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Golshahi L, Finlay WH, Wachtel H. Use of Airway Replicas in Lung Delivery Applications. J Aerosol Med Pulm Drug Deliv 2022; 35:61-72. [PMID: 35262408 DOI: 10.1089/jamp.2021.29057.lg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The use of extrathoracic airway replicas in optimization of drug delivery to the lungs with nebulizers, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs) is discussed. Such airway replicas have been useful in evaluating new pulmonary drug delivery platforms mainly based on the comparison of the total lung dose (TLD) and the aerodynamic particle size distribution (APSD) of the aerosol distal to the physical models. The ability of these in vitro methods to replicate in vivo results has allowed advancements in respiratory drug delivery and in the accuracy and utility of in vitro-in vivo correlations (IVIVCs).
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Affiliation(s)
- Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Warren H Finlay
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Herbert Wachtel
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
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Newman SP, Chan HK. In vitro-in vivo correlations (IVIVCs) of deposition for drugs given by oral inhalation. Adv Drug Deliv Rev 2020; 167:135-147. [PMID: 32593641 DOI: 10.1016/j.addr.2020.06.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 06/01/2020] [Accepted: 06/23/2020] [Indexed: 12/30/2022]
Abstract
Conventional in vitro tests to assess the aerodynamic particle size distribution (APSD) from inhaler devices use simple right-angle inlets ("mouth-throats", MTs) to cascade impactors, and air is drawn through the system at a fixed flow for a fixed time. Since this arrangement differs substantially from both human oropharyngeal airway anatomy and the patterns of air flow when patients use inhalers, the ability of in vitro tests to predict in vivo deposition of pharmaceutical aerosols has been limited. MTs that mimic the human anatomy, coupled with simulated breathing patterns, have yielded estimates of lung dose from in vitro data that closely match those from in vivo gamma scintigraphic or pharmacokinetic studies. However, different models of MTs do not always yield identical data, and selection of an anatomical MT and representative inhalation profiles remains challenging. Improved in vitro - in vivo correlations (IVIVCs) for inhaled drug products could permit increased reliance on in vitro data when developing new inhaled drug products, and could ultimately result in accelerated drug product development, together with reduced research and development spending.
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Comparison of in vitro deposition of pharmaceutical aerosols in an idealized child throat with in vivo deposition in the upper respiratory tract of children. Pharm Res 2014; 31:1525-35. [PMID: 24395403 DOI: 10.1007/s11095-013-1258-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 12/05/2013] [Indexed: 12/26/2022]
Abstract
PURPOSE Deposition of drug emitted from two commercially available inhalers was measured in an in vitro child oral airway model and compared to existing in vivo data to examine the ability of the child model to replicate in vivo deposition. METHODS In vitro deposition of drug from a QVAR® pressurized metered dose inhaler (pMDI) and Pulmicort® Turbuhaler® dry powder inhaler (DPI) in an Idealized Child Throat (1) and downstream filter was measured using UV spectroscopy and simulated realistic breathing profiles. Potential effects of ambient relative humidity ranging from 10% to 90% on deposition were also considered. RESULTS In vitro QVAR pMDI deposition in the idealized mouth-throat at 50% RH (39.2 ± 2.3% of delivered dose) compared well (p>0.05) with in vivo extrathoracic deposition in asthmatic children age 8 to 14 (45.8 ± 12.3%). In vitro Turbuhaler DPI deposition in the idealized mouth-throat at 50% RH (69.0 ± 1.5%) matched in vivo extrathoracic deposition (p>0.05) in 6 to 16 year old children with cystic fibrosis (70.4 ± 21.2%). The effects of ambient humidity were found to be insignificant for Turbuhaler and minor for QVAR. CONCLUSIONS The Idealized Child Throat successfully mimics in vivo deposition data in school age children for the inhalers tested, and may provide a standard platform for optimizing pediatric treatment with inhaled pharmaceutical aerosols.
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Ehtezazi T, Davies MJ, Seton L, Morgan MN, Ross S, Martin GD, Hutchings IM. Optimizing the primary particle size distributions of pressurized metered dose inhalers by using inkjet spray drying for targeting desired regions of the lungs. Drug Dev Ind Pharm 2013; 41:279-91. [PMID: 24252108 DOI: 10.3109/03639045.2013.858741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conventional suspension pressurized metered dose inhalers (pMDIs) suffer not only from delivering small amounts of a drug to the lungs, but also the inhaled dose scatters all over the lung regions. This results in much less of the desired dose being delivered to regions of the lungs. This study aimed to improve the aerosol performance of suspension pMDIs by producing primary particles with narrow size distributions. Inkjet spray drying was used to produce respirable particles of salbutamol sulfate. The Next Generation Impactor (NGI) was used to determine the aerosol particle size distribution and fine particle fraction (FPF). Furthermore, oropharyngeal models were used with the NGI to compare the aerosol performances of a pMDI with monodisperse primary particles and a conventional pMDI. Monodisperse primary particles in pMDIs showed significantly narrower aerosol particle size distributions than pMDIs containing polydisperse primary particles. Monodisperse pMDIs showed aerosol deposition on a single stage of the NGI as high as 41.75 ± 5.76%, while this was 29.37 ± 6.79% for a polydisperse pMDI. Narrow size distribution was crucial to achieve a high FPF (49.31 ± 8.16%) for primary particles greater than 2 µm. Only small polydisperse primary particles with sizes such as 0.65 ± 0.28 µm achieved a high FPF with (68.94 ± 6.22%) or without (53.95 ± 4.59%) a spacer. Oropharyngeal models also indicated a narrower aerosol particle size distribution for a pMDI containing monodisperse primary particles compared to a conventional pMDI. It is concluded that, pMDIs formulated with monodisperse primary particles show higher FPFs that may target desired regions of the lungs more effectively than polydisperse pMDIs.
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Affiliation(s)
- T Ehtezazi
- School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University , Liverpool , UK
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Abstract
Existing pharmacopeial methods for the in vitro testing of orally inhaled products (OIPs) are simplified representations of clinical reality, as their objective is to provide metrics that are discriminating of product quality. Attempts to correlate measures such as fine particle fraction <5 µm aerodynamic diameter with in vivo measures of lung deposition have therefore been notoriously difficult to achieve. Although particle imaging-based techniques may be helpful to link in vitro to in vivo data as surrogates for clinical responses, a reappraisal of the purposes for laboratory-based testing of OIPs is required. This article provides guidance on approaches that may be helpful to develop clinically appropriate methods to assess OIP performance in the laboratory, with the ultimate goal of developing robust in vitro–in vivo relationships for the major inhaled drug classes.
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Below A, Bickmann D, Breitkreutz J. Assessing the performance of two dry powder inhalers in preschool children using an idealized pediatric upper airway model. Int J Pharm 2013; 444:169-74. [PMID: 23333708 DOI: 10.1016/j.ijpharm.2013.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
Abstract
High prevalence of pulmonary diseases in childhood requires inhalable medication even for young children. Little is known about the efficiency of aerosol therapy especially in preschool children. One factor which limits the lung dose is the upper airway geometry. Based on clinical data a recently developed idealized pediatric upper airway model (children 4-5 years) was used to investigate the performance of two dry powder inhalers (Easyhaler and Novolizer). In vitro investigations were first examined using steady flow rates and an inhalation volume of 1L. Chosen flow rates were 28, 41 and 60L/min (Easyhaler) and 45, 60 and 75L/min (Novolizer). Afterwards inhalation profiles simulated by an electronic lung were included. The investigations showed high amounts of drug particles (up to 80%) which were deposited in the upper airway model. The pulmonary deposition in vitro using the Easyhaler was about 28% (28-60L/min) and 22% (inhalation profile). Using the Novolizer in vitro pulmonary doses of 8-12% (45-75L/min) and about 5% (inhalation profile) were observed. The idealized model shows good performance reproducibility of dry powder inhalers. We have shown that age-dependent models might be appropriate tools for formulation and device development in pediatric age groups.
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Affiliation(s)
- Antje Below
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine University, Düsseldorf, Germany.
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Wei X, Wu H, Lu Q, Xu J, Xu Y. Nebulized liposomal gadobenate dimeglumine contrast formulation for magnetic resonance imaging of larynx and trachea. Int J Nanomedicine 2012; 6:3383-91. [PMID: 22267923 PMCID: PMC3260032 DOI: 10.2147/ijn.s25546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To develop a lipid-stabilized contrast formulation containing gadobenate dimeglumine for clear visualization of the mucosal surfaces of the larynx and trachea for early diagnosis of disease by magnetic resonance imaging. Methods The contrast formulation was prepared by loading gadobenate dimeglumine into egg phosphotidylcholine, cholesterol, and sterylamine nanoliposomes using the dehydration-rehydration method. The liposomal contrast formulation was ultrasonically nebulized, and the deposition and coating pattern on explanted pig laryngeal and tracheal segments was examined by inductively coupled plasma atomic emission spectroscopy. The sizes of the nebulized droplets were characterized by photon correlation spectroscopy. The contrast-enhanced mucosal surface images of the larynx and trachea were obtained in a 3.0T magnetic resonance scanner using a T1-weighted spectral presaturation inversion recovery sequence. Results Various cationic liposome formulations were compared for their stabilization effects on the droplets containing gadobenate dimeglumine. The liposomes composed of egg phosphotidylcholine, cholesterol, and sterylamine in a molar ratio of 1:1:1 were found to enable the most efficient nebulization and the resulting droplet sizes were narrowly distributed. They also resulted in the most even coating on the laryngeal and tracheal lumen surfaces and produced significant contrast enhancement along the mucosal surface. Such contrast enhancement could help clearer visualization of several disease states, such as intraluminal protrusions, submucosal nodules, and craters. Conclusion This lipid-stabilized magnetic resonance imaging contrast formulation may be useful for improving mucosal surface visualization and early diagnosis of disease originating in the mucosal surfaces of the larynx and trachea.
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Affiliation(s)
- Xiaohui Wei
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Su G, Pidaparti RM. Generating Nanoparticles for Respiratory Drug Delivery. J Nanotechnol Eng Med 2011. [DOI: 10.1115/1.4005488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Generating liquid droplets is ideal for many applications including respiratory drug delivery because the droplets have uniform properties and can be easily controlled, sampled, and analyzed. In this study, a micropump-based droplet generator is proposed to produce the liquid droplets of micron to nano size. Numerical simulations were carried out to evaluate the ability of the proposed droplet generator device to produce liquid droplets. The velocity and diameter of the droplets generated by the droplet generator device were calculated, and the performance of the device’s flow rate and power consumption was evaluated. The effects of actuation frequency, actuation modes, and nozzle geometry on the performance of the device were investigated. Results showed that the proposed device can produce micron-/nano-sized liquid droplets with low power and the advantages of the proposed droplet generator device over traditional devices were discussed.
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Affiliation(s)
- Guoguang Su
- Department of Mechanical Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Ramana M. Pidaparti
- Department of Mechanical Engineering, Virginia Commonwealth University, Richmond, VA 23284
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Byron PR, Hindle M, Lange CF, Longest PW, McRobbie D, Oldham MJ, Olsson B, Thiel CG, Wachtel H, Finlay WH. In Vivo–In VitroCorrelations: Predicting Pulmonary Drug Deposition from Pharmaceutical Aerosols. J Aerosol Med Pulm Drug Deliv 2010; 23 Suppl 2:S59-69. [DOI: 10.1089/jamp.2010.0846] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Peter R. Byron
- School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Michael Hindle
- School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | | | - P. Worth Longest
- School of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Donald McRobbie
- Radiological Sciences Unit, Imperial College Healthcare NHS Trust, United Kingdom
| | - Michael J. Oldham
- School of Engineering, Virginia Commonwealth University, Richmond, Virginia
- Altria Client Services, Richmond, Virginia
| | | | | | - Herbert Wachtel
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
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Ehtezazi T, Saleem I, Shrubb I, Allanson DR, Jenkinson ID, O’Callaghan C. The Interaction Between the Oropharyngeal Geometry and Aerosols via Pressurised Metered Dose Inhalers. Pharm Res 2009; 27:175-86. [DOI: 10.1007/s11095-009-9994-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 10/05/2009] [Indexed: 11/30/2022]
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Ehtezazi T, Allanson D, Jenkinson I, Shrubb I, O'Callaghan C. Investigating improving powder deagglomeration via dry powder inhalers at a low inspiratory flow rate by employing add‐on spacers. J Pharm Sci 2008; 97:5212-21. [DOI: 10.1002/jps.21375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Finlay WH, Martin AR. Recent advances in predictive understanding of respiratory tract deposition. J Aerosol Med Pulm Drug Deliv 2008; 21:189-206. [PMID: 18518795 DOI: 10.1089/jamp.2007.0645] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Accurate prediction of respiratory tract deposition is important in gauging the health risks of ambient bioaerosols and environmental aerosols, as well as in developing pharmaceutical aerosols for drug delivery. The present article highlights recent advances in the prediction of total, extrathoracic, and lung deposition fractions of inhaled aerosols over a broad range of parameters for both oral and nasal breathing. These advances build on recent data from in vivo and in vitro studies that have benefited from recent improvements in high-resolution imaging, rapid prototyping, and computational simulation abilities that have significantly enhanced the current understanding of respiratory tract deposition. It is anticipated that the relatively simple equations for predicting total or whole lung deposition that follow from the recent work discussed herein will allow for improved correlation between respiratory tract deposition and a wide range of health outcomes.
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Ehtezazi T, Allanson DR, Jenkinson ID, O'Callaghan C. Effect of Oropharyngeal Length in Drug Lung Delivery via Suspension Pressurized Metered Dose Inhalers. Pharm Res 2006; 23:1364-72. [PMID: 16715362 DOI: 10.1007/s11095-006-0163-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Accepted: 02/01/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine the effect of the oropharyngeal length in adults on the lung dose of a suspension pressurized metered dose inhaler, and whether employing small volume spacers can alter this role. METHODS Depositions of Ventolin Evohaler (100) microg in the oropharyngeal models of two healthy adult subjects with 17.1 cm (short cast) and 19.9 cm (long cast) centerline lengths via three small volume spacers [two spacers with 3 cm effective length but one with 6.5 cm2 (L3) and the other with 24.6 cm2 (L3W) cross sections, and the Optimiser] were studied. RESULTS Without using spacers, lung dose of the long cast (19.52 +/- 2.32 microg, mean +/- standard deviation) was significantly larger than that for the short cast (8.08 +/- 1.01 microg, p < 0.006). However, using the L3 spacer with the short cast made the lung dose (18.59 +/- 3.33 microg) similar to that for the long cast alone. Lung doses of the short cast (20.43 +/- 1.42 microg) and the long cast (30.81 +/- 1.84 microg) with the L3W spacer were similar to those with the L3 spacer. However, using the Optimiser spacer increased the lung dose for the short cast (22.27 +/- 6.03 microg) and significantly for the long cast (35.61 +/- 2.19 microg, p < 0.006) compared to those for the L3 spacer. Using spacers increased drug deposition in the oropharynx part of the short cast, and this reduced the lung dose compared to that for the long cast. CONCLUSION The oropharyngeal length in adults may affect the lung dose via the pMDIs, which may not be eliminated by using small volume spacers.
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Affiliation(s)
- T Ehtezazi
- School of Pharmacy & Chemistry, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.
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de Boer AH, Hagedoorn P, Gjaltema D, Goede J, Frijlink HW. Air classifier technology (ACT) in dry powder inhalation. Int J Pharm 2006; 310:81-9. [PMID: 16442246 DOI: 10.1016/j.ijpharm.2005.11.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Revised: 11/02/2005] [Accepted: 11/07/2005] [Indexed: 11/27/2022]
Abstract
In this study, the in vitro fine particle deposition from a multi dose dry powder inhaler (Novolizer) with air classifier technology has been investigated. It is shown that different target values for the fine particle fraction (fpf<5 microm) of the same drug can be achieved in a well-controlled way. This is particularly relevant to the application of generic formulations in the inhaler. The well-controlled and predictable fpf is achieved through dispersion of different types of formulations in exactly the same classifier concept. On the other hand, it is shown that air classifier-based inhalers are less sensitive to the carrier surface and bulk properties than competitive inhalers like the Diskus. For 10 randomly selected lactose carriers for inhalation from four different suppliers, the budesonide fpf (at 4 kPa) from the Novolizer varied between 30 and 46% (of the measured dose; R.S.D.=14.2%), whereas the extremes in fpf from the Diskus dpi were 7 and 44% (R.S.D.=56.2%) for the same formulations. The fpf from a classifier-based inhaler appears to be less dependent of the amount of lactose (carrier) fines (<15 microm) in the mixture too. Classifier-based inhalers perform best with coarse carriers that have relatively wide size distributions (e.g. 50-350 microm) and surface discontinuities inside which drug particles can find shelter from press-on forces during mixing. Coarse carrier fractions have good flow properties, which increases the dose measuring accuracy and reproducibility. The fpf from the Novolizer increases with increasing pressure drop across the device. On theoretical grounds, it can be argued that this yields a more reproducible therapy, because it compensates for a shift in deposition to larger airways when the flow rate is increased. Support for this reasoning based on lung deposition modelling studies has been found in a scintigraphic study with the Novolizer. Finally, it is shown that this inhaler produces a finer aerosol than competitor devices, within the fpf<5 microm, subfractions of particles (e.g. <1, 1-2, 2-3, 3-4 and 4-5 microm) are higher.
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Affiliation(s)
- A H de Boer
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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