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Dose‐response to salbutamol via a novel palm sized nebuliser (Aerodose® Inhaler), conventional nebuliser (Pari LC Plus) and metered dose inhaler (Ventolin™ Evohaler™) in moderate to severe asthmatics
Author(s) -
Lipworth Brian J.,
Sims Erika J.,
Taylor Karla,
Cockburn Wendy,
Fishman Robert
Publication year - 2005
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 - 10.1111/j.1365-2125.2005.02168.x
Subject(s) - salbutamol , inhaler , metered dose inhaler , medicine , nebulizer , potency , dry powder inhaler , bronchodilator , crossover study , anesthesia , spirometry , inhalation , asthma , chemistry , biochemistry , alternative medicine , pathology , in vitro , placebo
Aims The Aerodose® inhaler is a novel, palm‐sized, breath actuated device which requires little patient coordination. This study compared the dose–response of salbutamol delivered by the Aerodose® Inhaler (Aerogen Inc., Mountain View, USA) vs Pari LC Plus jet nebulizer (Pari LC Plus; Pari GmbH, Starnberg, Germany) and Ventolin™ Evohaler™ HFA pMDI (Evohaler; Allen & Hanburys [GlaxoSmithkline], Uxbridge, UK). Methods Twenty‐two moderate to severe asthmatic patients, mean (s.d.) age: 44.7 (9.4), FEV 1 : 58.1 (12.0), received 4 cumulative doubling doses of salbutamol in a randomised, investigator blind, balanced crossover design. Spirometry and systemic safety variables (heart rate, blood pressure, T wave amplitude, QTc interval and potassium) were measured at baseline and after each dose. Results Parallel regression analysis revealed that microgram relative potency ratios for the Aerodose® Inhaler to be five times more efficient for FEV 1 than either the Pari LC Plus (0.202, 90% CI: 0.189–0.216) or the Evohaler (0.202, 90% CI: 0.189–0.216), while there was no difference between Pari LC Plus vs Evohaler. Similarly, Aerodose® Inhaler vs. Pari LC Plus showed approximately five‐fold greater potency for all systemic parameters, except blood pressure. As compared to the Evohaler, Aerodose® Inhaler had equivalent potency for plasma potassium and T wave amplitude, but demonstrated greater potency for heart rate and QT c interval. Conclusions This study has indicated therefore, that Aerodose® Inhaler is approximately five times as efficient as the Pari LC Plus and Evohaler in relative lung delivery of salbutamol in moderate to severe asthmatics.