Drug delivery to the lung / edited by Hans Bisgaard, Chris O'Callaghan, Gerald C. Smaldone.

Format:

Book

Contributor:

Bisgaard, Hans, 1955-

O'Callaghan, Christopher.

Smaldone, Gerald C.

Series:

Lung biology in health and disease ; v. 162.

Lung biology in health and disease ; 162

Language:

English

Subjects (All):

Aerosol therapy.

Inhalers.

Lung--metabolism.

Administration, Inhalation.

Aerosols.

Drug Delivery Systems.

Medical Subjects:

Lung--metabolism.

Administration, Inhalation.

Aerosols.

Drug Delivery Systems.

Genre:

Conference papers and proceedings.

Physical Description:

xvi, 511 pages, 1 unnumbered page of plates : illustrations (some color) ; 24 cm.

Place of Publication:

New York : M. Dekker, [2002]

Contents:

1. The History of Inhaled Drug Therapy / Chris O'Callaghan, Ola Nerbrink, Mika T. Vidgren 1

II. Smokes and Vapors 1

III. Inhalation of Droplets 3

IV. The Pressurized Metered-Dose Inhaler 9

V. Asthma Deaths 11

VI. Dry-Powder Inhalers 15

2. Basic Principles of Particle Behavior in the Human Respiratory Tract / Joachim Heyder, Magnus U. Svartengren 21

II. Particle Transport onto Airway Surfaces 22

III. Particle Deposition

Definitions and Fundamental Considerations 25

IV. Total Deposition 27

V. Regional Deposition 33

VI. Modeling of Particle Deposition 37

VII. Consequences for Aerosol Therapy of Particle Behavior in the Respiratory Tract 38

3. Structure and Function of the Respiratory System: Developmental Aspects and Their Relevance to Aerosol Therapy / Janet Stocks, Alison A. Hislop 47

II. Structural Organization of the Respiratory System 48

III. Developmental Changes in Respiratory Function That Will Influence Aerosol Therapy 71

IV. Conclusions and Future Directions 87

4. In Vitro Testing of Pharmaceutical Aerosols and Predicting Lung Deposition from In Vitro Measurements / Andy Clark, Lars Borgstrom 105

II. Aerosol Characterization Techniques 107

III. In Vivo Characterization Techniques 116

IV. In Vitro Characterization: Issues and Limitations 120

V. Predicting Lung Deposition 126

5. Factors Affecting the Clinical Outcome of Aerosol Therapy / Eric Derom, Lars Thorsson 143

II. In Vitro Performance of the Formulation 145

III. Patient Preference 146

IV. Patient Compliance 147

V. Pharmacodynamic and Pharmacokinetic Properties of the Inhaled Drug 148

VI. Handling and Maintenance of the Inhaler 152

VII. Relationship Between Pulmonary Deposition and Clinical Effect 154

VIII. Extrathoracic Deposition, Local Side Effects, and Systemic Effects 158

IX. Lung Versus Total Bioavailability Ratio (L/T Ratio) 160

X. Studies in Healthy Volunteers 161

XI. Cost-Effectiveness 162

6. In Vivo Measurements of Lung Dose / Mark L. Everard, Myrna B. Dolovich 173

II. Imaging and Pharmacokinetic Approaches 176

III. Imaging 180

IV. Pharmacokinetic Studies 197

V. Choice of Subjects 200

VI. Relationship Between Drug Delivery and Effect 201

7. Targeting the Lungs with Therapeutic Aerosols / Pieter Zanen, Beth L. Laube 211

II. Polydisperse Versus Monodisperse Aerosols 212

III. Mechanisms of Desposition 212

IV. Factors That Affect Aerosol Targeting 218

V. Therapeutic Aerosols and Their Targets 222

VI. The Clinical Effects of Targeting 230

VII. Targeting the Lungs During Nose Breathing 251

VIII. Targeting Constricted Airways 253

IX. Targeting Different Age Groups 258

8. Nebulization: The Device and Clinical Considerations / Gerald C. Smaldone, Peter N. LeSouef 269

I. Nebulizers and the Clinician 269

III. Gravimetric Measurements and the "Standing Cloud" 271

IV. Importance of Breathing Pattern 273

V. The Concept of Inhaled Mass and Lung Deposition 274

VI. Nebulizer Reproducibility 279

VII. Components of the Nebulizer Charge 280

VIII. The Lung Dose 283

IX. Measuring Particle Size During Nebulization 287

X. Labeling Pharmaceutical Nebulizer Solutions for Bench Testing and Deposition Studies 292

XI. Route of Inhalation 294

XII. Mechanical Ventilation 294

9. New Nebulizer Technology / John H. Dennis, Ola Nerbrink 303

III. New Nebulizer Technology 306

IV. The Ideal Nebulizer 307

V. Examples of New Nebulizer Technologies 309

VI. Assessment of Performance of New Nebulizer Technology 326

VII. Development of Clinical Nebulizer Guidelines Within the European Respiratory Society 330

10. The Metered-Dose Inhaler / Chris O'Callaghan, Paul Wright 337

II. What Is a Pressurized Metered-Dose Inhaler (pMDI)? 338

III. pMDI Technique 341

IV. Airway Deposition and the Effects of Anti-Asthma Drugs Delivered from MDIs 346

V. Use of pMDIs in the Very Young and in the Elderly 349

VI. Safety of pMDIs 350

VII. Breath-Actuated MDIs 351

VIII. The Synchroner 356

IX. The Spacehaler 356

X. Generic pMDIs

Salbutamol and Steroids 358

XI. CFC-Free MDIs 358

XII. CFC-Free Steroids Delivered by pMDI 361

XIII. Compliance Monitors 363

XIV. Future Research 364

11. Propellants / Martyn R. Partridge, Ashley A. Woodcock 371

III. Government Response 373

IV. New Propellants for pMDIs 376

V. Implementing the Montreal Protocol 381

VI. The Kyoto and the Montreal Protocol 386

VII. MDI Propellants: Where Will We Be in 2015? 387

12. Spacer Devices / Hans Bisgaard, Jacob Anhoj, Johannes H. Wildhaber 389

II. The Objectives of a Spacer Device 390

III. When Should a Spacer Be Used? 392

IV. Specifications of Spacer Devices 394

V. Sources of Aerosol Loss Within Spacers 395

VI. Effect of Spacer Construction on Dose Delivery 403

VII. The Optimal Spacer for Young Children 404

VIII. Choice of Spacer Depends on Choice of Drug 405

IX. Use of Spacers 406

X. Use of Facemasks with Spacers 407

XI. Use of Spacers in Neonates and Infants 409

XII. Use of Spacers in Ventilated Patients 409

XIII. Influence of Spacers on Lung Dose 410

XIV. A Spacer for a Dry-Powder Inhaler 411

13. Dry-Powder Inhalers / Lars Borgstrom, Hans Bisgaard, Chris O'Callaghan, Soren Pedersen 421

II. Dry-Powder Formulations 422

III. Dispersion of Powders in a DPI 425

IV. Aerosol Generation from a DPI 425

V. Particle Size Determination from DPIs 427

VI. Inhalation Resistance of DPIs 428

VII. The Clinical Importance of the Resistance of a DPI 430

VIII. Humidity 434

IX. Dry-Powder Inhalers 435

X. Lung Deposition via DPIs 439

XI. Variability in Lung Deposition 441

XII. Safety of DPIs 442

14. Compliance with Asthma Medicine / Michael E. Hyland, Cynthia S. Rand 449

I. What Is Compliance? 449

II. Measurement of Noncompliance and Prevalence 453

III. Reasons for Unintentional Noncompliance 456

IV. Reasons for Intentional Noncompliance 459

V. Issues in Pediatric Compliance 466

VI. Diagnosing Noncompliance 467

VII. Targeting Device/Oral Therapy According to Patient Profile and Individualizing Advice 471.

Notes:

Includes bibliographical references and index.

ISBN:

0824705416

OCLC:

47705776