Related Experiment Videos
Electrostatic charge on spacer devices and salbutamol response in young children
J C Dubus1, C Guillot, M Badier
1Unité de Médecine Infantile, Hôpital d'Enfants de la Timone, 13385 Cedex 5, Marseille, France. jean-christophe.dubus@ap-hm.fr
Insights
Electrostatic charge on plastic inhaler spacers does not impact bronchodilator effectiveness in young asthmatic children. Supramaximal doses of salbutamol likely overcome any charge-related drug loss.
Area of Science:
- Pediatric Pulmonology
- Respiratory Drug Delivery
- Medical Device Engineering
Background:
- Inhaler spacer devices can develop electrostatic charges that may reduce inhaled medication efficacy.
- The impact of these charges on drug delivery has not been studied in young children with asthma and airflow limitation.
Purpose of the Study:
- To evaluate the effect of electrostatic charge on plastic spacer devices on the bronchodilator response to hydrofluoroalkane-134a salbutamol in asthmatic children.
- To compare drug delivery from a static spacer, a reduced-static spacer, and a metal spacer.
Main Methods:
- Sixty-four pre-school children with asthma underwent a methacholine challenge.
- Following the challenge, children received salbutamol via a static plastic spacer, a reduced-static plastic spacer, or a metal spacer.
- Airway resistance and FEV1 were measured to assess bronchodilator response.
Main Results:
- Salbutamol administration resulted in significant bronchodilation, indicated by decreased specific airway resistance (SRaw) and increased forced expiratory volume in 1s (FEV1).
- No significant differences in bronchodilator response were observed between the different types of spacer devices used.
- The observed bronchodilation was consistent across all groups, regardless of spacer device charge.
Conclusions:
- Electrostatic charges on plastic spacer devices do not appear to affect the bronchodilator efficacy of hydrofluoroalkane-134a salbutamol in pre-school children with asthma and airflow limitation.
- The use of supramaximal doses of salbutamol may contribute to the lack of observed differences between spacer devices.
Abstract:
Electrostatic charge on plastic spacer devices may affect the efficacy of inhaled drugs, but its consequences have never been evaluated in asthmatic children with airflow limitation. At the end of a positive metacholine challenge, 64 children (51.3+/-12.9 months, 32 boys, specific airway resistance (SRaw) 257.1+/-56.7% and forced expiratory volume in 1s (FEV(1)) 64.2+/-17.9% of the predicted value) inhaled one puff of hydrofluoroalkane-134a (HFA-134a) salbutamol (Ventoline((R))), and 15min later two other puffs (total dose of 300 microgram), delivered through either a new static Babyhaler((R)) (n=21), a detergent-coated, reduced static, Babyhaler((R)) (n=20), or a metal NES-Spacer((R)) (n=23) equipped with facemask. SRaw and FEV(1) were measured after each treatment and compared between groups by a Kruskal-Wallis test. The first 100 microgram salbutamol induced a 151.7+/-43.9% decrease in SRaw and a 19.9+/-10.6% increase in FEV(1). Additional 200 microgram salbutamol allowed a supplementary decrease of 35.1+/-25.7% in SRaw and increase of 12.1+/-11.8% in FEV(1), without significant difference between the spacer devices. Electrostatic charge on spacer devices does not affect bronchodilation with HFA-134a salbutamol in metacholine-challenged pre-school children. This could be in part explained by the use of supramaximal doses of salbutamol.