Semin Respir Crit Care Med 2015; 36(04): 543-551
DOI: 10.1055/s-0035-1555612
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Novel Aerosol Delivery Devices

Supriya Singh
1   Section of Pulmonary, Critical Care & Sleep Medicine, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas
2   Section of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas
,
Faisal Kanbar-Agha
1   Section of Pulmonary, Critical Care & Sleep Medicine, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas
,
Amir Sharafkhaneh
1   Section of Pulmonary, Critical Care & Sleep Medicine, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas
2   Section of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
03 August 2015 (online)

Abstract

Delivery of medication to sites of action through airways has been used for centuries but has gained momentum in recent decades. Currently available modes of aerosol delivery offer advantages but still there are shortcomings. Delivery of active agents to sites of action is affected by many factors beyond the characteristics of the delivery devices, including the coordination between inhalation and actuation and dependence on the patient's inspiratory flow and breathing pattern. Recent advances in drug delivery focus around changes in the generation of particle size with better penetration to the targeted sites, easier activation of the device with inspiratory flow, ease of use including fewer steps in using the device, and better portability. Availability of computer chips allows for smart delivery devices to tailor delivery to the patient's breathing pattern and lung function. Further, smart devices can provide feedback to patients. Novel inhaler technologies, separately or in combination with new therapeutic agents, are in development not only for respiratory diseases but also for diseases of other systems. This article reviews some of the recent clinically relevant advances in aerosol delivery devices.

 
  • Reference

  • 1 Dolovich MB, Dhand R. Aerosol drug delivery: developments in device design and clinical use. Lancet 2011; 377 (9770) 1032-1045
  • 2 Lavorini F, Fontana GA, Usmani OS. New inhaler devices - the good, the bad and the ugly. Respiration 2014; 88 (1) 3-15
  • 3 Zhou QT, Tang P, Leung SSY, Chan JGY, Chan HK. Emerging inhalation aerosol devices and strategies: where are we headed?. Adv Drug Deliv Rev 2014; 75 (0) 3-17
  • 4 Hendeles L, Colice GL, Meyer RJ. Withdrawal of albuterol inhalers containing chlorofluorocarbon propellants. N Engl J Med 2007; 356 (13) 1344-1351
  • 5 Given J, Taveras H, Iverson H, Lepore M. Prospective, open-label assessment of albuterol sulfate hydrofluoroalkane metered-dose inhaler with new integrated dose counter. Allergy Asthma Proc 2013; 34 (1) 42-51
  • 6 Guidance for Industry: Integration of Dose-Counting Mechanisms into MDI Drug Products; 2003. 1–1-2015
  • 7 Laube BL, Janssens HM, de Jongh FH , et al; European Respiratory Society; International Society for Aerosols in Medicine. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J 2011; 37 (6) 1308-1331
  • 8 Newman SP, Weisz AW, Talaee N, Clarke SW. Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique. Thorax 1991; 46 (10) 712-716
  • 9 Tinkelman D Using an Autohaler®. 2012. National Jewish Health. 1–5-2015
  • 10 National Asthma Council Australia. Using Your Inhaler (Puffer) Properly Is Important When You Have Asthma or COPD (Chronic Obstructive Pulmonary Disease). 2015. 1–5-2015
  • 11 Price DB, Pearce L, Powell SR, Shirley J, Sayers MK. Handling and acceptability of the Easi-Breathe device compared with a conventional metered dose inhaler by patients and practice nurses. Int J Clin Pract 1999; 53 (1) 31-36
  • 12 Hampson NB, Mueller MP. Reduction in patient timing errors using a breath-activated metered dose inhaler. Chest 1994; 106 (2) 462-465
  • 13 Julius SM, Sherman JM, Hendeles L. Accuracy of three electronic monitors for metered-dose inhalers. Chest 2002; 121 (3) 871-876
  • 14 Weinstein C, Staudinger H, Scott I, Amar NJ, LaForce C. Dose counter performance of mometasone furoate/formoterol inhalers in subjects with asthma or COPD. Respir Med 2011; 105 (7) 979-988
  • 15 Leach CL, Davidson PJ, Hasselquist BE, Boudreau RJ. Influence of particle size and patient dosing technique on lung deposition of HFA-beclomethasone from a metered dose inhaler. J Aerosol Med 2005; 18 (4) 379-385
  • 16 Gupta R, Hindle M, Byron PR, Cox KA, McRae DD. Investigation of a novel condensation aerosol generator: solute and solvent effects. Aerosol Sci Technol 2003; 37 (8) 672-681
  • 17 Barnes PJ. Triple inhalers for obstructive airways disease: will they be useful?. Expert Rev Respir Med 2011; 5 (3) 297-300
  • 18 Chatterjee A, Shah M, D'Souza AO, Bechtel B, Crater G, Dalal AA. Observational study on the impact of initiating tiotropium alone versus tiotropium with fluticasone propionate/salmeterol combination therapy on outcomes and costs in chronic obstructive pulmonary disease. Respir Res 2012; 13: 15
  • 19 Brambilla G, Howlett D, Johnson R, Lewis DA. Metered-Dose Inhaler and Method of Using the Same. 3–15–2012. Google Patents
  • 20 Vehring R, Hartman MS, Lechuga-Ballesteros D, Smith AE, Joshi VB, Dwivedi SK. Compositions, Methods and Systems for Respiratory Delivery of Two or More Active Agents. 12–4-2012. Google Patents
  • 21 Vehring R, Lechuga-Ballesteros D, Joshi V, Noga B, Dwivedi SK. Cosuspensions of microcrystals and engineered microparticles for uniform and efficient delivery of respiratory therapeutics from pressurized metered dose inhalers. Langmuir 2012; 28 (42) 15015-15023
  • 22 Borgstrom L, Bisgaard H, O'Callaghan C, Pedersen S. Dry-Powder Inhaler. In: Bisgaard H, O'Callaghan C, Smaldone GC, , eds. Drug Delivery to the Lungs. New York: Marcel Dekker; 2002: 421-448
  • 23 Dolovich MB, Ahrens RC, Hess DR , et al; American College of Chest Physicians; American College of Asthma, Allergy, and Immunology. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest 2005; 127 (1) 335-371
  • 24 Developing an Efficient Dry Powder Inhaler 3M Conix™ DPI. 2011. 1–7-2015
  • 25 Hoppentocht M, Hagedoorn P, Frijlink HW, de Boer AH. Technological and practical challenges of dry powder inhalers and formulations. Adv Drug Deliv Rev 2014; 75: 18-31
  • 26 Usmani OS, Biddiscombe MF, Barnes PJ. Regional lung deposition and bronchodilator response as a function of beta2-agonist particle size. Am J Respir Crit Care Med 2005; 172 (12) 1497-1504
  • 27 Niven RW, Hickey AJ. Atomization and Nebulizers. In: Hickey AJ, , ed. Inhalation Aerosols. New York: Informa Healthcare; 2006: 253-284
  • 28 Daniels T, Mills N, Whitaker P. Nebuliser systems for drug delivery in cystic fibrosis. Cochrane Database Syst Rev 2013; 4: CD007639
  • 29 Dennis JH, Nerbrink O. New Nebulizer Technology. In: Bisgaard H, O'Callaghan C, Smaldone GC, , eds. Drug Delivery to the Lung. New York: Marcel Dekker, Inc.; 2002: 303-336
  • 30 Nikander K, Denyer J, Dodd M , et al. The Adaptive Aerosol Delivery system in a telehealth setting: patient acceptance, performance and feasibility. J Aerosol Med Pulm Drug Deliv 2010; 23 (Suppl. 01) S21-S27
  • 31 Denyer J, Dyche T. The Adaptive Aerosol Delivery (AAD) technology: Past, present, and future. J Aerosol Med Pulm Drug Deliv 2010; 23 (Suppl. 01) S1-S10
  • 32 Fischer A, Stegemann J, Scheuch G, Siekmeier R. Novel devices for individualized controlled inhalation can optimize aerosol therapy in efficacy, patient care and power of clinical trials. Eur J Med Res 2009; 14 (Suppl. 04) 71-77
  • 33 Rottier BL, van Erp CJ, Sluyter TS, Heijerman HG, Frijlink HW, Boer AH. Changes in performance of the Pari eFlow rapid and Pari LC Plus during 6 months use by CF patients. J Aerosol Med Pulm Drug Deliv 2009; 22 (3) 263-269
  • 34 Lenney W, Edenborough F, Kho P, Kovarik JM. Lung deposition of inhaled tobramycin with eFlow rapid/LC Plus jet nebuliser in healthy and cystic fibrosis subjects. J Cyst Fibros 2011; 10 (1) 9-14
  • 35 Dalby R, Spallek M, Voshaar T. A review of the development of Respimat Soft Mist Inhaler. Int J Pharm 2004; 283 (1-2) 1-9
  • 36 Wise RA, Anzueto A, Cotton D , et al; TIOSPIR Investigators. Tiotropium Respimat inhaler and the risk of death in COPD. N Engl J Med 2013; 369 (16) 1491-1501
  • 37 Bhavna, Ahmad FJ, Khar RK, Sultana S, Bhatnagar A. Techniques to develop and characterize nanosized formulation for salbutamol sulfate. J Mater Sci Mater Med 2009; 20 (1) (Suppl. 01) S71-S76
  • 38 Suk JS, Lai SK, Boylan NJ, Dawson MR, Boyle MP, Hanes J. Rapid transport of muco-inert nanoparticles in cystic fibrosis sputum treated with N-acetyl cysteine. Nanomedicine (Lond) 2011; 6 (2) 365-375
  • 39 Sosnik A, Carcaboso AM, Glisoni RJ, Moretton MA, Chiappetta DA. New old challenges in tuberculosis: potentially effective nanotechnologies in drug delivery. Adv Drug Deliv Rev 2010; 62 (4-5) 547-559
  • 40 Gelperina S, Kisich K, Iseman MD, Heifets L. The potential advantages of nanoparticle drug delivery systems in chemotherapy of tuberculosis. Am J Respir Crit Care Med 2005; 172 (12) 1487-1490
  • 41 Pison U, Welte T, Giersig M, Groneberg DA. Nanomedicine for respiratory diseases. Eur J Pharmacol 2006; 533 (1–3) 341-350
  • 42 Pandey R, Khuller GK. Solid lipid particle-based inhalable sustained drug delivery system against experimental tuberculosis. Tuberculosis (Edinb) 2005; 85 (4) 227-234
  • 43 Venegas J, Winkler T, Harris RS. Lung physiology and aerosol deposition imaged with positron emission tomography. J Aerosol Med Pulm Drug Deliv 2013; 26 (1) 1-8
  • 44 Mentore K, Froh DK, de Lange EE, Brookeman JR, Paget-Brown AO, Altes TA. Hyperpolarized HHe 3 MRI of the lung in cystic fibrosis: assessment at baseline and after bronchodilator and airway clearance treatment. Acad Radiol 2005; 12 (11) 1423-1429
  • 45 Klein JP, Cohen AB, Kimberly WT , et al. Diffusion-weighted magnetic resonance imaging of bilateral simultaneous optic nerve infarctions. Arch Neurol 2009; 66 (1) 132-133
  • 46 Plank C. Nanomagnetosols: magnetism opens up new perspectives for targeted aerosol delivery to the lung. Trends Biotechnol 2008; 26 (2) 59-63
  • 47 Dames P, Gleich B, Flemmer A , et al. Targeted delivery of magnetic aerosol droplets to the lung. Nat Nanotechnol 2007; 2 (8) 495-499
  • 48 Chatmongkolchart S, Schettino GP, Dillman C, Kacmarek RM, Hess DR. In vitro evaluation of aerosol bronchodilator delivery during noninvasive positive pressure ventilation: effect of ventilator settings and nebulizer position. Crit Care Med 2002; 30 (11) 2515-2519
  • 49 Branconnier MP, Hess DR. Albuterol delivery during noninvasive ventilation. Respir Care 2005; 50 (12) 1649-1653
  • 50 Jolliet P, Tassaux D, Roeseler J , et al. Helium-oxygen versus air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: A prospective, multicenter study. Crit Care Med 2003; 31 (3) 878-884