Abstract
Several factors affect drug delivery from dry powder inhalers (DPIs). Some are related to patient’s physiological characteristics, while others depend on DPIs’ technical aspects. The patient’s inspiratory airflow rate (IAR) affects the pressure drop and the turbulence needed to disaggregate the powder inside a DPI. The present study investigated whether lung function limitations occurring in asthmatic adolescents affect their IAR when inhaling through a DPI simulator. Eighteen consecutive adolescents with asthma were recruited, and IAR was randomly assessed at low-, mid-, and high-resistance regimens. A multiple logistic model was developed to evaluate the association of patients’ lung function characteristics and devices’ resistance with the probability to achieve the expected IAR (E-IAR). The mean value of E-IAR achieved seemed to be sex- and age-independent. Low- and high-resistance regimens were less likely to consent the E-IAR level (odds ratio [OR] = 0.035 and OR = 0.004, respectively). Only the basal residual volume and the inspiratory resistance, but not the Forced Expiratory Volume in 1 s (FEV1), seemed to affect the extent of IAR in asthmatic adolescents (OR = 1.131 and OR = 0.290, respectively). The results suggest that the assessment of current lung function is crucial for choosing the proper DPI for asthmatic adolescents.
Highlights
Inhalation is the most suitable and convenient route for delivering active drugs to patients suffering from airway obstruction
The results suggest that the assessment of current lung function is crucial for choosing the proper Dry powder inhalers (DPIs) for asthmatic adolescents
The present study investigated whether some parameters of lung function may predict the inspiratory airflow rate (IAR) of adolescents suffering from asthma when inhaling at different regimens of resistance
Summary
Inhalation is the most suitable and convenient route for delivering active drugs to patients suffering from airway obstruction. The inhalation technology was greatly improved over the last years, with the aim to improve its therapeutic effectiveness in more “difficult” and/or in “less compliant” patients who need long-term respiratory treatments, such as teenagers suffering from bronchial asthma. They are the most prescribed devices for daily and long-term asthma treatments [7,8]. Each DPI is characterized by its own intrinsic resistance This resistance depends on the original engineering of each DPI and determines the pressure drop induced by patients’ inspiratory airflow rate (IAR) across the DPI itself [9]. IAR is the only active force causing the pressure drop and consequent turbulence inside the DPI that are required for disaggregating the powder to inhale
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