Skip to main content

Pulmonary Deposition and Effects of Aerosolized Drugs in Pulmonary Patients

  • Conference paper
  • 390 Accesses

Abstract

Over the two last decades, clinicians have conducted numerous studies to document both the beneficial and the adverse effects of aerosolized drugs in pulmonary patients and to determine their exact place in the treatment of pulmonary disorders. This body of literature has been recently summarized in a number of consensus documents on the management of asthma and chronic obstructive pulmonary disease (COPD), the two most prominent pulmonary disorders. In these statements, the important role of inhaled drugs in the treatment of these disorders has been unequivocally reported.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

10. References

  1. Brocklebank D, Wright J, Cates C. Systematic review of clinical effectiveness of pressurised metered dose inhalers versus other hand held inhaler devices for delivering corticosteroids in asthma. BMJ 2001; %20;323(7318):896–900.

    Google Scholar 

  2. Ram FS, Wright J, Brocklebank D, White JE. Systematic review of clinical effectiveness of pressurised metered dose inhalers versus other hand held inhaler devices for delivering beta (2)agonists bronchodilators in asthma. BMJ 2001; %20;323(7318):901–905.

    Google Scholar 

  3. International commission on radiological protection (ICRP). Human respiratory tract model for radiological protection. Ann ICRP 1994; 24:36–52.

    Article  Google Scholar 

  4. Zanen P, Go LT, Lammers JW. The efficacy of a low-dose, monodisperse parasympathicolytic aerosol compared with a standard aerosol from a metered-dose inhaler. Eur J Clin Pharmacol 1998; 54(l):27–30.

    Article  PubMed  CAS  Google Scholar 

  5. Newman SP, Hirst PH, Pitcairn GR. Understanding regional lung deposition data in gamma scintigraphy. In: Dalby RN, Byron PR, Farr SJ, editors. Respiratory Drug Delivery VI. Interpharm Press, Inc: Buffalo Grove, IL, 1998: 9–16.

    Google Scholar 

  6. Linden A, Rabe KF, Lofdahl CG. Pharmacological basis for duration of effect: formoterol and salmeterol versus short-acting beta 2-adrenoceptor agonists. Lung 1996; 174(1): 1–22.

    PubMed  CAS  Google Scholar 

  7. Derom EY, Pauwels RA. Time course of bronchodilating effect of inhaled formoterol, a potent and long acting sympathomimetic. Thorax 1992; 47(l):30–33.

    Article  PubMed  CAS  Google Scholar 

  8. Ullman A, Svedmyr N. Salmeterol, a new long acting inhaled beta2 adrenoceptor agonist: comparison with salbutamol in adult asthmatic patients. Thorax 1988; 43(9):674–678.

    Article  PubMed  CAS  Google Scholar 

  9. Palmqvist M, Persson G, Lazer L, Rosenborg J, Larsson P, Lötvall J. Inhaled dry-powder formoterol and salmeterol in asthmatic patients: onset of action, duration of effect and potency. Eur Respir J 1997; 10(ll):2484–2489.

    Article  PubMed  CAS  Google Scholar 

  10. McFadden ER, Casale TB, Edwards TB, Kemp JP, Metzger WJ, Nelson HS et al. Administration of budesonide once daily by means of turbuhaler to subjects with stable asthma. J Allergy Clin Immunol 1999; 104(l):46–52.

    Article  PubMed  CAS  Google Scholar 

  11. Campbell LM. Once-daily inhaled corticosteroids in mild to moderate asthma: improving acceptance of treatment. Drugs 1999; 58 Suppl 4:25–33.

    Article  Google Scholar 

  12. Miller-Larsson A, Mattsson H, Hjertberg E, Dahlback M, Tunek A, Brattsand R. Reversible fatty acid conjugation of budesonide. Novel mechanism for prolonged retention of topically applied steroid in airway tissue. Drug Metab Dispos 1998; 26(7):623–630.

    PubMed  CAS  Google Scholar 

  13. Saari M, Vidgren MT, Koskinen MO, Turjanmaa VM, Nieminen MM. Pulmonary distribution and clearance of two beclomethasone liposome formulations in healthy volunteers. Int J Pharm 1999; 181(l):l-9.

    Google Scholar 

  14. Currie DC, Pavia D, Agnew JE, Lopez-Vidriero MT, Diamond PD, Cole PJ et al. Impaired tracheobronchial clearance in bronchiectasis. Thorax 1987; 42(2): 126–130.

    Article  PubMed  CAS  Google Scholar 

  15. Newman S, Steed K, Hooper G, Källén A, Borgström L. Comparison of gamma scintigraphy and a pharmacokinetic technique for assessing pulmonary deposition of terbutaline sulphate delivered by pressurized metered dose inhaler. Pharm Res 1995; 12(2):231–236.

    Article  PubMed  CAS  Google Scholar 

  16. Borgström L, Newman S, Weisz A, Morén F. Pulmonary deposition of inhaled terbutaline: comparison of scanning gamma camera and urinary excretion methods. J Pharm Sci 1992;81(8):753–755.

    Article  PubMed  Google Scholar 

  17. Bennett WD, Ilowite JS. Dual pathway clearance of 99mTc-DTPA from the bronchial mucosa. Am Rev Respir Dis 1989; 139(5): 1132–1138.

    Article  PubMed  CAS  Google Scholar 

  18. Hochhaus G, Mollmann H, Derendorf H, Gonzalez-Rothi RJ. Pharmacokinetic/pharmacodynamic aspects of aerosol therapy using glucocorticoids as a model. J Clin Pharmacol 1997; 37(10):881–892.

    Article  PubMed  CAS  Google Scholar 

  19. Thorsson L, Dahlstrom K, Edsbäcker S, Källén A, Paulson J, Wiren JE. Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects. Br J Clin Pharmacol 1997; 43(2):155–161.

    Article  PubMed  CAS  Google Scholar 

  20. Ryrfeldt Â, Andersson P, Edsbäcker S, Tonnesson M, Davies D, Pauwels R. Pharmacokinetics and metabolism of budesonide, a selective glucocorticoid. Eur J Respir Dis Suppl 119 1982; 122:86–95.

    Google Scholar 

  21. Lönnebo A, Grahnén A, Jansson B, Brundin RM, Ling-Andersson A, Eckernas SA. An assessment of the systemic effects of single and repeated doses of inhaled fluticasone propionate and inhaled budesonide in healthy volunteers. Eur J Clin Pharmacol 1996; 49(6):459–463.

    Article  PubMed  Google Scholar 

  22. Derom E, Van Schoor J, Verhaeghe W, Vincken W, Pauwels R. Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma. Am J Respir Crit Care Med 1999; 160(1):157–161.

    Article  PubMed  CAS  Google Scholar 

  23. Kelly HW. Establishing a therapeutic index for the inhaled corticosteroids: part I. Pharmacokinetic/pharmacodynamic comparison of the inhaled corticosteroids. J Allergy Clin Immunol 1998; 1998(102):S36–S51.

    Article  Google Scholar 

  24. Daley-Yates PT, Price AC, Sisson JR, Pereira A, Dallow N. Beclomethasone dipropionate: absolute bioavailability, pharmacokinetics and metabolism following intravenous, oral, intranasal and inhaled administration in man. Br J Clin Pharmacol 2001; 51(5):400–409.

    Article  PubMed  CAS  Google Scholar 

  25. WHO. Global Initiative for Asthma;Pocket guide for asthma management and prevention. National Heart LaBI, editor. 1998. Washington.

    Google Scholar 

  26. WHO. Global Initiative for Chronic Obstructive Lung Disease; NHLBI/WHO workshop report. National Heart LaBI, editor. 2001. Washington.

    Google Scholar 

  27. Pauwels RA, Lofdahl CG, Postma DS, Tattersfield AE, O’Byrne P, Barnes PJ et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med 1997; 337(20):1405–1411.

    Article  PubMed  CAS  Google Scholar 

  28. Pedersen S. Inhalers and nebulizers: which to choose and why. Respir Med 1996; 90(2):69–77.

    Article  PubMed  CAS  Google Scholar 

  29. Lipworth BJ, Clark RA, Dhillon DP, Brown RA, McDevitt DG. Beta-adrenoceptor responses to high doses of inhaled salbutamol in patients with bronchial asthma. Br J Clin Pharmacol 1988;26(5):527–533.

    Article  PubMed  CAS  Google Scholar 

  30. Pauwels R, Newman S, Borgström L. Airway deposition and airway effects of antiasthma drugs delivered from metered-dose inhalers. Eur Respir J 1997; 10(9):2127–2138.

    Article  PubMed  CAS  Google Scholar 

  31. Barnes PJ, Pedersen S, Busse WW. Efficacy and safety of inhaled corticosteroids. New developments. Am J Respir Crit Care Med 1998; 157(3 Pt 2):S1-S53.

    Article  Google Scholar 

  32. Taylor DA, Jensen MW, Kanabar V, Engelstätter R, Steinijans VW, Barnes PJ et al. A dose-dependent effect of the novel inhaled corticosteroid ciclesonide on airway responsiveness to adenosine-5’-monophosphate in asthmatic patients. Am J Respir Crit Care Med 1999; 160(l):237–243.

    Article  PubMed  CAS  Google Scholar 

  33. Pauwels RA, Hargreave FE, Camus P, Bukoski M, Stahl E. A 1-year comparison of turbuhaler vs pressurized metered-dose inhaler in asthmatic patients. Chest 1996; 110(l):53–57.

    Article  PubMed  CAS  Google Scholar 

  34. Snell NJ, Ganderton D. Assessing lung deposition of inhaled medications. Consensus statement from a workshop of the British Association for Lung Research, held at the Institute of Biology, London UK on 17 april 1998. Respir Med 1999; 93:123–133.

    Article  PubMed  CAS  Google Scholar 

  35. Dolovich MB, Sanchis J, Rossman C., Newhouse MT. Aerosol penetrance: a sensitive index of peripheral airways obstruction. J Appl Physiol 1976; 40(3):468–471.

    PubMed  CAS  Google Scholar 

  36. Itoh H, Ishii Y, Maeda H, Todo G, Torizuka K, Smaldone GC. Clinical observations of aerosol deposition in patients with airways obstruction. Chest 1981; 80(6 Suppl):837–840.

    PubMed  CAS  Google Scholar 

  37. Dolovich M. In vitro measurements of delivery of medications from MDIs and spacer devices. J Aerosol Med 1996; 9 Suppl 1:S49–58.:S49-S58.

    Google Scholar 

  38. Richards R, Dickson CR, Renwick AG, Lewis RA, Holgate ST. Absorption and disposition kinetics of cromolyn sodium and the influence of inhalation technique. J Pharmacol Exp Ther 1987;241(3):1028–1032.

    PubMed  CAS  Google Scholar 

  39. Borgström L, Nilsson M. A method for determination of the absolute pulmonary bioavailability of inhaled drugs: terbutaline. Pharm Res 1990; 7:1068–1070.

    Article  PubMed  Google Scholar 

  40. Thorsson L, Edsbäcker S. Lung deposition of budesonide from a pressurized metered-dose inhaler attached to a spacer. Eur Respir J 1998; 12(6):1340–1345.

    Article  PubMed  CAS  Google Scholar 

  41. Thorsson L, Edsbäcker S, Conradson TB. Lung deposition of budesonide from Turbuhaler is twice that from a pressurized metered-dose inhaler P-MDI. Eur Respir J 1994; 7(10): 1839–1844.

    Article  PubMed  CAS  Google Scholar 

  42. Thorsson L, Kenyon C., Newman S, Borgström L. Lung deposition of budesonide in asthmatics: a comparison of different formulations. Int J Pharm 1998; 168:119–127.

    Article  CAS  Google Scholar 

  43. Borgström L. The pharmacokinetics of inhaled hydrofluoroalkane formulations. J Allergy Clin Immunol 1999; 104(6):S246–S249.

    Article  Google Scholar 

  44. Leach C. Effect of formulation parameters on hydrofluoroalkane-beclomethasone dipropionate drug deposition in humans. J Allergy Clin Immunol 1999; 104(6):S250-S252.

    Article  Google Scholar 

  45. Leach CL, Davidson PJ, Boudreau RJ. Improved airway targeting with the CFC-free HFA- beclomethasone metered-dose inhaler compared with CFC-beclomethasone. Eur Respir J 1998; 12(6):1346–1353.

    Article  PubMed  CAS  Google Scholar 

  46. Mackie AE, McDowall JE, Falcoz C., Ventresca P, Bye A, Daley-Yates PT. Pharmacokinetics of fluticasone propionate inhaled via the Diskhaler and Diskus powder devices in healthy volunteers. Clin Pharmacokinet 2000; 39 Suppl l:23–30.:23–30.

    Article  PubMed  CAS  Google Scholar 

  47. Brindley C., Falcoz C., Mackie AE, Bye A. Absorption kinetics after inhalation of fluticasone propionate via the Diskhaler, Diskus and metered-dose inhaler in healthy volunteers. Clin Pharmacokinet 2000; 39 Suppl l:l-8.:l-8.

    Article  Google Scholar 

  48. Newman SP, Steed KP, Reader SJ, Hooper G, Zierenberg B. Efficient delivery to the lungs of flunisolide aerosol from a new portable hand-held multidose nebulizer. J Pharm Sci 1996; 85(9):960–964.

    Article  PubMed  CAS  Google Scholar 

  49. Newman SP, Brown J, Steed KP, Reader SJ, Kladders H. Lung deposition of fenoterol and flunisolide delivered using a novel device for inhaled medicines: comparison of RESPIMAT with conventional metered-dose inhalers with and without spacer devices. Chest 1998; 113(4):957–963.

    Article  PubMed  CAS  Google Scholar 

  50. Newman S, Pavia D, Garland N, Clarke SW. Effects of various inhalation modes on the deposition of radioactive pressurized aerosols. Eur J Respir Dis 1982; 63 Suppl. 119:57–65.

    CAS  Google Scholar 

  51. Farr SJ, Rowe AM, Rubsamen R, Taylor G. Aerosol deposition in the human lung following administration from a microprocessor controlled pressurised metered dose inhaler. Thorax 1995; 50(6):639–644.

    Article  PubMed  CAS  Google Scholar 

  52. 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.

    Article  PubMed  CAS  Google Scholar 

  53. Newman S, Pavia D, Clarke S. Simple instructions for using pressurized aerosol bronchodilators. J Roy Soc Med 1980; 73:776–779.

    PubMed  CAS  Google Scholar 

  54. Lawford P, McKenzie D. Pressurized aerosol inhaler technique: how important are inhalation from residual volume, inspiratory flow rate and the time interval between puffs? Br J Dis Chest 1983; 77:276–281.

    Article  PubMed  CAS  Google Scholar 

  55. Dolovich M. Inhalation technique and inhalation devices. In: Pauwels R, O’Byrne PO, editors. Beta2-agonists in asthma treatment. New York, Basel, Hong Kong: M.Dekker, Inc, 1997: 229–256.

    Google Scholar 

  56. Pitcairn G, Lunghetti G, Ventura P, Newman S. A comparison of the lung deposition of salbutamol inhaled from a new dry powder inhaler, at two inhaled flow rates. Int J Pharm 1994; 102:11–18.

    Article  CAS  Google Scholar 

  57. Newman S, Morén F, Trofast E, Talaee N, Clarke S. Terbutaline sulphate terbutaline: effect of inhaled flow rate on drug deposition and efficacy. Int J Pharm 1991; 74:209–213.

    Article  CAS  Google Scholar 

  58. Olsson B, Borgström L. Author’s response. J Aerosol Med 1996; 9:281–283.

    Article  Google Scholar 

  59. Borgström L, Bondesson E, Morén F, Trofast E, Newman SP. Lung deposition of budesonide inhaled via Turbuhaler: a comparison with terbutaline sulphate in normal subjects. Eur Respir J 1994;7(l):69–73.

    Article  PubMed  Google Scholar 

  60. Pedersen S. How to use a Rotahaler? Arch Dis Child 1986; 61:11–14.

    Article  PubMed  CAS  Google Scholar 

  61. Dolovich M, Vanziegelheim M, Hidinger K. Influence of inspiratory flow rate on the response to terbutaline sulphate inhaled via the Turbuhaler. Am.Rev.Respir.Dis. 137, 433. 1988.

    Google Scholar 

  62. Pedersen S, Hansen OR, Fuglsang G. Influence of inspiratory flow rate upon the effect of a Turbuhaler. Arch Dis Child 1990; 65(3):308–310.

    Article  PubMed  CAS  Google Scholar 

  63. Pauwels R, Derom E. Deposition and pharmacodynamics of terbutaline inhaled via Turbuhaler. J Aerosol Med 1991; 4:A187.

    Google Scholar 

  64. Borgström L, Derom E, Stâhl E, Wâhlin-Boll E, Pauwels R. The inhalation device influences lung deposition and bronchodilating effect of terbutaline. Am J Respir Crit Care Med 1996; 153(5):1636–1640.

    Article  PubMed  Google Scholar 

  65. Derom E, Van Schoor J, Borgström L, Löfroos AB, Pauwels R. Lung deposition and clinical effect of Terbutaline delivered from pMDI and turbuhaler on airway responsiveness in patients with asthma. Am J. Respir. Crit. Care Med. 159, A859. 1999.

    Google Scholar 

  66. Svedmyr N, Löfdahl C., Svedmyr K. The effect of powder aerosol compared to pressurized aerosol. Eur J Respir Dis 1982; 63 Suppl. 119:81–88.

    CAS  Google Scholar 

  67. Duncan D, Paterson I, Harris D, Crompton G. Comparison of the effects of salbutamol inhaled as a dry powder and by conventional pressurized aerosol. Br J Clin Pharmacol 1977; 4:669–671.

    Article  Google Scholar 

  68. Hetzel MR, Clark TJ. Comparison of salbutamol Rotahaler with conventional pressurized aerosol. Clin Allergy 1977; 7(6):563–568.

    Article  PubMed  CAS  Google Scholar 

  69. Carlsson LG, Arwestrom E, Friberg K, Källén A, Lunde H, Löfdahl CG. Efficacy of cumulative doses of salbutamol administered via Turbuhaler or Diskhaler in patients with reversible airway obstruction. Allergy 1998; 53(7):712–715.

    Article  PubMed  CAS  Google Scholar 

  70. Löfdahl CG, Andersson L, Bondesson E, Carlsson LG, Friberg K, Hedner J et al. Differences in bronchodilating potency of salbutamol in Turbuhaler as compared with a pressurized metered-dose inhaler formulation in patients with reversible airway obstruction. Eur Respir J 1997; 10(11):2474–2478.

    Article  PubMed  Google Scholar 

  71. Goodman DE, Israel E, Rosenberg M, Johnston R, Weiss ST, Drazen JM. The influence of age, diagnosis, and gender on proper use of metered-dose inhalers. Am J Respir Crit Care Med 1994; 150(5 Pt 1): 1256–1261.

    Article  PubMed  CAS  Google Scholar 

  72. Böllert FG, Matusiewicz SP, Dewar MH, Brown GM, McLean A, Greening AP et al. Comparative efficacy and potency of ipratropium via Turbuhaler and pressurized metered-dose inhaler in reversible airflow obstruction. Eur Respir J 1997; 10(8): 1824–1828.

    Article  PubMed  Google Scholar 

  73. Gross G, Thompson PJ, Chervinsky P, Van den Burgt J. Hydrofluoroalkane-134a beclomathasone dipropionate, 400 ug, is as effective as chlorofluorocarbon beclomethasone dipropionate, 800 jug, for the treatment of moderate asthma. Chest 1999; 115:343–351.

    Article  PubMed  CAS  Google Scholar 

  74. Salzman GA, Pyszczynski DR. Oropharyngeal candidiasis in patients treated with beclomethasone dipropionate delivered by metered-dose inhaler alone and with Aerochamber. J Allergy Clin Immunol 1988; 81(2):424–428.

    Article  PubMed  CAS  Google Scholar 

  75. Selroos O, Backman R, Forsen KO, Löfroos AB, Niemisto M, Pietinalho A et al. Local side-effects during 4-year treatment with inhaled corticosteroids: a comparison between pressurized metered-dose inhalers and Turbuhaler. Allergy 1994; 49(10):888–890.

    Article  PubMed  CAS  Google Scholar 

  76. Borgström L. Local versus total systemic bioavailability as a means to compare different inhaled formulations of the same substance. J Aerosol Med 1998; 11:55–63.

    Article  PubMed  Google Scholar 

  77. Thorsson L. Studies on the deposition, bioavailability and systemic activity of glucocorticoids in man. Lund University, Lund, Sweden, 1998.

    Google Scholar 

  78. Morgan DJ, Pauli JD, Richmond BH, Wilson-Evered E, Ziccone SP. Pharmacokinetics of intravenous and oral salbutamol and its sulphate conjugate. Br J Clin Pharmacol 1986; 22(5):587–593.

    Article  PubMed  CAS  Google Scholar 

  79. Roy A, Leblanc C., Paquette L, Ghezzo H, Cote J, Cartier A et al. Skin bruising in asthmatic subjects treated with high doses of inhaled steroids: frequency and association with adrenal function. Eur Respir J 1996; 9(2):226–231.

    Article  PubMed  CAS  Google Scholar 

  80. Brown PH, Matusiewicz SP, Shearing C., Tibi L, Greening AP, Crompton GK. Systemic effects of high dose inhaled steroids: comparison of beclomethasone dipropionate and budesonide in healthy subjects. Thorax 1993; 48(10):967–973.

    Article  PubMed  CAS  Google Scholar 

  81. Pedersen S, Steffensen G, Ohlsson SV. The influence of orally deposited budesonide on the systemic availability of budesonide after inhalation from a Turbuhaler. Br J Clin Pharmacol 1993; 36(3):211–214.

    Article  PubMed  CAS  Google Scholar 

  82. Borgström L. In vitro, ex vivo, in vivo Veritas. Allergy 1999; 54:88–92.

    Article  PubMed  Google Scholar 

  83. Derom E, Pauwels R. Bioequivalence of inhaled drugs. Eur Respir J 1995; 8(10): 1634–1636.

    Article  PubMed  CAS  Google Scholar 

  84. Miller MR, Bright P. Differences in output from corticosteroid inhalers used with a volumatic spacer. Eur Respir J 1995; 8(10):1637–1638.

    Article  PubMed  CAS  Google Scholar 

  85. Barry PW, O’Callaghan C. In vitro comparison of the amount of salbutamol available for inhalation from different formulations used with different spacer devices. Eur Respir J 1997; 10(6):1345–1348.

    Article  PubMed  CAS  Google Scholar 

  86. Borgström L, Bengtsson T, Derom E, Pauwels R. Variability in lung deposition of inhaled drug, within and between asthmatic patients, with a pMDI and a dry powder inhaler, Turbuhaler(R). Int J Pharm 2000; 193(2):227–230.

    Article  PubMed  Google Scholar 

  87. Borgström L, Asking L, Beckman O, Bondesson E, Källén A, Olsson B. Discrepancy between in vitro and in vivo dose variability for a pressurized metered dose inhaler and a dry powder. J Aerosol Med 1998; 11 :S59–S64.

    Article  Google Scholar 

  88. Meakin BJ, Cainey J, Woodcock PM. Effect of exposure to humidity on terbutaline delivery from turbuhaler dry power inhalation devices. Eur Respir J 1993; 6(5):760–761.

    PubMed  CAS  Google Scholar 

  89. Everard ML, Devadason SG, Summers QA, LeSoüef PN. Factors affecting total and “respirable” dose delivered by a salbutamol metered dose inhaler. Thorax 1995; 50(7):746–749.

    Article  PubMed  CAS  Google Scholar 

  90. Wildhaber JH, Devadason SG, Eber E, Hayden MJ, Everard ML, Summers QA et al. Effect of electrostatic charge, flow, delay and multiple actuations on the in vitro delivery of salbutamol from different small volume spacers for infants. Thorax 1996; 51(10):985–988.

    Article  PubMed  CAS  Google Scholar 

  91. Barry PW, O’Callaghan C. The effect of delay, multiple actuations and spacer static charge on the in vitro delivery of budesonide from the Nebuhaler. Br J Clin Pharmacol 1995; 40(1):76–78.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media Dordrecht

About this paper

Cite this paper

Derom, E. (2003). Pulmonary Deposition and Effects of Aerosolized Drugs in Pulmonary Patients. In: Gradoń, L., Marijnissen, J. (eds) Optimization of Aerosol Drug Delivery. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0267-6_13

Download citation

  • DOI: https://doi.org/10.1007/978-94-017-0267-6_13

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-90-481-6436-3

  • Online ISBN: 978-94-017-0267-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics