The influence of inhaler selection on efficacy of asthma therapies

Advanced Drug Delivery Reviews

Volumn 55, Issue 7, 2003, Pages 879-923

  Barry, P W ^a   O'Callaghan, C ^a  

^a UNIVERSITY OF LEICESTER   (United Kingdom)

Author keywords

Asthma; Bronchodilators; Corticosteroids; Drug administration inhalation; Dry powder inhalers; Holding chambers; Metered dose inhalers

Indexed keywords

BIOMEDICAL EQUIPMENT; CLINICAL LABORATORIES; DRUG PRODUCTS; PULMONARY DISEASES;

DRUG DELIVERY;

RESPIRATORY THERAPY;

BECLOMETASONE DIPROPIONATE; BUDESONIDE; CROMOGLYCATE DISODIUM; FLUTICASONE; HISTAMINE; ORCIPRENALINE; PLACEBO; SALBUTAMOL; TERBUTALINE;

ASTHMA; CLINICAL TRIAL; CONFERENCE PAPER; DISEASE SEVERITY; DOSE RESPONSE; DRUG DELIVERY SYSTEM; HEALTH CARE PERSONNEL; HUMAN; INHALER; METERED DOSE INHALER; POWDER INHALER; PRIORITY JOURNAL; SIDE EFFECT;

EID: 0038771108     PISSN: 0169409X     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0169-409X(03)00083-8     Document Type: Conference Paper

References (334)

1. Bauer K., Dietersdorfer F., Sertl K., Kaik B., Kaik G. Pharmacodynamic effects of inhaled dry powder formulations of fenoterol and colforsin in asthma. Clin. Pharmacol. Ther. 53:1993;76-83.
2. Bauer K., Sertl K., Kaik B., Kaik G. Effect of solution and suspension type aerosol of formoterol on tremor response and airways in patients with asthma. J. Allergy Clin. Immunol. 96:1995;495-501.
3. Snell N.J. Assessing equivalence of inhaled products. J. Pharm. Pharmacol. 49:1997;55-60.
4. Janssens H.M., Devadason S.G., Hop W.C., LeSouef P.N., de Jongste J.C., Tiddens H.A. Variability of aerosol delivery via spacer devices in young asthmatic children in daily life. Eur. Respir. J. 13:1999;787-791.
5. Newman S.P., Talaee N., Clarke S.W. Salbutamol aerosol delivery in man with the Rondo Spacer. Acta Ther. 17:1991;49-58.
6. Fairshter R.D. Evaluation of a metered-dose aerosol delivery system using partial flow-volume curves. Am. Rev. Respir. Dis. 135:1987;741-743.
7. 2 adrenoceptor agonists delivered via chlorofluorocarbon-containing inhalers. Thorax. 54:1999;1087-1092.
8. Jones B., Jarvis P., Lewis J.A., Ebbutt A.F. Trials to assess equivalence: the importance of rigorous methods. Br. Med. J. 313:1996;36-39.
9. ® and by chlorofluorocarbon (CFC) inhaler in children with exercise-induced asthma. Allergy. 49:1994;408-412.
10. Wong B.J.O., Hargreave F.E. Bioequivalence of metered dose inhaler medications. J. Allergy Clin. Immunol. 92:1993;373-379.
11. Fowler S.J., Lipworth B.J. Therapeutic equivalence of inhaled salbutamol. Thorax. 55:2000;345.
12. Clark D.J., Lipworth B.J. Dose-response of inhaled drugs in asthma. An update. Clin. Pharmacokinet. 32:1997;58-74.
13. Anonymous, The use of inhaled corticosteroids in adults with asthma. Drug Ther. Bull. 38 (2000) 5-8.
14. Agertoft L., Pedersen S. Importance of the inhalation device on the effect of budesonide. Arch. Dis. Child. 69:1993;130-133.
15. Brocklebank D., Ram F., Wright J., Barry P., Cates C., Davies L., Douglas G., Muers M., Smith D., White J. Comparison of the effectiveness of inhaler devices in asthma and chronic obstructive airways disease: a systematic review of the literature. Health Technol. Assess. 5:2001;1-147.
16. British Thoracic Society, The British guidelines on asthma management. Thorax 52 (1997) S1-S21.
17. Mercer T.T. Production and characterisation of aerosols. Arch. Intern. Med. 131:1973;39-50.
18. Lippmann M., Yeates D.B., Albert R.E. Deposition, retention, and clearance of inhaled particles. Br. J. Ind. Med. 37:1980;337-362.
19. Dolovich M. Measurement of particle-size characteristics of metered dose inhaler (MDI) aerosols. J. Aerosol Med. 4:1991;251-263.
20. P.W. Barry, Problems with inhalational drug delivery. Ph.D. thesis, University of Leicester, 1999.
21. Smaldone G.C., Perry R.J., Deutsch D.G. Characteristics of nebulisers used in the treatment of AIDS related pneumocystis carinii pneumonia. J. Aerosol Med. 1:1988;113-126.
22. Thomas S.H., O'Doherty M.J., Page C.J., Nunan T.O., Bateman N.T. Which apparatus for inhaled pentamidine? A comparison of pulmonary deposition via eight nebulisers. Eur. Respir. J. 4:1991;616-622.
23. Crompton G.K. Problems patients have using pressurized aerosol inhalers. Eur. J. Respir. Dis. Suppl. 119:1982;101-104.
24. Schultz R.K. Drug delivery characteristics of metered dose inhalers. J. Allergy Clin. Immunol. 96:1995;284-287.
25. Everard M.L., Devadason S.G., Summers Q.A., Le Souef P.N. Factors affecting total and 'respirable' dose delivered by a salbutamol metered dose inhaler. Thorax. 50:1995;746-749.
26. Cyr T.D., Graham S.J., Li K.Y., Lovering E.G. Low first-spray drug content in albuterol metered-dose inhalers. Pharm. Res. 8:1991;658-660.
27. Blake K.V., Harman E., Hendeles L. Evaluation of a generic albuterol metered-dose inhaler: importance of priming the MDI. Ann. Allergy. 68:1992;169-174.
28. Fiese E.F., Gorman W.G., Dolinsky D., Harwood R.J., Hunke W.A., Miller N.C., Mintzer H., Harper N.J. Test method for evaluation of loss of prime in metered-dose aerosols. J. Pharm. Sci. 77:1988;90-93.
29. W.F. Jackson, Inhalers in Asthma, The New Perspective. Clinical Vision Ltd., The Old Chapel, Harwell, Oxfordshire, 1995. ('Data ou file' from Astra Drace).
30. Byron P.R. Performance characteristics of pressurized metered dose inhalers in vitro. Journal of Aerosol Medicine. 10:(1):1997;S3-S6.
31. Moren F. Drug deposition of pressurised inhalation aerosols. II. Influence of vapour pressure and metering volume. Int. J. Pharm. 1:1978;213-218.
32. Hampson N.B., Mueller M.P. Cooling of metered-dose inhalers decreases pressure output from canisters. N. Engl. J. Med. 320:1989;321.
33. Clark D.J., Gordon-Smith J., McPhate G., Clark G., Lipworth B.J. Lung bioavailability of generic and innovator salbutamol metered dose inhalers. Thorax. 51:1996;325-326.
34. Dhand R., Malik S.K., Balakrishnan M., Verma S.R. High speed photographic analysis of aerosols produced by metered dose inhalers. J. Pharm. Pharmacol. 40:1988;429-430.
35. Newman S.P., Clarke S.W. Bronchodilator delivery from Gentlehaler, a new low-velocity pressurized aerosol inhaler. Chest. 103:1993;1442-1446.
36. Gunawardena K.A., Sohal T., Jones J.I., Upchurch F.C., Crompton G.K. The Spacehaler for delivery of salbutamol: a comparison with the standard metered-dose inhaler plus Volumatic spacer device. Respir. Med. 91:1997;311-316.
37. Tansey I. The technical transition to CFC-free inhalers. Br. J. Clin. Pract. Suppl. 89:1997;22-27.
38. Cripps A., Riebe M., Schulze M., Woodhouse R. Pharmaceutical transition to non-CFC pressurised metered dose inhalers. Respir. Med. 94:2000;S3-S9.
39. Barry P.W., 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. 10:1997;1345-1348.
40. Clark A.R., Rachelefsky G., Mason P.L., Goldenhersh M.J., Hollingworth A. The use of reservoir devices for the simultaneous delivery of two metered-dose aerosols. J. Allergy Clin. Immunol. 85:1990;75-79.
41. Barry P.W., Robertson C.F., O'Callaghan C. Optimum use of a spacer device. Arch. Dis. Child. 69:1993;693-694.
42. Barry P.W., 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. 40:1995;76-78.
43. O'Callaghan C., Cant M., Robertson C. Delivery of beclomethasone dipropionate from a spacer device: what dose is available for inhalation? Thorax. 49:1994;961-964.
44. Barry P.W., O'Callaghan C. Multiple actuations of salbutamol MDI into a spacer device reduce the amount of drug recovered in the respirable range. Eur. Respir. J. 7:1994;1707-1709.
45. Everard M.L., Clark A.R., Milner A.D. Drug delivery from holding chambers with attached facemask. Arch. Dis. Child. 67:1992;580-585.
46. Clarke D.J., Lipworth B.J. Lung bioavailability of salbutamol from a spacer device comparing single versus multiple actuations, delayed inhalation and antistatic treated spacer. Thorax. 50:1995;981-984.
47. Hindle M., Chrystyn H. Relative bioavailability of salbutamol to the lung following inhalation using metered dose inhalation methods and spacer devices. Thorax. 49:1994;549-553.
48. Chege J.K., Chrystyn H. Volumatic usage: some generic salbutamol metered dose inhalers can be used. Thorax. 49:1994;1162-1163.
49. Moren F. Drug deposition of pressurised inhalation aerosols. 1. Influence of actuator tube design. Int. J. Pharm. 1:1978;205-212.
50. Kim C.S., Eldridge M.A., Sackner M.A. Oropharyngeal deposition and delivery aspects of metered-dose inhaler aerosols. Am. Rev. Respir. Dis. 135:1987;157-164.
51. Barry P.W., O'Callaghan C. Inhalational drug delivery from seven different spacer devices. Thorax. 51:1996;835-840.
52. Ahrens R., Lux C., Bahl T., Han S.H. Choosing the metered-dose inhaler spacer or holding chamber that matches the patient's need: evidence that the specific drug being delivered is an important consideration. J. Allergy Clin. Immunol. 96:1995;288-294.
53. Barry P.W., O'Callaghan C. The optimum size and shape of spacer devices for inhalational therapy. J. Aerosol Med. 8:1995;303-305.
54. Agertoft L., Pedersen S. Influence of spacer device on drug delivery to young children with asthma. Arch. Dis. Child. 71:1994;217-220.
55. Barry P.W., O'Callaghan C. Video analysis of the aerosol cloud produced by metered dose inhalers. Pharm. Sci. 1:1995;119-121.
56. Finlay W.H., Zuberbuhler P. In vitro comparison of salbutamol hydrofluoralkane (Airomir) metered dose inhaler aerosols inhaled during pediatric tidal breathing from five valved holding chambers. J. Aerosol Med. 12:1999;285-291.
57. Mitchell J.P., Nagel M.W. In vitro performance testing of three small volume-holding chambers under conditions that correspond with use by infants and small children. J. Aerosol Med. 10:1997;341-349.
58. Finlay W.H., Zuberbuhler P. In vitro comparison of beclomethasone and salbutamol metered-dose inhaler aerosols inhaled during pediatric tidal breathing from four valved holding chambers. Chest. 114:1998;1676-1680.
59. Finlay W.H., Zuberbuhler P., Mandl M. Particle size measurements for the Space-Chamber metered dose inhaler holding chamber compared with Aerochamber and metered dose inhaler alone. J. Aerosol Med. 10:1997;213-219.
60. Wildhaber J.H., Devadason S.G., Eber E., Hayden M.J., Everard M., Summers A., LeSouef P.N. Effect of electrostatic charge, flow, delay and multiple actuations on the in vitro delivery of salbutamol from different small volume spacers for infants. Thorax. 51:1996;985-988.
61. Sackner M.A., Kim C.S. Auxiliary MDI aerosol delivery systems. Chest. 88:1985;161s-170s.
62. Barry P.W., O'Callaghan C. A comparative analysis of the particle size output of beclomethasone diproprionate, salmeterol xinofoate and fluticasone proprionate metered dose inhalers used with the Babyhaler, Volumatic and Aerochamber spacer devices. Br. J. Clin. Pharmacol. 47:1999;357-360.
63. Berg E., Madsen J., Bisgaard H. In vitro performance of three combinations of spacers and pressurized metered dose inhalers for treatment in children. Eur. Respir. J. 12:1998;472-476.
64. O'Callaghan C., Lynch J., Cant M., Robertson C. Improvement in drug delivery from spacer devices by use of an anti static lining. Thorax. 48:1993;603-606.
65. Barry P.W., O'Callaghan C. The level of static charge on spacer devices used with inhalational drugs. Paediatr. Rev. Commun. 8:1995;210.
66. Pierart F., Wildhaber J.H., Vrancken I., Devadason S.G., Le Souef P.N. Washing plastic spacers in household detergent reduces electrostatic charge and greatly improves delivery. Eur. Respir. J. 13:1999;673-678.
67. Wildhaber J.H., Devadason S.G., Hayden M.J., James R., Dufty A.P., Fox R.A., Summers Q.A., LeSouef P.N. Electrostatic charge on a plastic spacer device influences the delivery of salbutamol. Eur. Respir. J. 9:1996;1943-1946.
68. Bisgaard H., Anhoj J., Klug B., Berg E. A non-electrostatic spacer for aerosol delivery. Arch. Dis. Child. 73:1995;226-230.
69. Bisgaard H. A metal aerosol holding chamber devised for young children with asthma. Eur. Respir. J. 8:1995;856-860.
70. McCarthy T.P. Use of 'Nebuhaler' and face-mask in young asthmatic children. Lancet. 335:1990;983-984.
71. J.T. Hayden, N. Smith, D.A. Woolf, P.W. Barry, C. O'Callaghan, Choice of facemask attached to a spacer may markedly affect drug delivery to children. Arch. Dis. Child., in press.
72. Dolovich M.B. Measuring total and regional lung deposition using inhaled radiotracers. J. Aerosol Med. 14:2001;S35-S44.
73. Newman S.P. How well do in vitro particle size measurements predict drug delivery in vivo? J. Aerosol Med. 11:(Suppl. 1):1998;S97-104.
74. J.M. Bland, D.G. Altman, Statistical methods for assessing agreement between two methods of clinical measurement, Lancet i (1986) 307-310.
75. Vidgren P., Silvasti M., Vidgren M., Paronen P., Tukiainen H., Lehti H. In vitro inhalation behaviour and therapeutical response of salbutamol particles administered from two metered dose aerosols. Pharmazie. 46:1991;41-43.
76. Adjei A., Garren J. Pulmonary delivery of peptide drugs: effect of particle size on bioavailability of leuprolide acetate in healthy male volunteers. Pharm. Res. 7:1990;565-569.
77. Asmundsson T., Johnson R.F., Kilburn K.H., Goodrich J.K. Efficiency of nebulizers for depositing saline in human lung. Am. Rev. Respir. Dis. 108:1973;506-512.
78. Lewis R.A., Fleming J.S. Fractional deposition from a jet nebulizer: how it differs from a metered dose inhaler. Br. J. Dis. Chest. 79:1985;361-367.
79. Clark A.R. The use of laser diffraction for the evaluation of the aerosol clouds generated by medical nebulizers. Int. J. Pharm. 115:1995;69-78.
80. Borgstrom L. In vitro, ex vivo, in vivo veritas. Allergy. 54:1999;88-92.
81. Olsson B. Can in vitro measurements predict the lung deposition of dry-powder inhalers? J. Aerosol Med. 10:1997;S13-S16.
82. Clark A.R., Hollingworth A.M. The relationship between powder inhaler resistance and peak inspiratory conditions in healthy volunteers - implications for in vitro testing. J. Aerosol Med. 6:1993;99-110.
83. Berg E. In vitro properties of pressurized metered dose inhalers with and without spacer devices. J. Aerosol Med. 8:1995;S3-S11.
84. Dolovich M., Rhem R. Impact of oropharyngeal deposition on inhaled dose. J. Aerosol Med. 11:1998;S112-S115.
85. Olsson B. Aerosol particle generation from dry powder inhalers: can they equal pressurized metered dose inhalers? J. Aerosol Med. 8:(Suppl. 3):1995;S13-S19.
86. Niven R.W., Lott F.D., Ip A.Y., Somaratne K.D., Kearney M. Development and use of an in vitro system to evaluate inhaler devices. Int. J. Pharm. 101:1994;81-87.
87. Hallworth G.W., Westmoreland D.G. The twin impinger: a simple device for assessing the delivery of drugs from metered dose pressurized aerosol inhalers. J. Pharm. Pharmacol. 39:1987;966-972.
88. Miller N.C., Purrington A.M. A cascade impactor entry port for MDI sprays with collection characteristics imitating a physical model of the human throat. Pharm. Res. 13:1996;391-397.
89. Olsson B., Asking L., Borgstrom L., Bondesson F. Effect of inlet throat on the correlation between measured fine particle dose and lung deposition. Dalby R.N., Byron P.R., Farr S.Y. Respiratory Drug Delivery V. 1996;273-281 Interpharm Press, Buffalo Grove, IL.
90. Warren S., Taylor G., Godfrey C., Embleton J.K., Buck H., Birrell C.E., Morton D.A.V., Meakin B. Budesonide Clickhaler formulation development: Does in vitro aerosol performance predict in vitro lung delivery. Drug Delivery to the Lungs X. 1999;160-162 The Aerosol Society, Bristol.
91. Vidgren P., Vidgren M., Laurikainen K., Pietila T., Silvasti M., Paronen P. In vitro deposition and clinical efficacy of two sodium cromoglycate inhalation powders. Int. J. Clin. Pharmacol. Ther. Toxicol. 29:1991;108-112.
92. Kenyon C.J., Thorsson L., Borgstrom L., Newman S.P. The effects of static charge in spacer devices on glucocorticosteroid aerosol deposition in asthmatic patients. Eur. Respir. J. 11:1998;606-610.
93. Wildhaber J.H., Janssens H.M., Pierart F., Dore N.D., Devadason S.G., LeSouef P.N. High-percentage lung delivery in children from detergent-treated spacers. Pediatr. Pulmonol. 29:2000;389-393.
94. Newman S.P., Newhouse M.T. Effect of add-on devices for aerosol drug delivery: deposition studies and clinical aspects. J. Aerosol Med. 9:1996;55-70.
95. Anhoj J., Bisgaard H., Lipworth B.J. Effect of electrostatic charge in plastic spacers on the lung delivery of HFA-salbutamol in children. Br. J. Clin. Pharmacol. 47:1999;333-336.
96. Wildhaber J.H., Waterer G.W., Hall G.L., Summers Q.A. Reducing electrostatic charge on spacer devices and bronchodilator response. Br. J. Clin. Pharmacol. 50:2000;277-280.
97. Dompeling E., Oudesluys-Murphy A.M., Janssens H.M., Hop W., Brinkman J.G., Sukhai R.N., de Jongste J.C. Randomised controlled trial of clinical efficacy of spacer therapy in asthma with regard to electrostatic charge. Arch. Dis. Child. 84:2001;178-182.
98. N. Adams, C.J. Cates, J. Bestall, Holding chambers versus nebulisers for inhaled steroids in chronic asthma (Cochrane Review). In: The Cochrane Library, Issue 3, Update Software, Oxford, 2002.
99. C.J. Cates, B.H. Rowe, A. Bara, Holding chambers versus nebulisers for beta-agonists treatment of acute asthma (Cochrane Review). In: The Cochrane Library, Issue 3, Update Software, Oxford, 2002.
100. Corr D., Dolovich M., McCormack D., Ruffin R., Obminski G., Newhouse M. The Aerochamber: a new demand inhalation device for delivery of aerosolised drugs. Am. Rev. Respir. Dis. 121:1980;123.
101. Corr D., Dolovich M., McCormack D., Ruffin R., Obminski G., Newhouse M.T. Design and characteristics of a portable breath actuated, particle size selective medical aerosol inhaler. J. Aerosol Sci. 13:1982;1-7.
102. Dolovich M., Ruffin R., Corr D., Newhouse M.T. Clinical evaluation of a simple demand inhalation MDI aerosol delivery device. Chest. 84:1983;36-41.
103. Epstein S.W., Parsons J.E., Corey P.N., Worsley G.H., Reilly P.A. A comparison of three means of pressurized aerosol inhaler use. Am. Rev. Respir. Dis. 128:1983;253-255.
104. Salzman G.A., Pyszczynski D.R. A comparison of two delivery methods for aerosolized metaproterenol sulfate. J. Asthma. 23:1986;297-301.
105. Berenberg M.J., Baigelman W., Cupples L.A., Pearce L. Comparison of metered-dose inhaler attached to an aerochamber with an updraft nebulizer for the administration of metaproterenol in hospitalized patients. J. Asthma. 22:1985;87-92.
106. Gurwitz D., Levison H., Mindorff C., Reilly P., Worsley G. Assessment of a new device (aerochamber) for use with aerosol drugs in asthmatic children. Ann. Allergy. 50:1983;166-170.
107. Rachelefsky G.S., Rohr A.S., Wo J., Gracey V., Spector S.L., Siegel S.C., Katz R.M., Mickey M.R. Use of a tube spacer to improve the efficacy of a metered-dose inhaler in asthmatic children. Am. J. Dis. Child. 140:1986;1191-1193.
108. Salzman G.A., Pyszczynski D.R. Oropharyngeal candidiasis in patients treated with beclomethasone dipropionate delivered by metered-dose inhaler alone and with Aerochamber. J. Allergy Clin. Immunol. 81:1988;424-428.
109. Windom H., Heald S., Burgess C., Crane J., Beasley R. Reduction of the cardiovascular effects of inhaled fenoterol by use of a valved holding chamber device. J. Aerosol Med. 2:1989;309-314.
110. Dalby R.N., Somaraju S., Chavan V.S., Jarvis D. Evaluation of aerosol drug output from the OptiChamber and AeroChamber spacers in a model system. J. Asthma. 35:1998;173-177.
111. Gibson P.G., Wlodarczyk J.H., Borgas T. Drug delivery in asthma: a comparison of spacers with a jet nebuliser. Aust. N.Z. J. Med. 25:1995;324-329.
112. Ashurst I.C., Ambrose C.V., Russell D.J. Pharmaceutical evaluation of a new spacer device for delivery of metered dose inhalers to infants and young children. J. Aerosol Sci. 23:1992;S499-S502.
113. Kraemer R. Babyhaler - A new paediatric aerosol device. J. Aerosol Med. 8:1995;S19-S26.
114. Clarke J.R., Aston H., Silverman M. Delivery of salbutamol by metered dose inhaler and valved spacer to wheezy infants: effect on bronchial responsiveness. Arch. Dis. Child. 69:1993;125-129.
115. Kraemer R., Frey U., Sommer C.W., Russi E. Short term effect of albuterol, delivered via a new auxiliary device, in wheezy infants. Am. Rev. Respir. Dis. 144:1991;347-351.
116. Kraemer R., Birrer P., Modelska K., Aebischer C.C., Schoni M.H. A new baby-spacer device for aerosolized bronchodilator administration in infants with bronchopulmonary disease. Eur. J. Pediatr. 151:1992;57-60.
117. Avital A., Godfrey S., Schachter J., Springer C. Protective effect of albuterol delivered via a spacer device (Babyhaler) against methacholine induced bronchoconstriction in young wheezy children. Pediatr. Pulmonol. 17:1994;281-284.
118. Prendiville A., Green S., Silverman M. Airway responsiveness in wheezy infants: evidence for functional beta adrenergic receptors. Thorax. 42:1987;100-104.
119. Cushley M.J., Lewis R.A., Tattersfield A.E. Comparison of three techniques of inhalation on the airway response to terbutaline. Thorax. 38:1983;908-913.
120. Newman S.P., Moren F., Pavia D., Little F., Clarke S.W. Deposition of pressurized suspension aerosols inhaled through extension devices. Am. Rev. Respir. Dis. 124:1981;317-320.
121. Lindgren S.B., Formgren H., Moren F. Improved aerosol therapy of asthma: effect of actuator tube size on drug availability. Eur. J. Respir. Dis. 61:1980;56-61.
122. Lulling J., Delwiche J.P., Hidinger K.G., Prignot J. Influence of different extension-actuator tubes on the bronchodilation effect of a terbutaline sulfate aerosol. Eur. J. Respir. Dis. 64:1983;33-37.
123. Lewis R.A., Cushley M.J., Fleming J.S., Tattersfield A.E. Is a nebuliser less efficient than a metered dose inhaler and do pear-shaped extension tubes work? Am. Rev. Respir. Dis. 125:1982;94.
124. Newman S.P., Millar A.B., Lennard Jones T.R., Moren F., Clarke S.W. Improvement of pressurised aerosol deposition with Nebuhaler spacer device. Thorax. 39:1984;935-941.
125. Newman S.P., Pavia D., Garland N., Clarke S.W. Effects of various inhalation modes on the deposition of radioactive pressurized aerosols. Eur. J. Respir. Dis. Suppl. 119:1982;57-65.
126. Morris J., Milledge J.S., Moszoro H., Higgins A. The efficacy of drug delivery by a pear-shaped spacer and metered dose inhaler. Br. J. Dis. Chest. 78:1984;383-387.
127. Munch E.P., Hidinger K.G., Weeke B. Bronchodilation of terbutaline in small doses from a 750 ml spacer. A cumulative dose-response study. Allergy. 38:1983;487-491.
128. Hidinger K.G., Kjellman N.I. Childhood asthma: improved efficacy of pressurized terbutaline aerosol by use of a 750-ml spacer. Respiration. 45:1984;157-160.
129. Hassanally D., Ganderton D. The influence of a spacer on the respirable fraction of an aerosol cloud. J. Pharm. Pharmacol. 39:1987;75P.
130. Selroos O., Halme M. Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler. Thorax. 46:1991;891-894.
131. Lipworth B.J., Clark D.J. Early lung absorption profile of non-CFC salbutamol via small and large volume plastic spacer devices. Br. J. Clin. Pharmacol. 46:1998;45-48.
132. Chapman B.J., Crompton G.K. Comparison of terbutaline via the Nebuhaler and salbutamol via the Volumatic: theory and practice. Eur. Respir. J. 3:1990;584-585.
133. Gleeson J.G., Price J.F. Nebuhaler technique. Br. J. Dis. Chest. 82:1988;172-174.
134. James R.W., Masters I.B. Single breath versus panting technique in salbutamol delivery through a 750 ml spacing device. Pediatr. Pulmonol. 8:1990;263-267.
135. Comis A., Valletta E.A., Sette L., Andreoli A., Boner A.L. Comparison of nedocromil sodium and sodium cromoglycate administered by pressurized aerosol, with and without a spacer device in exercise-induced asthma in children. Eur. Respir. J. 6:1993;523-526.
136. McCarthy T.P. Nebulised budesonide in severe childhood asthma. Lancet. 1:1989;379-380.
137. Noble V., Ruggins N.R., Everard M.L., Milner A.D. Inhaled budesonide for chronic wheezing under 18 months of age. Arch. Dis. Child. 67:1992;285-288.
138. Connett G.J., Warde C., Wooler E., Lenney W. Use of budesonide in severe asthmatics aged 1-3 years. Arch. Dis. Child. 69:1993;351-355.
139. Cox I.D., Wallis P.J., Apps M.C. Potential limitations of a conical spacer device in severe asthma. Br. Med. J. 288:1984;1044.
140. Bucknall C.E. Conical spacer devices in severe asthma. Br. Med. J. 288:1984;1379-1380.
141. Collier J.G., Dobbs R.J., Williams I. Salbutamol causes a tachycardia due to the inhaled rather than the swallowed fraction. Br. J. Clin. Pharmacol. 9:1980;273-274.
142. Kung M., Croley S.W., Phillips B.A. Systemic cardiovascular and metabolic effects associated with the inhalation of an increased dose of albuterol. Influence of mouth rinsing and gargling. Chest. 91:1987;382-387.
143. Geddes D.M. Inhaled corticosteroids: benefits and risks. Thorax. 47:1992;404-407.
144. Lipworth B.J. New perspectives on inhaled drug delivery and systemic bioactivity. Thorax. 50:1995;105-110.
145. Kelly H.W. Pharmacokinetic/pharmacodynamic comparison of the inhaled corticosteroids. J. Allergy Clin. Immunol. 102:1998;S36-S51.
146. Simons F.E. Benefits and risks of inhaled glucocorticoids in children with persistent asthma. J. Allergy Clin. Immunol. 102:1998;S77-84.
147. Toogood J.H. Complications of topical steroid therapy for asthma. Am. Rev. Respir. Dis. 141:1990;s89-s96.
148. Brown P.H., Blundell G., Greening A.P., Crompton G.K. Do large volume spacer devices reduce the systemic effects of high dose inhaled corticosteroids? Thorax. 45:1990;736-739.
149. Farrer M., Francis A.J., Pearce S.J. Morning serum cortisol concentration after 2 mg inhaled beclomethasone diproprionate in normal subjects: effect of a 750 ml spacing device. Thorax. 45:1990;740-742.
150. Prahl P., Jensen T. Decreased adreno-cortical suppression utilizing the Nebuhaler for inhalation of steroid aerosols. Clin. Allergy. 17:1987;393-398.
151. Meeran K., Burrin J.M., Noonan K.A., Price C.P., Ind P.W. A large volume spacer significantly reduces the effect of inhaled steroids on bone formation. Postgrad. Med. J. 71:1995;156-159.
152. Toogood J.H., White F.A., Baskerville J.C., Fraher L.J., Jennings B. Comparison of the antiasthmatic, oropharyngeal, and systemic glucocorticoid effects of budesonide administered through a pressurized aerosol plus spacer or the Turbuhaler dry powder inhaler. J. Allergy Clin. Immunol. 99:1997;186-193.
153. Dhand R., Sethi D.S. Bronchodilator effect of terbutaline aerosol in asthmatic: comparison of two spacer devices. Indian J. Chest Dis. Allied Sci. 32:1990;101-106.
154. Crimi N., Palermo F., Cacopardo B., Vancheri C., Oliveri R., Palermo B., Mistretta A. Bronchodilator effect of Aerochamber and Inspirease in comparison with metered dose inhaler. Eur. J. Respir. Dis. 71:1987;153-157.
155. Lee H., Evans H.E. Evaluation of inhalation aids of metered dose inhalers in asthmatic children. Chest. 91:1987;366-369.
156. Fuller H.D. Comparison of two chamber devices in patients using a metered-dose inhaler with satisfactory technique. Can. Med. Assoc. J. 135:1986;625-629.
157. Clark D.J., Clark R.A., Lipworth B.J. Adrenal suppression with inhaled budesonide and fluticasone propionate given by large volume spacer to asthmatic children. Thorax. 51:1996;941-943.
158. Crompton G.K. Use of pressurised aerosols by asthmatic patients. Br. Med. J. 1:1976;76-77.
159. Pedersen S., Frost L., Arnfred T. Errors in inhalation technique and efficiency in inhaler use in asthmatic children. Allergy. 41:1986;118-124.
160. Newman S.P., Weisz A.W., Talaee N., Clarke S.W. Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique. Thorax. 46:1991;712-716.
161. Ruggins N.R., Milner A.D., Swarbrick A. An assessment of a new breath actuated inhaler device in acutely wheezy children. Arch. Dis. Child. 68:1993;477-480.
162. Schecker M.H., Wilson A.F., Mukai D.S., Hahn M., Crook D.S., Novey H.S. A device for overcoming discoordination with metered-dose inhalers. J. Allergy Clin. Immunol. 92:1993;783-789.
163. Woodman K., Bremner P., Burgess C., Crane J., Pearce N., Beasley R. A comparative study of the efficacy of beclomethasone dipropionate delivered from a breath activated and conventional metered dose inhaler in asthmatic patients. Curr. Med. Res. Opin. 13:1993;61-69.
164. Waterhouse J.C., Simmons J.L., Wray H., Howard P. Comparative assessment of a new breath-actuated inhaler in patients with reversible airways obstruction. Respiration. 59:1992;155-158.
165. Fergusson R.J., Lenney J., McHardy G.J., Crompton G.K. The use of a new breath-actuated inhaler by patients with severe airflow obstruction. Eur. Respir. J. 4:1991;172-174.
166. Giannini D., Di Franco A., Bacci E., Dente F.L., Taccola M., Vagaggini B., Paggiaro P. The protective effect of salbutamol inhaled using different devices on methacholine bronchoconstriction. Chest. 117:2000;1319-1323.
167. Diggory P., Bailey R., Vallon A. Effectiveness of inhaled bronchodilator delivery systems for elderly patients. Age Ageing. 20:1991;379-382.
168. Allen S.C., Prior A. What determines whether an elderly patient can use a metered dose inhaler correctly? Br. J. Dis. Chest. 80:1986;45-49.
169. Zureik M., Delacourt C. Evaluation of the ability of asthmatic children to use a breath-actuated pressurized inhaler. Arch. Pediatr. 6:1999;1172-1178.
170. Zainudin B.M., Biddiscombe M., Tolfree S.E., Short M., Spiro S.G. Comparison of bronchodilator responses and deposition patterns of salbutamol inhaled from a pressurised metered dose inhaler, as a dry powder, and as a nebulised solution. Thorax. 45:1990;469-473.
171. Chatterjee S.S., Butler A.G. Beclomethasone in asthma: a comparison of two methods of administration. Br. J. Dis. Chest. 74:1980;175-179.
172. Latimer K.M., Roberts R., Dolovich J., Hargreave F.E. Salbutamol: comparison of bronchodilating effect of inhaled powder and aerosol in asthmatic subjects. Can. Med. Assoc. J. 127:1982;857-859.
173. Hartley J.P.R., Nogrady N.G., Seaton A. Bronchodilator effects of dry salbutamol powder administered by rotahaler with salbutamol aerosol in asthmatic out-patients. Br. J. Dis. Chest. 73:1979;271-276.
174. Kemp J.P., Furukawa C.T., Bronsky E.A., Grossman J., Lemanske R.F., Mansfield L.E., Murphy S., Ratner P.H., Reese M.E., Rogenes P.R. Albuterol treatment for children with asthma: a comparison of inhaled powder and aerosol. J. Allergy Clin. Immunol. 83:1989;697-702.
175. Bronsky E., Bucholtz G.A., Busse W.W., Chervinsky P., Condemi J., Ghafouri M.A., Hudson L., Lakshminarayan S., Lockey R., Reese M.E. Comparison of inhaled albuterol powder and aerosol in asthma. J. Allergy Clin. Immunol. 79:1987;741-747.
176. Croner S., Hedenskog S., Kjellman N.I., Oderlram H. Salbutamol by powder or spray inhalation in childhood asthma. Allergy. 35:1980;589-592.
177. Hetzel M.R., Clark T.J.H. Comparison of salbutamol Rotahaler with conventional pressurised aerosol. Clin. Allergy. 7:1977;563-568.
178. Hindle M., Newton D.A., Chrystyn H. Dry powder inhalers are bioequivalent to metered-dose inhalers. A study using a new urinary albuterol (salbutamol) assay technique. Chest. 107:1995;629-633.
179. Mathieu M., Goldman M., Lellouche N., Sartene R. Kinetics of action of salbutamol inhaled from a metered dose inhaler (MDI) and a 'Diskhaler'. Eur. J. Clin. Pharmacol. 42:1992;435-438.
180. Kou M., Phil M., Kumana C.R., Ip M.S., Lauder I.J., Lam W.K., Chan J.C. Bronchodilator responses to salbutamol using diskhaler versus metered-dose inhaler. J. Asthma. 35:1998;505-511.
181. Lundback B., Alexander M., Day J., Herbert J., Holzer R., Van U., Kesten S., Jones A.L. Evaluation of fluticasone propionate (500 microg day-1) administered either as a dry powder via a Diskhaler (R) or pressurized inhaler and compared with beclomethasone diprionate (1000 microg day-1) administered by pressurized inhaler. Respir. Med. 87:1993;609-620.
182. Thorsson L., Edsbacker S., Kallen A., Lofdhal C.G. Pharmacokinetics and systemic activity of fluticasone via Diskus and pMDI, and of budesonide via Turbohaler. Br. J. Clin. Pharmacol. 52:2001;529-538.
183. Bateman E.D., Silins V., Bogolubov M. Clinical equivalence of salmeterol/fluticasone propionate in combination (50/100 μg twice daily) when administered via a chlorofluorocarbon-free metered dose inhaler or dry powder inhaler to patients with mild-to-moderate asthma. Respir. Med. 95:2001;136-146.
184. Wolfe J., Kreitzer S., Chervinsky P., Lawrence M., Wang Y., Reilly D., Davis S., Stahl E. Comparison of powder and aerosol formulations of salmeterol in the treatment of asthma. Ann. Allergy Asthma Immunol. 84:2000;334-340.
185. Lofdahl C.G., Andersson L., Bondesson E., Carlsson L.G., Friberg K., Hedner J., Hornblad Y., Jemsby P., Kallen A., Ullman A., Werner S., Svedmyr N. 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. 10:1997;2474-2478.
186. Borgstrom L., Derom E., Stahl E., Wahlin-Boll E., Pauwels R. The inhalation device influences lung deposition and bronchodilating effect of terbutaline. Am. J. Respir. Crit. Care Med. 153:1996;1636-1640.
187. Ekstrom T., Andersson A.C., Skedinger M., Lindbladh C., Stahl E. Dose potency relationship of terbutaline inhaled via Turbuhaler or via a pressurized metered dose inhaler. Ann. Allergy Asthma Immunol. 74:1995;328-332.
188. Bondesson E., Friberg K., Soliman S., Lofdahl C.G. Safety and efficacy of a high cumulative dose of salbutamol inhaled via Turbuhaler or via a pressurized metered-dose inhaler in patients with asthma. Respir. Med. 92:1998;325-330.
189. Mellen A., Arvidsson P., Palmqvist M., Lotvall J. Equivalent bronchodilation with salbutamol given via pMDI or Turbuhaler. Am. J. Respir. Crit. Care Med. 159:1999;1663-1665.
190. Jackson L., Stahl E., Holgate S.T. Terbutaline via pressurised metered dose inhaled (P-MDI) and Turbuhaler in highly reactive asthmatic patients. Eur. Respir. J. 7:1994;1598-1601.
191. Osterman K., Stahl E., Kallen A. Bricanyl Turbuhaler in the treatment of asthma: a six week multi-centre study carried out in Sweden, the United Kingdom, Denmark, Norway and Finland. Eur. Respir. J. 4:1991;175-179.
192. Thorsson L., Edsbacker S., Conradson T.B. Lung deposition of budesonide from Turbuhaler is twice that from a pressurized metered-dose inhaler P-MDI. Eur. Respir. J. 7:1994;1839-1844.
193. Borgstrom 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. Int. J. Pharm. 193:2000;227-230.
194. Hirsch T., Peter-Kern M., Koch R., Leupold W. Influence of inspiratory capacity on bronchodilatation via Turbuhaler or pressurized metered-dose inhaler in asthmatic children: a comparison. Respir. Med. 91:1997;341-346.
195. Hultquist C., Ahlstrom H., Kjellman N.I., Malmqvist L.A., Svenonius E., Melin S. A double-blind comparison between a new multidose powder inhaler (Turbuhaler) and metered dose inhaler in children with asthma. Allergy. 44:1989;467-470.
196. Razzouk H., dos Santos L., Giudicelli J., Queiros M., de Lurdes Chieira M., Castro A.M., Ramos C., Lindbladh C. A comparison of the bronchodilatory effect of 50 and 100 microg salbutamol via Turbuhaler and 100 microg salbutamol via pressurized metered dose inhaler in children with stable asthma. Int. J. Pharm. 180:1999;169-175.
197. Fuglsang G., Pedersen S. Comparison of a new multidose powder inhaler with a pressurized aerosol in children with asthma. Pediatr. Pulmonol. 7:1989;112-115.
198. Nieminen M.M., Vidgren M., Laurikainen K., Jarvinen M., Liippo K., Tammivaara R., Silvasti M. Easyhaler, a novel multiple dose powder inhaler: clinically equivalent to salbutamol metered dose inhaler and easier to use. Respiration. 61:1994;37-41.
199. Silvasti M., Laurikainen K., Nieminen M., Jarvinen M., Liippo K., Tammivaara R., Vidgren M. Single dose comparison between a novel multiple dose powder inhaler and a conventional metered dose inhaler in asthmatic patients. Acta Ther. 19:1993;125-135.
200. Haahtela T., Vidgren M., Nyberg A., Korhonen P., Laurikainen K., Silvasti M. A novel multiple dose powder inhaler. Salbutamol powder and aerosol give equal bronchodilatation with equal doses. Ann. Allergy. 72:1994;178-182.
201. Newhouse M.T., Nantel N.P., Chambers C.B., Pratt B., Parry-Billings M. Clickhaler (a novel dry powder inhaler) provides similar bronchodilation to pressurized metered-dose inhaler, even at low flow rates. Chest. 115:1999;952-956.
202. Morice A.H., Peake M.D., Allen M.B. Comparison of the efficacy and safety of salbutamol delivered via a novel multidose powder inhaler (DPI) or a metered dose inhaler (MDI) before and after a period of clinical use. Eur. Respir. J. 9:1996;S23.
203. Newman S.P., Moren F., Trofast E., Talaee N., Clarke S.W. Terbutaline Sulphate Turbuhaler: Effect of inhaled flow rate on drug deposition and efficacy. Int. J. Pharm. 74:1991;209-213.
204. Engel T., Heinig J.H., Malling H.J., Scharling B., Nikander K., Madsen F. Clinical comparison of inhaled budesonide delivered either via pressurized metered dose inhaler or Turbuhaler. Allergy. 44:1989;220-225.
205. Nieminen M.M., Lahdensuo A. Inhalation treatment with budesonide in asthma. A comparison of Turbuhaler and metered dose inhalation with Nebuhaler. Acta Ther. 21:1995;179-192.
206. Stahl E., Ribeiro L.B., Sandahl G. Dose response to inhaled terbutaline powder and peak inspiratory flow through Turbuhaler in children with mild to moderate asthma. Pediatr. Pulmonol. 22:1996;106-110.
207. Agertoft L., Pedersen S., Nikander K. Drug delivery from the Turbuhaler and Nebuhaler pressurized metered dose inhaler to various age groups of children with asthma. J. Aerosol Med. 12:1999;161-169.
208. Laberge S., Spier S., Drblik S.P., Turgeon J.P. Comparison of inhaled terbutaline administered by either the Turbuhaler dry powder inhaler or a metered-dose inhaler with spacer in preschool children with asthma. J. Pediatr. 124:1994;815-817.
209. Ahlstrom H., Svenonius E., Svensson M. Treatment of asthma in pre-school children with inhalation of terbutaline in Turbuhaler compared with Nebuhaler. Allergy. 44:1989;515-518.
210. Agertoft L., Pedersen S. Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir. Med. 88:1994;373-381.
211. Pedersen S., Steffensen G., Ohlsson S.V. The influence of orally deposited budesonide on the systemic availability of budesonide after inhalation from a turbohaler. Br. J. Clin. Pharmacol. 36:1993;211-214.
212. Hirst P.H., Bacon R.E., Pitcairn G.R., Silvasti M., Newman S.P. A comparison of the lung deposition of budesonide from Easyhaler, Turbohaler and pMDI plus spacer in asthmatic subjects. Respir. Med. 95:2001;720-727.
213. Vidgren M., Arppe J., Vidgren P., Hyvarinen L., Vainio P., Silvasti M., Tukiainen H. Pulmonary deposition and clinical response of 99mTc-labelled salbutamol delivered from a novel multiple dose powder inhaler. Pharm. Res. 11:1994;1320-1324.
214. Malmstrom K., Sorva R., Silvasti M. Application and efficacy of the multi-dose powder inhaler, Easyhaler, in children with asthma. Pediatr. Allergy Immunol. 10:1999;66-70.
215. Nieminen M.M., Vidgren P., Kokkarinen J., Laasonen K., Liippo K., Lindqvist A.P.M., Poukkula A., Ruotsalainen E., Salomaa E., Sovijarvi A.S.T., Silvasti M., Vidgren M., Laitinen L.A. A new beclomethasone dipropionate multidose powder inhaler in the treatment of bronchial asthma. Respiration. 65:1998;275-281.
216. Koskela T., Hedman J., Ekroos H., Kauppinen R., Sivasti M., Tukainen H. Equivalence of two steroid containing inhalers: easyhaler multidose powder inhaler compared with conventional aerosol with large volume spacer. Respiration. 67:2000;194-202.
217. O'Callaghan C., Everard M.L., Bush A., Hiller E.J., Ross-Russell R., O'Keefe P., Weller P. Salbutamol dry powder inhaler: efficacy, tolerability, and acceptability study. Pediatr. Pulmonol. 33:2002;189-193.
218. Lipworth B.J., Clark D.J. Lung delivery of salbutamol given by breath activated pressurized aerosol and dry powder inhaler devices. Pulm. Pharmacol. Ther. 10:1997;211-214.
219. Boulet L.P., Cowie R., Johnston P., Krakovsky D., Mark S. Comparison of Diskus inhaler, a new multidose powder inhaler, with Diskhaler inhaler for the delivery of salmeterol to asthmatic patients. Canadian Study Group. J. Asthma. 32:1995;429-436.
220. Bronsky E.A., Pearlman D.S., Pobiner B.F., Scott C., Wang Y., Stahl E. Prevention of exercise induced bronchospasm in pediatric asthma patients: A comparison of two salmeterol powder delivery devices. Pediatrics. 104:1999;501-506.
221. Mackie A.E., McDowall J.E., Falcoz C., Ventresca P., Bye A., Daley-Yates P.T. Pharmacokinetics of fluticasone proprionate inhaled via the Diskhaler and Diskus powder devices in healthy volunteers. Clin. Pharmacokinet. 39:2000;23-30.
222. Falcoz C., Horton J., Mackie A.E., Harding S.M., Daley-Yates P.T. Pharmacokinetics of fluticasone proprionate inhaled via the Diskhaler and Diskus powder devices in patients with mild-to-moderate asthma. Clin. Pharmacokinet. 39:2000;31-37.
223. Pieters W.R., Stallaert R.A., Prins J., Greefhorst A.P., Bosman H.G., van Uffelen R., Schreurs A.J., Van Helmond J.L., Janssen P.G. A study on the clinical equivalence and patient preference of fluticasone propionate 250 microg twice daily via the Diskus/Accuhaler inhaler or the Diskhaler inhaler in adult asthmatic patients. J. Asthma. 35:1998;337-345.
224. Peden D.B., Berger W.E., Noonan M.J., Thomas M.R., Hendricks V.L., Hamedani P., Mahajan A.G., House K.W. Inhaled fluticasone propionate delivered by means of two different multidose powder inhalers is effective and safe in a large pediatric population with persistent asthma. J. Allergy Clin. Immunol. 102:1998;32-38.
225. Bisgaard H., Klug B., Sumby B.S., Burnell P.K. Fine particle mass from the Diskus inhaler and Turbuhaler inhaler in children with asthma. Eur. Respir. J. 11:1998;1111-1115.
226. Prime D., Grant A.C., Slater A., Woodhouse R.N. A critical comparison of the dose delivery characteristics of four alternative inhalation devices delivering salbutamol: Pressurised metered dose inhaler, Diskus inhaler, Diskhaler inhaler and Turbuhaler inhaler. J. Aerosol Med. 12:1999;75-84.
227. Schlaeppi M., Edwards K., Fuller R.W., Sharma R. Patient perception of the diskus inhaler: a comparison with the turbuhaler inhaler. Br. J. Clin. Pract. 50:1996;14-19.
228. Serra-Battles J., Plaza V., Badiola C., Morejon E. Patient perception and acceptability of multidose dry powder inhalers: A randomised cross over comparison of Diskus/Accuhaler with Turbohaler. J. Aerosol Med. 15:2002;59-64.
229. Venables T.L., Addlestone M.B., Smithers A.J., Blagden M.D., Weston D., Gooding T., Carr E.P., Follows R.M.A. A comparison of the efficacy and patient acceptability of once daily budesonide via turbohaler and twice daily fluticasone proprionate via dischaler at an equal daily dose of 400 mcg in adult asthmatics. Br. J. Clin. Res. 7:1996;15-32.
230. van der Palen J., Klein J.J., Schildkamp A.M. Comparison of a new multidose powder inhaler (Diskus/Accuhaler) and the Turbuhaler regarding preference and ease of use. J. Asthma. 35:1998;147-152.
231. Williams J., Richards K.A. Ease of handling and clinical efficacy of fluticasone propionate Accuhaler/Diskus inhaler compared with the Turbohaler inhaler in paediatric patients. UK Study Group. Br. J. Clin. Pract. 51:1997;147-153.
232. Agertoft L., Pedersen S. A randomized, double-blind dose reduction study to compare the minimal effective dose of budesonide Turbuhaler and fluticasone propionate Diskhaler. J. Allergy Clin. Immunol. 99:1997;773-780.
233. Fuller R., Johnson M., Bye A. Fluticasone propionate: an update on preclinical and clinical experience. Respir. Med. 89:1995;3-18.
234. Gustafsson P., Tsanakas J., Gold M., Primhak R., Radford M., Gillies E. Comparison of the efficacy and safety of inhaled fluticasone propionate 200 micrograms/day with inhaled beclomethasone dipropionate 400 micrograms/day in mild and moderate asthma. Arch. Dis. Child. 69:1993;206-211.
235. -1. Eur. Respir. J. 9:1996;2263-2272.
236. Ferguson A.C., Spier S., Manjra A., Versteegh F.G.A., Mark S., Zhang P. Efficacy and safety of high-dose inhaled steroids in children with asthma: A comparison of fluticasone propionate with budesonide. J. Pediatr. 134:1999;422-427.
237. Lipworth B.J., Clark D.J. Comparative lung delivery of salbutamol given via Turbuhaler and Diskus dry powder inhaler devices. Eur. J. Clin. Pharmacol. 53:1997;47-49.
238. Arvidsson P., Mellen A., Palmquist M., Lotvall J. Equivalent therapeutic ratio of salbutamol given by Turbuhaler and Diskus. Respir. Med. 94:2000;574-577.
239. Palander A., Mattila T., Karhu M., Muttonen E. In vitro comparison of three salbutamol-containing multidose dry powder inhalers Buventol Easyhaler(TM), Inspiryl Turbuhaler(TM) and Ventoline Diskus(TM). Clin. Drug Invest. 20:2000;25-33.
240. Schweisfurth H., Malinen A., Koskela T., Toivanen P., Ranki-Pesonen M. Comparison of two budesonide powder inhalers, Easyhaler and Turbuhaler, in steroid naïve asthmatic patients. Respir. Med. 96:2002;599-606.
241. Kisch G.L., Paloucek F.P. Metered-dose inhalers and nebulizers in the acute setting. Ann. Pharmacother. 26:1992;92-95.
242. Pierce R.J., McDonald C.F., Landau L.I., Le Souef P.N., Armstrong J.G., Mitchell C.A., Francis P.W., Martin A.J., Musk A.W., Antic R. Nebuhaler versus wet aerosol for domiciliary bronchodilator therapy. A multi-centre clinical comparison. Med. J. Aust. 156:1992;771-774.
243. Blackhall M.I., O'Donnell S.R. A dose-response study of inhaled terbutaline administered via Nebuhaler or nebuliser to asthmatic children. Eur. J. Respir. Dis. 71:1987;96-101.
244. Rivlin J., Mindorff C., Reilly P., Levison H. Pulmonary responses to a bronchodilator delivered from three inhalation devices. J. Pediatr. 104:1984;470-473.
245. Benton G., Thomas R.C., Nickerson B.G., McQuitty J.C., Okikawa J. Experience with a metered-dose inhaler with a spacer in the pediatric emergency department. Am. J. Dis. Child. 143:1989;678-681.
246. Maguire G.P., Newman T., DeLorenzo L.J., Brown R.B., Stone D. Comparison of a hand-held nebulizer with a metered dose inhaler-spacer combination in acute obstructive pulmonary disease. Chest. 100:1991;1300-1305.
247. Campbell I.A., Colman S.B., Mao J.H., Prescott R.J., Weston C.F. An open, prospective comparison of beta 2 agonists given via nebuliser, Nebuhaler, or pressurised inhaler by ambulance crew as emergency treatment. Thorax. 50:1995;79-80.
248. Robertson C.F., Norden M.A., Fitzgerald D.A., Connor F.L., Van Asperen P.P., Cooper P.J., Francis P.W., Allen H.D.W. Treatment of acute asthma: Salbutamol via jet nebuliser vs. spacer and metered dose inhaler. J. Paediatr. Child Health. 34:1998;142-146.
249. Freelander M., Van Asperen P.P. Nebuhaler versus nebuliser in children with acute asthma. Br. Med. J. 288:1984;1873-1874.
250. Pendergast J., Hopkins J., Timms B., Van Asperen P.P. Comparative efficacy of terbutaline administered by Nebuhaler and by nebulizer in young children with acute asthma. Med. J. Aust. 151:1989;406-408.
251. Bowton D.L., Goldsmith W.M., Haponik E.F. Substitution of metered-dose inhalers for hand-held nebulizers: success and cost savings in a large, acute-care hospital. Chest. 101:1992;305-308.
252. Newhouse M.T. Pulmonary drug targeting with aerosols. Am. J. Asthma Allergy Pediatr. 7:1993;23-35.
253. Molina M.J., Rowland F.S. Stratospheric sink for chlorofluoromethanes: Chlorine atom destruction of ozone. Nature. 249:1974;810-812.
254. Partridge M.R. Metered-dose inhalers and CFCs: What respiratory physicians need to know. Respir. Med. 88:1994;645-647.
255. Montreal Protocol, Montreal Protocol on substances that deplete the ozone layer 26 1LM 1541 (1987).
256. Kleerup E.C., Tashkin D.P., Cline A.C., Ekholm B.P. Cumulative dose-response study of non-CFC propellant HFA 134a salbutamol sulfate metered-dose inhaler in patients with asthma. Chest. 109:1996;702-707.
257. Clark D.J., Lipworth B.J. Lung bioavailability of chlorofluorocarbon free, dry powder and chlorofluorocarbon containing formulations of salbutamol. Br. J. Clin. Pharmacol. 41:1996;247-249.
258. Ekholm B., Colice G., Klinger N., Kleerup E., Tashkin D. Relative potency of an HFA salbutamol product compared to a CFC salbutamol product. Eur. Respir. J. 9:1996;256S.
259. Dockhorn R., Vanden Burgt J.A., Ekholm B.P., Donnell D., Cullen M.T. Clinical equivalence of a novel non-chlorofluorocarbon-containing salbutamol sulfate metered-dose inhaler and a conventional chlorofluorocarbon inhaler in patients with asthma. J. Allergy Clin. Immunol. 96:1995;50-56.
260. Langley S.J., Sykes A.P., Batty E.P., Masterson C.M., Woodcock A. A comparison of the efficacy and tolerability of single doses of HFA 134a albuterol and CFC albuterol in mild-to-moderate asthmatic patients. Ann. Allergy Asthma Immunol. 88:2002;488-493.
261. Hawksworth R.J., Sykes A.P., Faris M., Mant T., Lee T.H. Albuterol HFA is as effective as albuterol CFC in preventing exercise-induced bronchoconstriction. Ann. Allergy Asthma Immunol. 88:2002;473-477.
262. Lumry W., Noveck R., Weinstein S., Barnhart F., Vandermeer A., Murray A., Reisner C. Switching from Ventolin CFC to Ventolin HFA is well tolerated and effective in patients with asthma. Ann. Allergy Asthma Immunol. 86:2001;297-303.
263. Ramsdell J.W., Colice G.L., Ekholm B.P., Klinger N.M. Cumulative dose-response study comparing HFA-134a albuterol sulfate and conventional CFC albuterol in patients with asthma. Ann. Allergy Asthma Immunol. 81:1998;593-599.
264. Shapiro G.S., Klinger N.M., Ekholm B.P., Colice G.L. Comparable bronchodilation with hydrofluoroalkane-134a (HFA) albuterol and chlorofluorocarbons-11/12 (CFC) albuterol in children with asthma. J. Asthma. 37:2000;667-675.
265. Bleecker E.R., Tinkelman D.G., Ramsdell J., Ekholm B.P., Klinger N.M., Colice G.L.S.H.B. Proventil HFA provides bronchodilation comparable to ventolin over 12 weeks of regular use in asthmatics. Chest. 113:1998;283-289.
266. Desager K.N., Van Bever H.P., Vermeire P.A. Comparison of non-chlorofluorocarbon-containing salbutamol and conventional inhaler. Lancet. 348:1996;200-201.
267. Leach C.L., Davidson P.J., Boudreau R.J. Improved airway targeting with the CFC-free HFA-beclomethasone metered-dose inhaler compared with CFC-beclomethasone. Eur. Respir. J. 12:1998;1346-1353.
268. Leach C.L. Improved delivery of inhaled steroids to the large and small airways. Respir. Med. 92:1998;3-8.
269. Dahl A.R., Ringdal N., Ward S.M., Stampone P., Donnell D. Equivalence of asthma control with new CFC-free formulation HFA-134a beclomethasone dipropionate and CFC-beclomethasone dipropionate. Br. J. Clin. Pharmacol. 51:2000;11-15.
270. Davies R.J., Stampone P., O'Connor B.J. Hydrofluoroalkane-134a beclomethasone dipropionate extrafine aerosol provides equivalent asthma control to chlorofluorocarbon beclomethasone dipropionate at approximately half the total daily dose. Respir. Med. 92:1998;23-31.
271. Cross G., Thompson P.J., Chervinsky P., Vanden Burgt J.A. Hydrofluoroalkane-134a Beclomethasone Dipropionate, 400 μg, is as effective as chlorofluorocarbon beclomethasone dipropionate, 800 μg, for the treatment of moderate asthma. Chest. 115:2000;343-351.
272. Busse W.W., Brazinsky S., Jacobsen K., Stricker W., Schmitt K., Vanden Burgt J., Donnell D., Hannon S., Colice G.L. Efficacy response of inhaled beclomethasone dipropionate in asthma is proportional to dose and is improved by formulation with a new propellant. J. Allergy Clin. Immunol. 104:1999;1215-1222.
273. Milanowski J., Qualtrough J., Perrin V.L. Inhaled beclomethasone (BDP) with non-CFC propellant (HFA 134a) is equivalent to BDP-CFC for the treatment of asthma. Respir. Med. 93:1999;245-251.
274. Farmer I.S., Middle M., Savic J., Perrin V.L., Herdman M.J. Therapeutic equivalence of inhaled beclomethasone dipropionate with CFC and non-CFC (HFA 134a) propellants both delivered via the Easibreathe inhaler for the treatment of paediatric asthma. Respir. Med. 94:2000;57-63.
275. Agertoft L., Pedersen S., Harrison L. Lung deposition and basic pharmacokinetic parameters of beclomethasone dipropionate in asthmatic children after inhalation from a HFA-pMDI (Autohaler) and a CFC-pMDI with spacer. Am. J. Respir. Crit. Care Med. 160:1999;A37.
276. Fowler S.J., Orr L.C., Sims E.J., Wilson A.M., Currie G.P., McFarlane L., Lipworth B.J. Therapeutic ratio of hydrofluoroalkane and chlorofluorocarbon formulations of fluticasone proprionate. Chest. 122:2002;618-623.
277. Tonnel A.B., Tons J., Legendre M., PrudHomme A., Bugnas B., Evano-Celli I., Stuart A.M. Clinical efficacy and safety of fluticasone propionate 250 μg twice daily administered via a HFA 134a pressurised metered dose inhaler to patients with mild to moderate asthma. Respir. Med. 94:2000;S29-S34.
278. Perruchoud A.P., Lundback B., Yigla M., Sykes A.P. Clinical efficacy and safety of fluticasone propionate 1 mg per day administered via a HFA 134a pressurised metered dose inhaler to patients with moderate to severe asthma. Respir. Med. 94:2000;S35-S41.
279. Ayres J.G., Millar A.B., Sykes A.P. Clinical efficacy and safety of fluticasone propionate 1 mg twice daily administered via a HFA 134a pressurised metered dose inhaler to patients with severe asthma. Respir. Med. 94:2000;S42-S50.
280. Kamps A.W.A., van Ewijk B., Roorda R.J., Brand P.L.P. Poor inhalation technique, even after inhalation instructions, in children with asthma. Pediatr. Pulmonol. 29:2000;39-42.
281. De Boeck K., Alifier M., Warnier G. Is the correct use of a dry powder inhaler (Turbohaler) age dependent? J. Allergy Clin. Immunol. 103:1999;763-767.
282. Pedersen S., Hansen O.R., Fuglsang G. Influence of inspiratory flow rate upon the effect of a Turbuhaler. Arch. Dis. Child. 65:1990;308-319.
283. Anonymous, Drug delivery systems in asthma. Drug Ther. Bull. 38 (2000) 9-14.
284. O'Callaghan C., Barry P.W. How to choose delivery devices for asthma. Arch. Dis. Child. 82:2000;185-187.
285. O'Callaghan C., Barry P.W. Asthma drug delivery devices for children. Br. Med. J. 320:2000;664.
286. Bender B., Milgrom H., Rand C., Ackerson L. Psychological factors associated with medication nonadherence in asthmatic children. J. Asthma. 35:1998;347-353.
287. Milgrom H., Bender B., Ackerson L., Bowry P., Smith B., Rand C. Noncompliance and treatment failure in children with asthma. J. Allergy Clin. Immunol. 98:1996;1051-1057.
288. Spector S.L., Kinsman R., Mawhinney H., Siegel S.C., Rachelefsky G.S., Katz R.M., Rohr A.S. Compliance of patients with asthma with an experimental aerosolized medication: implications for controlled clinical trials. J. Allergy Clin. Immunol. 77:1986;65-70.
289. Coutts J.A., Gibson N.A., Paton J.Y. Measuring compliance with inhaled medication in asthma. Arch. Dis. Child. 67:1992;332-333.
290. Gibson N.A., Ferguson A.E., Aitchison T.C., Paton J.Y. Compliance with inhaled asthma medication in preschool children. Thorax. 50:1995;1274-1279.
291. Jonassen G., Carlsen K.H., Sodal A., Jonassen C., Mowinckel P. Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma. Eur. Respir. J. 14:1999;150-154.
292. Jonasson G., Carlsen K.H., Mowinckel P. Asthma drug adherence in a long term clinical trial. Arch. Dis. Child. 83:2000;330-333.
293. Mahajan P., Okamoto L. Patient satisfaction with the Diskhaler and the Diskus inhaler, a new multidose power delivery system for the treatment of asthma. Clin. Ther. 19:1997;1126-1134.
294. Nielson K., Shah T. Importance of selected inhaler characteristics and acceptance of a new breath-actuated powder inhalation device. J. Asthma. 34:1997;249-253.
295. Newman S.P., Clark A.R., Talaee N., Clarke S.W. Pressurised aerosol deposition in the human lung with and without an 'open' spacer device. Thorax. 44:1989;706-710.
296. Newman S., Steed K., Hooper G., Kallen A., Borgstrom L. Comparison of gamma scintigraphy and a pharmacokinetic technique for assessing pulmonary deposition of terbutaline sulphate delivered by pressurized metered dose inhaler. Pharm. Res. 12:1995;231-236.
297. Pitcairn G.R., Lim J., Hollingworth A., Newman S.P. Scintigraphic assessment of drug delivery from the Ultrahaler dry powder inhaler. J. Aerosol Med. 10:1997;295-306.
298. Newman S.P., Steed K.P., Reader S.J., Hooper G., Zierenberg B. Efficient delivery to the lungs of flunisolide aerosol from a new portable hand-held multidose nebulizer. J. Pharm. Sci. 85:1996;960-964.
299. Ashworth H.L., Wilson C.G., Sims E.E., Wotton P.K., Hardy J.G. Delivery of propellant soluble drug from a metered dose inhaler. Thorax. 46:1991;245-247.
300. Vidgren M.T., Paronen T.P., Karkkainen A., Karjalainen P. Effect of extension devices on the drug deposition from inhalation aerosols. Int. J. Pharm. 39:1987;107-112.
301. Newman S., Pitcairn G., Steed K., Harrison A., Nagel J. Deposition of fenoterol from pressurized metered dose inhalers containing hydrofluoroalkanes. J. Allergy Clin. Immunol. 104:1999;S253-S257.
302. Newman S.P., Steed K.P., Hooper G., Jones J.I., Upchurch F.C. Improved targeting of beclomethasone diproprionate (250 micrograms metered dose inhaler) to the lungs of asthmatics with the Spacehaler. Respir. Med. 93:1999;424-431.
303. Leach C.L., Davidson P.J., Hasselquist B.E., Boudreau R.J. Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest. 122:2002;510-516.
304. Leach C.L., Davidson P.J., Boudreau R.J. Improved airway targeting with the CFC-free HFA-beclomethasone metered-dose inhaler compared with CFC-beclomethasone. Eur. Respir. J. 12:1998;1346-1353.
305. Hirst P.H., Pitcairn G.R., Richards J.C., Rohatagi S., Gillen M.S., Newman S.P. Deposition and pharmacokinetics of an HFA formulation of triamcinolone acetonide delivered by pressurized metered dose inhaler. J. Aerosol Med. 14:2001;155-165.
306. Richards J., Hirst P., Pitcairn G., Mahashabde S., Abramowitz W., Nolting A., Newman S.P. Deposition and pharmacokinetics of flunisolide delivered from pressurized inhalers containing non-CFC and CFC propellants. J. Aerosol Med. 14:2001;197-208.
307. Newman S.P., Pitcairn G.R., Adkin D.A., Vidgren M.T., Silvasti M. Comparison of beclomethasone dipropionate delivery by easyhaler dry powder inhaler and pMDI plus large volume spacer. J. Aerosol Med. 14:2001;217-225.
308. O'Reilly J.F., Buchanan D.R., Sudlow M.F. Pressurised aerosol with conical spacer is an effective alternative to nebuliser in chronic stable asthma. Br. Med. J. 286:1983;1548.
309. Gibson P.G., Wlodarczyk J.H., Borgas T. Drug delivery in asthma: a comparison of spacers with a jet nebuliser. Aust. N.Z. J. Med. 25:1995;324-329.
310. Laursen L.C., Munch E.P., Weeke E., Hidinger K.G. Comparison of a 750 ml spacer and a nebulizer in domiciliary treatment of severe chronic asthma with terbutaline. Eur. J. Respir. Dis. 64:1983;498-503.
311. Salzman G.A., Pyszczynski D.R. A comparison of two delivery methods for aerosolized metaproterenol sulfate. J. Asthma. 23:1986;297-301.
312. Madsen E.B., Bundgaard A., Hidinger K.G. Cumulative dose-response study comparing terbutaline pressurized aerosol administered via a pearshaped spacer and terbutaline in a nebulized solution. Eur. J. Clin. Pharmacol. 23:1982;27-30.
313. Pedersen J.Z., Bundgaard A. Comparative efficacy of different methods of nebulising terbutaline. Eur. J. Clin. Pharmacol. 25:1983;739-742.
314. Stauder J., Hidinger K.G. Terbutaline aerosol from a metered dose inhaler with a 750-ml spacer or as a nebulized solution. Comparison of two delivery systems for bronchodilator aerosol. Respiration. 44:1983;237-240.
315. Cushley M.J., Lewis R.A., Tattersfield A.E. Comparison of three techniques of inhalation on the airway response to terbutaline. Thorax. 38:1983;908-913.
316. Prior J.G., Nowell R.V., Cochrane G.M. High-dose inhaled terbutaline in the management of chronic severe asthma: comparison of wet nebulisation and tube-spacer delivery. Thorax. 37:1982;300-303.
317. Summer W., Elston R., Tharpe L., Nelson S., Haponik E.F. Aerosol bronchodilator delivery methods. Relative impact on pulmonary function and cost of respiratory care. Arch. Intern. Med. 149:1989;618-623.
318. Fuglsang G., Pedersen S. Comparison of Nebuhaler and nebulizer treatment of acute severe asthma in children. Eur. J. Respir. Dis. 69:1986;109-113.
319. Morgan M.D., Singh B.V., Frame M.H., Williams S.J. Terbutaline aerosol given through pear spacer in acute severe asthma. Br. Med. J. 285:1982;849-850.
320. Salzman G.A., Steele M.T., Pribble J.P., Elenbaas R.M., Pyszczynski D.R. Aerosolized metaproterenol in the treatment of asthmatics with severe airflow obstruction. Comparison of two delivery methods. Chest. 95:1989;1017-1020.
321. Turner J.R., Corkery K.J., Eckman D., Gelb A.M., Lipavsky A., Sheppard D. Equivalence of continuous flow nebulizer and metered-dose inhaler with reservoir bag for treatment of acute airflow obstruction. Chest. 93:1988;476-481.
322. Colacone A., Afilalo M., Wolkove N., Kreisman H. A comparison of albuterol administered by metered dose inhaler (and holding chamber) or wet nebulizer in acute asthma. Chest. 104:1993;835-841.
323. Berenberg M.J., Baigelman W., Cupples L.A., Pearce L. Comparison of metered-dose inhaler attached to an aerochamber with an updraft nebulizer for the administration of metaproterenol in hospitalized patients. J. Asthma. 22:1985;87-92.
324. Lin Y.Z., Hsieh K.H. Metered dose inhaler and nebuliser in acute asthma. Arch. Dis. Child. 72:1995;214-218.
325. Parkin P.C., Saunders N.R., Diamond S.A., Winders P.M., Macarthur C. Randomised trial spacer v nebuliser for acute asthma. Arch. Dis. Child. 72:1995;239-240.
326. Berry R.B., Shinto R.A., Wong F.H., Despars J.A., Light R.W. Nebulizer vs. spacer for bronchodilator delivery in patients hospitalized for acute exacerbations of COPD. Chest. 96:1989;1241-1246.
327. Ba M., Spier S., Lapierre G., Lamarre A. Wet nebulizer versus spacer and metered dose inhaler via tidal breathing. J. Asthma. 26:1989;355-358.
328. Morley T.F., Marozsan E., Zappasodi S.J., Gordon R., Griesback R., Giudice J.C. Comparison of beta-adrenergic agents delivered by nebulizer vs. metered dose inhaler with InspirEase in hospitalized asthmatic patients. Chest. 94:1988;1205-1210.
329. Beasley C.R.W., O'Donnel T.V. Pear shaped spacer nebuhaler compared with nebulised solution for terbutaline administration in acute severe asthma. New Zealand Med. J. 98:1985;854-855.
330. Gervais A., Begin P. Bronchodilatation with a metered dose inhaler plus an extension, using tidal breathing vs. jet nebulisation. Chest. 92:1987;822-824.
331. Jasper A.C., Mohsenifar Z., Kahan S., Goldberg H.S., Koerner S.K. Cost-benefit comparison of aerosol bronchodilator delivery methods in hospitalized patients. Chest. 91:1987;614-618.
332. Idris A.H., McDermott M.F., Raucci J.C., Morrabel A., McGorray S., Hendeles L. Emergency department treatment of severe asthma. Metered-dose inhaler plus holding chamber is equivalent in effectiveness to nebulizer. Chest. 103:1993;665-672.
333. Kerem E., Levison H., Schuh S., O'Brodovich H., Reisman J., Bentur L., Canny G.J. Efficacy of albuterol administered by nebulizer versus spacer device in children with acute asthma. J. Pediatr. 123:1993;313-317.
334. Chou K.J., Cunningham S.J., Crain E.F. Metered-dose inhalers with spacers vs. nebulizers for pediatric asthma. Arch. Pediatr. Adolesc. Med. 149:1995;201-205.