuhaler^® was investigated using a Twin-Stage Liquid Impinger. Output efficiency (OE), stage 2 deposition (St2), and OE × St2 were calculated. An incorrect angle during the drug-loading step was observed in 33.3% of the participants. In vitro testing demonstrated that OE, an index of the loaded dose, significantly decreased by 73.3% at an incorrect angle, while St2, an index of the deagglomerating efficiency, was stable independent of the holding angle. OE × St2, indicating the bronchial and pulmonary drug delivery amount, decreased by 76.9%. An incorrect holding angle reduced the loaded dose, resulting in decreased pulmonary delivery. Error in the inhaler angle occurs frequently and demonstrates a considerable impact on pulmonary drug delivery. Hence, it is necessary to assess the Turbuhaler^® angle during inhalation.

収録刊行物

• Ｂｉｏｌｏｇｉｃａｌ　＆　Ｐｈａｒｍａｃｅｕｔｉｃａｌ　Ｂｕｌｌｅｔｉｎ

  Ｂｉｏｌｏｇｉｃａｌ　＆　Ｐｈａｒｍａｃｅｕｔｉｃａｌ　Ｂｕｌｌｅｔｉｎ 44 (6), 822-829, 2021-06-01

  公益社団法人 日本薬学会

キーワード

• inhalation instruction
• pulmonary drug delivery
• inhaled corticosteroid
• anti-asthmatic drug
• inhalation therapy

詳細情報

• CRID: 1390006740593099264
• NII論文ID: 130008046714
• NII書誌ID: AA10885497
• DOI: 10.1248/bpb.b21-00009
• ISSN: 13475215
• ISSN: 09186158
• NDL書誌ID: 031478631
• PubMed: 34078814
• Web Site: http://id.ndl.go.jp/bib/031478631
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I031478631
• Web Site: https://www.jstage.jst.go.jp/article/bpb/44/6/44_b21-00009/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022074042
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可