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Effect of electrostatic charge in plastic spacers on the lung delivery of HFA‐salbutamol in children
Author(s) -
Anhøj Jacob,
Bisgaard Hans,
Lipworth Brian J.
Publication year - 1999
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.1999.00893.x
Subject(s) - salbutamol , crossover study , metered dose inhaler , inhalation , benzalkonium chloride , anesthesia , mouthpiece , medicine , chemistry , chromatography , inhaler , asthma , alternative medicine , dentistry , pathology , placebo
Aims The effect of the electrostatic charge in plastic spacers in vivo on drug delivery to the lung of hydrofluoroalkane (HFA) salbutamol spray was studied in children.Methods Five children, aged 7–12 years, were included in a 3‐way crossover randomised single‐blind trial. Salbutamol HFA spray was delivered on 3 different study days from plastic spacers with mouthpiece. Pre‐treatment of the spacers differed between study days: (a) Non‐electrostatic 350 ml Babyhaler (coated with benzalkonium chloride) (b) New 350 ml Babyhaler (rinsed in water), and (c) New 145 ml AeroChamber (rinsed in water). Plasma salbutamol was measured before and 5, 10, 15 and 20 min after inhalation of four single puffs of 100 μg salbutamol. C max and C av (5–20min) were calculated as a reflection of lung dose.Results For C max : (A) Non‐electrostatic Babyhaler 4.3 ng ml −1 (B) New Babyhaler 1.9 ng ml −1 (C) New AeroChamber 1.6 ng ml −1 : AvsB (95% CI for difference 0.5–4.5 ng ml −1 ), A vs C (95% CI for difference 0.7–4.8 ng ml −1 ). The geometric mean ratio for A:B was 2.4 fold, and for A:C was 2.9 fold. The values for C av were similar with ratios for A:B of 2.4 fold, and A:C of 4.1 fold. The nonelectrostatic Babyhaler delivered a significantly (P<0.05) higher lung dose (for both C max and C av ) than either of the other two spacers.Conclusions The electrostatic charge in plastic spacers reduces lung dose in children by more than two‐fold. This is clinically significant and the use of potentially electrostatically charged spacers should be avoided.