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Delivery of glucocorticoids by jet nebulization: aerosol characteristics and output

J Leflein1, E Brown, M Hill

  • 1Department of Pediatrics, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206, USA.

The Journal of Allergy and Clinical Immunology
|May 1, 1995
PubMed

Insights

Parenteral triamcinolone acetonide (TAA) can be nebulized for asthma treatment, but only about 35% of the dose is delivered in respirable particles. Further clinical studies are needed to assess efficacy and safety.

Area of Science:

  • Pulmonary Medicine
  • Pharmacology
  • Respiratory Therapy

Background:

  • Inflammation is key in asthma pathogenesis, increasing inhaled corticosteroid use.
  • Lack of approved nebulized corticosteroids in the US leads to off-label use of parenteral and intranasal preparations.
  • Young children struggle with metered-dose inhaler coordination.

Purpose of the Study:

  • To evaluate the nebulization delivery of a parenteral triamcinolone acetonide (TAA) preparation.
  • To assess particle size distribution and TAA output for nebulized TAA.

Main Methods:

  • Parenteral TAA (1000 micrograms) was nebulized using MB5 and Pari-Jet devices with saline.
  • Laser particle analysis, high-performance liquid chromatography, and cascade impactor were used.
  • Particle size, TAA output, and concentration within the respirable range (1-5 microns) were measured.

Main Results:

  • 34% (MB5) and 47% (Pari-Jet) of aerosol volume had particles in the 1-5 micron respirable range.
  • TAA output was nearly complete within 2-4 minutes, totaling 352-367 micrograms.
  • Cascade impactor confirmed 33.4% of TAA aerosol from MB5 was in the respirable range.

Conclusions:

  • Approximately 35-37% of the initial 1000 micrograms of TAA was delivered by the tested nebulizers.
  • The amount of TAA delivered in the respirable range was theoretically 12.5% (MB5) to 16.5% (Pari-Jet).
  • Clinical studies are required to determine the efficacy and safety of nebulized parenteral TAA due to excipients.
Abstract

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