Comparison of Output Particle Size Distributions from Pressurized Aerosols Formulated as Solutions or Suspensions

The delivery of particles as small as possible (preferably <5 µm) to the respiratory tract should be the aim of those formulating metered dose inhalers (MDIs). This may be facilitated by the formulation of solution, rather than suspension-type, pressurized aerosol units. Two series of MDIs were compared; one contained suspended micronized disodium fluorescein (0.1%, w/v), while the other contained the same concentration of dissolved salicylic acid. Either oleic acid, L--phosphatidylcholine, or sorbitan trioleate was incorporated at 0.15% (w/v) as suspending agent (disodium fluorescein) or solubilizing agent (salicylic acid). The propellant blend was 70% (w/w) Freon 12 and 30% (w/w) Freon 11 in all cases. This exhibited a vapor pressure of 50.6 psig (444.7 kPa) at 21°C. The output particle size distribution of the aerosol reaching the cascade impactor showed a mass median aerodynamic diameter (MMAD) of approximately 4 and 2 µm for the suspension and solution formulations respectively, regardless of the surfactant used. Larger MMADs were observed for solution aerosols formulated with oleic acid (2.32 µm) compared to those containing L--phosphatidylcholine (1.93 µm) or sorbitan trioleate (2.07 µm). Possible reasons for these observations are discussed.     

Prediction and Assessment of Flammability Hazards Associated with Metered-Dose Inhalers Containing Flammable Propellants

Several potential replacements for chlorofluorocarbons (CFCs) in metered-dose inhalers (MDIs) are flammable. The flammability hazard associated with their use was assessed using a range of MDIs containing 0–100% (w/w) n-butane (flammable) in HFC-134a (nonflammable) fitted with either 25-, 63-, or 100-µl metering valves or continuous valves. In flame projection tests each MDI was fired horizontally into a flame, and the ignited flume length emitted from the MDI was measured. Flame projections of 60 cm were produced by all formulations fitted with continuous valves which contained 40% (w/w) n-butane in HFC-134a. Using metering valves the maximum flame projection obtained was 30 cm. This was observed with a formulation containing 90% (w/w) n-butane in HFC-134a and a 100-µl valve. For a particular formulation, smaller metering valves produced shorter flame projections. Because many MDIs are used in conjunction with extension devices, the likelihood of accidental propellant vapor ignition was determined in Nebuhaler and Inspirease reservoirs and a Breathancer spacer. Ignition was predictable based on propellant composition, metered volume, number of actuations, and spacer capacity. Calculated n-butane concentrations in excess of the lower flammability limit [LFL; 1.9% (v/v)] but below the upper flammability limit [UFL; 8.5% (v/v)] were usually predictive of flammability following ignition by a glowing nichrome wire mounted inside the extension device. No ignition was predicted or observed following one or two 25-µl actuations of 100% n-butane into large volume Nebuhaler (750 ml) or Inspirease (660 ml) devices. Additionally, several other formulations containing lower proportions of n-butane also remained nonflammable, due to failure to reach the LFL. In the small-volume Breathancer spacer (140 ml), nonflammability was usually due to n-butane exceeding its UFL. In this situation further dilution during respiration could result in a flammable mixture. Using a carefully selected propellant blend, metering volume, and spacer design, environmentally acceptable flammable propellants may have considerable utility in MDIs reformulated without CFCs.     

The Pulmonary Absorption of Aerosolized and Intratracheally Instilled rhG-CSF and monoPEGylated rhG-CSF

Purpose. The objective of this study was to highlight differences in the pulmonary absorption of a monoPEGylated rhG-CSF and rhG-CSF after intratracheal instillation and aerosol delivery. Methods. Male Sprague Dawley rats (250 g) were anesthetized and intratracheally instilled (IT) with protein solution or were endotracheally intubated and administered aerosol for 20 min via a Harvard small animal ventilator. A DeVilbiss Aerosonic nebulizer containing 5 ml of protein solution at 3 mg/ml was used to generate aerosol. The volume of protein solution deposited in the lung lobes was estimated to be 13 µl after delivery of Tc-99m HSA solutions. The PEGylated proteins consisted of a 6 kDa (P6) or 12 kDa PEG (PI2) linked to the N-terminus of rhG-CSF. rhG-CSF also was administered IT in buffers at pH 4 and pH 7 and in dosing volumes ranging from 100 to 400 µl. Blood samples were removed at intervals after dosing and the total white blood cell counts (WBC) were determined. Plasma was assayed for proteins by an enzyme immuno assay. Results. The plasma protein concentration v. time profiles were strikingly different for aerosol v. IT delivery. The C _max values for rhG-CSF and P12 after aerosol delivery were greater than found after IT (Aerosol: 598 ± 135 (ng/ml) rhG-CSF; 182 ± 14 P12 v. IT: 105 ± 12 rhG-CSF; 65.9 ± 5 P12). Similarly, T_max was reached much earlier after aerosol administration (Aerosol: 21.7 ± 4.8 (min) rhG-CSF; 168 ± 31 P12 v. IT: 100 ± 17 rhG-CSF; 310 ± 121 P12). Estimated bioavailabilities (F_lung %) were significantly greater via aerosol delivery than those obtained after IT (Aerosol: 66 ± 14 rhG-CSF; 12.3 ± 1.9 P12 v. IT: 11.9 ± 1.5 rhG-CSF; 1.6 ± 0.1 P12). An increase in circulating WBC counts was induced by all proteins delivered to the lungs. The rate and extent of absorption of rhG-CSF was not influenced by the pH employed nor the instilled volume. Conclusions. Estimates of bioavailability are dependent upon the technique employed to administer drug to the lungs. Aerosol administration provides a better estimate of the systemic absorption of macromolecules.     

The Influence of Sodium Glycocholate and Other Additives on the in vivo Transfection of Plasmid DNA in the Lungs

Purpose. A plasmid containing the luciferase marker cDNA was constructed to test non viral gene delivery formulations in vivo. Methods. A scale up procedure was devised to produce up to gram quantities of plasmid. Sufficient quantities were generated to process and test the DNA with various additives and to generate a spray-dried powder formulation of the plasmid. Male Sprague-Dawley rats (250 g) were intratracheally instilled with 200–250 µl of solution containing 200 µg plasmid ± lipid [DC Chol:DOPE 1:1 molar (2mg/kg)] growth factors [KGF (10 mg/kg), EGF (5 mg/kg)], permeation enhancers [sodium glycocholate (0.01 to 10% w/v)), sodium deoxycholate (1% w/v), beta-cyclodextrin (1% w/v)], surfactant [Tween 80 (1% w/v)], a mucolytic [N-acetylcysteine (10% w/v)] and positively charged synthetic polymers [PVAVAM 6 and 14%]. Animals were sacrificed 24 hr post-dose and the lungs were assayed for luciferase using a chemiluminescent assay. Results. The relative ability of the materials to promote luciferase production in the lungs was permeation enhancer >> DNA alone lipid, mucolytic, surfactant, growth factor > polymer. Protein production in the lungs ranged from 10 times below the DNA control (16 pg) using the polymers (1.5 pg) to 125 times greater than the control using the permeation enhancer (2050 pg). The transfection capabilities of the majority of additives was low. The enhancing effects of sodium glycocholate were dose-dependent and perhaps associated with the critical micelle concentration. Although the bile salt was the most successful of the tested compounds, it resulted in significant mortality when used at concentrations greater than 1 % w/v. Conclusions. The results suggest that transfection can be significantly enhanced by additives such as NaGC but some toxicity may be unavoidable.     

Optimized Inhalation Aerosols. I. The Effects of Spherical Baffle Size and Position upon the Output of Several Pressurized Nonaqueous Suspension Formulations

Baffles contained in conventional actuators may be a convenient alternative to some of the extension devices used presently with metered-dose inhalers (MDIs). Actuators were modified to determine whether baffles could be used to decrease the output of large nonrespirable droplets. These actuators were tested using a series of nonaqueous suspension aerosols containing 0.1 to 2.0% micronized disodium fluorescein (DF) as the model drug, stabilized by sorbitan trioleate in a constant blend of fluorocarbons 11, 12, and 114. A 25-µl metering volume was used throughout. Aerosol output was characterized by cascade impaction. Baffle size and position had pronounced effects on actuator retention and aerosol output. Increasing baffle size resulted in increased retention in the actuator. The total output of the MDI in the respirable range (aerodynamic diameter, D _ae, <5.5 µm) was greater in the unbaffled actuator than in all baffled actuators. However, all baffles increased the respirable fraction (DF with D _ae <5.5 µm: total DF leaving the actuator), R, when compared to their unbaffled controls. For example, for a 0.1% DF, 0.14% surfactant formulation, R was increased from 0.40 (unbaffled) to 0.71 by incorporation of a 0.6-cm-diameter sphere 1.3 cm from the jet of the actuator. In these cases, aerosol segregation occurred due to droplet inertia in the high velocity gas flows. Increasing the respirable fraction at the expense of the total respirable output may obviate undesirable clinical effects.     

Pulmonary Delivery of Powders and Solutions Containing Recombinant Human Granulocyte Colony-Stimulating Factor (rhG-CSF) to the Rabbit

Two powder formulations (MMAD <4 µm) containing rhG-CSF were insufflated (IF) via an endotracheal tube at doses of 5, 75 or 500 µg/kg to New Zealand white rabbits. Doses of 5 and 500 µg/kg of solutions were administered by intratracheal instillation (IT), subcutaneous (SC) injection in the thigh and intravenous injection (IV) via the marginal ear vein. Blood samples were removed at regular intervals from an indwelling jugular catheter. Blood was analyzed directly for total white blood cell counts (WBC). Plasma was assayed for rhG-CSF by a specific ELISA. The distribution of radioactive dose in lung tissue was found after administering Tc99m HSA in solution or when incorporated into powders. The pharmacokinetics and pharmacodynamics were determined for all routes of administration. High dose IV concentration vs. time profiles declined biexponentially (t_1/2 = 0.6 ± 0.2 hrs, t_1/2 = 4.6 ± 0.2 hrs, n = 8). Clearance was dose dependent (11.6 ± 2.6 [500 µg/kg, n = 8] vs. 21.8 ± 3.3 ml/hr/kg [5 µg/kg, n = 5]). A normal systemic response was obtained after IF, indicating that rhG-CSF retains activity in the solid state. Dissolution and absorption of rhG-CSF from the powders were not rate limiting. The plasma concentration vs. time profiles peaked at similar times to those after IT (T_max 1 -2 hrs) but were earlier than obtained after SC (T_max 6-10 hrs). Powders were less efficiently dosed to the lung lobes after insufflation compared with instillates (14.7 ± 10.5 vs. 60.1 ± 10.6%), resulting in bioavailabilities ranging from 5 to 33%. Bioavailability after SC was 11.0 ± 7.0% and 95.3 ± 7.9% (n = 6) for the low and high doses, respectively.     

Nebulization of Liposomes. I. Effects of Lipid Composition

A series of multilamellar liposome dispersions was prepared from lipids of soy phosphatidylcholine or hydrogenated soy phosphatidylcholine containing from 0 to 30 mol% of either cholesterol, steary-lamine, or dipalmitoyl phosphatidylglycerol. The liposome dispersions were aerosolized with a Collison nebulizer for 80 min at an output flow rate of 4.7 liters of air/min. The effects of nebulization on the vesicles were determined by monitoring the release of encapsulated 5,6-carboxyfluorescein (CF) from dispersions containing 200 µg of total CF, of which 93.1 ± 2.4% (N = 18) was initially encapsulated. In all experiments CF was released from the liposomes while being aerosolized, and this ranged from a mean of 12.7 ± 3.8 to 60.9 ± 1.9% of the encapsulated CF, depending upon the lipid composition. The lipid concentration in the dispersions did not affect the rate or percentage release of CF over a range of 0.5 to 50 mg per nebulized dispersion. If liposomes are to be used as drug carriers in an inhalation aerosol a lipid composition should be employed which will minimize the release of encapsulated drug caused by nebulization.     

The Effects of Permeation Enhancers on the Surface Morphology of the Rat Nasal Mucosa: A Scanning Electron Microscopy Study

A rat model has been developed to compare relative morphological changes in the nasal mucosa after exposure to potential membrane permeation enhancers. Scanning electron microscopy was used to characterize gross structural and specific cellular changes following exposure. Micrographs of the rat nasal mucosa were scored in four categories: (1) mucosal surface integrity, (2) ciliary morphology, (3) mucus/extracellular debris, and (4) presence of red blood cells. The order of increasing morphological damage resulting from a 5-min exposure to each surfactant was 0.5% Solulan C-24 0.5% Solulan C-24/0.5% sodium tauro-24,25-dihydrofusidate (STDHF) < 0.5% STDHF < 1.0% STDHF 1.0% Laureth-9 < 1.0% sodium taurodeoxycholate 1.0% sodium deoxycholate. The changes observed in the mucosal morphology after exposure to the various surfactants are in general agreement with data in the literature. This model is able to compare rapidly the relative morphological effects on the mucosal membrane of different nasal formulations.     

Pulmonary Absorption of Recombinant Methionyl Human Granulocyte Colony Stimulating Factor (r-huG-CSF) After Intratracheal Instillation to the Hamster

Recombinant methionyl human granulocyte colony stimulating factor (G-CSF), a molecule of 18.8 kDa, has been shown to induce a systemic response after delivery by aerosol. In this work, rate and extent of absorption as well as the response were determined after bolus administration of solutions by intratracheal instillation (IT). The protein was quantified using a specific ELISA and the biological response was assessed by monitoring the increase in numbers of circulating white blood cells (WBC). A dose–response curve was obtained after IT, subcutaneous injection (SC), and intracardiac injection (IC) of 100 µL of a nominal dose ranging from 1 to 1000 µg/kg G-CSF (n = 5). WBC numbers were determined 24 hr postadministration. Absorption and clearance kinetics were determined after IT and IC of 500 µg/kg protein over a 24-hr time period (n = 5). The response of the lung to G-CSF was monitored by WBC counts and differentials in lung lavage fluid. 73.6 ± 10.5% (n = 7) of the IT dose reached the lung lobes. The response to single doses of G-CSF by IT or SC was similar, with WBC numbers increasing over 4× baseline at the higher doses. Absorption from the lung was rapid and did not follow first-order kinetics. Clearance after the IC dose was described by a biexponential equation ( = 1.41, = 0.24 hr^–1). Peak serum levels were obtained 1–2 hr after IT. The bioavailability was 45.9% of the administered dose and 62.0% of the dose reaching the lung lobes. These results indicate that G-CSF is rapidly absorbed from the lung. Pulmonary delivery via the airways has promise as an alternative to parenteral injection.     

Selecting an accessory device with a metered-dose inhaler: variable influence of accessory devices on fine particle dose, throat deposition, and drug delivery with asynchronous actuation from a metered-dose inhaler.

Accessory devices reduce common problems with metered-dose inhalers (MDIs), namely high oropharyngeal deposition of aerosol and incoordination between actuation and inhalation by the patient. The objective of this study was to systematically compare the performance of various accessory devices in vitro. MDIs were tested alone or in combination with four spacers (Toilet paper roll, Ellipse, Optihaler, Myst Assist) and five holding chambers (Aerochamber, Optichamber, Aerosol Cloud Enhancer, Medispacer, and Inspirease). An Anderson cascade impactor was used to measure aerosol mass median aerodynamic diameter (MMAD) and fine particle dose (MMAD < 4.7 microm). In separate experiments, the influence of asynchronous MDI actuation on drug delivery was determined with a simulated spontaneous breathing model. Compared with the MDI alone, all of the accessory devices reduced aerosol MMAD and increased lung-throat ratio (fine particle dose/throat impaction; p < 0.05 for both parameters). The fine particle dose of albuterol was 40% higher with the Ellipse (p < 0.01), was equivalent with the Toilet Paper Roll, Aerochamber, Optichamber, and Medispacer, and was 33-56% lower with the Optihaler, Myst Assist, Aerosol Cloud Enhancer, and Inspirease (p < 0.03). MDI actuation in synchrony with inspiration produced highest drug delivery; when MDI actuation occurred 1-sec before inspiration or during exhalation, decrease in drug delivery with holding chambers (10-40% reduction) was less than that with spacers (40-90% reduction). Accessory device selection is complicated by variability in performance between devices, and in the performance of each device in different clinical settings. In vitro characterization of a MDI and accessory device could guide appropriate device selection in various clinical settings.     

Application of in Vivo Microdialysis to Transdermal Absorption of Methotrexate in Rats

Microdialysis was applied to determine the in vivo transdermal absorption of methotrexate (MTX) in rats with or without a new penetration enhancer, l-[2-(decylthio)ethyl]azacyclopentan-2-one (HPE-101). A solution composed of 2.5 mM MTX and 3% (w/v) HPE-101 was applied to the shaved abdomen, in which a semipermeable membrane cannula of 10-mm length was inserted intracutaneously with the use of an L-shaped needle. Intradermal microdialysis was performed at a flow rate of 1.0 µL/min for 12 hr. The concentration of MTX in the dialysate was measured by fluorescence polarization immunoassay (FPIA). HPE-101 (3%, w/v) significantly increased the dermal MTX concentration from 0.06±0.04 µM in the control to 56±26 µM in the dialysate from 8 to 12 hr. HPE-101 at concentrations of 0.75, 1.5, 2.25, and 3% (w/v) enhanced the total recovery of MTX in dermal dialysate from 0 to 10 hr by approximately 5, 18, 42, and 500 times compared with the control, respectively. The microdialysis system is useful for assessing in vivo transdermal drug absorption.     

Potentiation of Enteral Absorption of Human Interferon Alpha and Selective Transfer into Lymphatics in Rats

Enhancement of human leucocyte interferon (HuIFN-) absorption from rat large intestine was studied with the aid of lipid, surfactant and lipid-surfactant mixed micelles. Neither the emulsified lipid (linoleic acid) nor the surfactant (HCO60, polyoxyethylated [60 moles] hydrogenated castor oil) alone were able to enhance the absorption of HuIFN-. However, linoleic acid-HCO60 mixed micelles enhanced the absorption of HuIFN- from the large intestine. Highly selective delivery of HuIFN- into the lymphatics compared to the blood was also observed.     

Absorption Enhancing Effect of Cyclodextrins on Intranasally Administered Insulin in Rats

The absorption enhancing effect of -, -, and -cyclodextrin (CD), dimethyl--cyclodextrin (DMCD), and hydroxypropyl--cyclodextrin (HPCD) on intranasally administered insulin was investigated in rats. Coadministration of 5% (w/v) DMCD to the insulin solution resulted in a high bioavailability, 108.9 ± 36.4% (mean ± SD, n = 6), compared to i.v. administration, and a strong decrease in blood glucose levels, to 25% of their initial values. Coadministration of 5% -CD gave rise to an insulin bioavailability of 27.7 ± 11.5% (mean ± SD, n = 6) and a decrease in blood glucose to 50% of its initial value. The rate of insulin absorption and the concomitant hypoglycemic response were delayed for the -CD-containing solution as compared to the DMCD preparation. The other CDs, HPCD (5%), -CD (1.8%), and -CD (5%), did not have significant effects on nasal insulin absorption. DMCD at a concentration of 5% (w/v) induces ciliostasis as measured on chicken embryo tracheal tissue in vitro, but this effect is reversible. In conclusion, DMCD is a potent enhancer of nasal insulin absorption in rats.     

Evaluation of Impaction Force of Nasal Sprays and Metered-Dose Inhalers Using the Texture Analyser

The impaction force from an inhalation product is an important characteristics by which to characterize the spray plume. It is one of the plume characteristics that can be perceived by a patient, and is expected to be good measures of local delivery equivalence for inhalation drugs. A Stable Micro Systems TA-XT.plus Texture Analyser equipped with 750 g load cell was used to measure the impaction force of several nasal sprays and metered-dose inhalers (MDIs). A survey of several commercial nasal spray and MDI products shows that impaction forces of these products varies from 1.5 to 6.5 g force and are significantly different from each other. A 3-level, 4-factor Box-Behnken design was applied to the study of impaction force of nasal sprays using placebo solutions. The influences of four factors: actuation stroke length, actuation velocity, concentration of gelling agent, and concentration of surfactant, were investigated. Of those factors examined here, actuation velocity exerts the greatest effect on impaction force. Impaction force is a discriminative parameter for in vitro testing of nasal spray and MDI products. Since impaction force is more directly related to patient sensation and aerosol deposition in the nasal mucus than other, more traditional parameters, it may provide a better way to evaluate in vitro equivalence in support of abbreviated new drug applications (ANDAs) for orally inhaled and nasal drug products     

A microcalorimetric study of surfactant aggregation and surfactant-drug interaction in a model inhalation aerosol system

Two surfactants, oleic acid and Span 85, have been diluted from concentrated solution in Arcton 113 by gradual titration into Arcton 113 in a titration cell of an isothermal microcalorimeter. The heat of dilution responses revealed areas of interest in which it can be assumed that the state of aggregation of the surfactants changes. These points are at concentrations of approx. 0.3 and 0.7% w/v for oleic acid and at 0.8% w/v for Span 85. The experiments were repeated with salbutamol base suspended in Arcton 113, such that the adsorption of surfactant to the drug could be investigated. For both surfactants the results when drug was present were significantly different from those when drug was absent (dilution only). For oleic acid the data with drug were more exothermic and for Span 85 they were more endothermic, indicating different thermodynamics of adsorption for the two surfactants. For both surfactants there were break points in the adsorption data at concentrations corresponding to the break points in the dilution data. It can be concluded that the adsorption process is highly dependent upon the structure of surfactant in solution. For both surfactants the critical concentration was at or just below the value of 1% that has been found to be an effective surfactant loading for the production of inhalation aerosols. This data provides an explanation for the practical observation on surfactant use and demonstrates that microcalorimetry is a valuable technique for studies on these difficult systems.     

Polystyrene microsphere spray standards based on CFC-free inhaler technology.

Metered pressurized sprays were formulated containing polystyrene microspheres (PSM) suspended in 5% w/w ethanol in 1,1,1,2-tetrafluoroethane (HFA 134a). Suspensions with defined number concentrations, packaged in pressure-resistant glass containers, and fitted with specified 50-microL metering values and actuators were sonicated and fired (as if they were metered dose inhalers or MDIs). Following propellant evaporation, PSM dispersions in air containing > 98% singlets resulted from actuation of 3, 5, and 8 microns PSM suspensions containing 0.00125% w/w 3 microns, 0.05% w/w 5 microns or 0.3% w/w 8 microns PSMs, respectively. Spray characteristics from these systems depended on PSM concentration, PSM size, PSM source, and actuator dimensions. Adhesion of suspended PSMs to the internal glass surfaces of the containers were easily reversed by sonication but not prevented by a wide range of surfactants. Over a period of 6 months storage, these formulations produced reproducible PSM aerosols with known aerodynamic properties useful for calibration purposes.     

The Site of Absorption in the Small Intestine Determines Diltiazem Bioavailability in the Rabbit

Purpose. Since the ability of the small intestine to biotransform a drug may decrease in distal segments of the intestine, this study aimed to assess whether the site of administration in the small intestine could affect the systemic bioavailability of diltiazem and its two active metabolites, N-desmethyldiltiazem (MA) and desacetyldiltiazem (Ml). Methods. Five mg/kg of diltiazem were administered into the lumen of the proximal (0–30 cm, n = 9) or the distal (150–180 cm) small intestine (n = 7) of anesthetized New Zealand rabbits. Blood samples were drawn from the femoral artery for 6 hours, and diltiazem, MA and M1 were assayed by HPLC. Results. The area under the curve (AUC₀ )of diltiazem administered into the distal small intestine was larger than that estimated when diltiazem was given in the proximal segment (14.20 ± 2.82 vs 8.14 ± 0.88 µg.min/ml, p < 0.05), due to a lower diltiazem oral clearance (440 ± 78 vs 660 ± 55 ml/min/kg, p < 0.05). The AUC_{0 360} of MA was not affected by the site of diltiazem administration, but the AUC_{0 360} of M1 was increased when diltiazem was administered in the distal segment of the small intestine. When administered into the distal segment of the intestine, the molar sum of diltiazem and its active metabolites was 48% greater than when delivered into the 0–30 cm segment of the small intestine; as a consequence, absorption of diltiazem in distal segments of the small intestine may enhance its pharmacological response. Conclusions. The site of absorption into the intestine modulates the bioavailability of diltiazem and its two active metabolites.     

Studies on the autonomic nervous system in borderline hypertension

Summary Parameters of the autonomic nervous system were studied in normotensive subjects (NT; standing blood pressure (BP)125/85 mmHg) and in subjects with borderline hypertension (BHT; 140/90standing BP<60/100 mmHg). No differences in plasma noradrenaline and adrenaline levels were found between NT and BHT subjects, neither at rest nor during exercise at 75% of maximum work capacity. The dose of noradrenaline required to increase systolic BP by 10 mmHg was significantly higher in NT than in BHT subjects (5.13±0.42 vs 3.50±0.57 µg · min^–1). No difference between NT and BHT subjects was found in the dose of isoprenaline required to increase heart rate by 20 beats · min^–1 (1.21±0.12 vs 1.09±0.11 µg · min^–1). Resting salivary flow was significantly lower in BHT than in NT subjects (0.39±0.06 vs 0.98±0.06 g · min^–1), suggesting decreased parasympathetic activity in the former group. The enhanced pressor effect of noradrenaline, together with the decreased parasympathetic activity, could explain the elevated blood pressure and heart rate in subjects with borderline hypertension.     

A Microcalorimetric Investigation of the Interaction of Surfactants with Crystalline and Partially Crystalline Salbutamol Sulphate in a Model Inhalation Aerosol System

Purpose. The purpose of the work is to study the adsorption of Oleic acid and Span 85 (materials frequently used in aerosols as surfactants) onto partially amorphous and essentially crystalline salbutamol sulphate, attempting to understand the behaviour of metered dose inhalers (MDIs) and observing whether there were any differences in adsorption behaviour and if this could be related to the surface properties of the powder. Methods. Isothermal titration microcalorimetry was the principal technique used to measure the adsorption behaviour of surfactants to salbutamol sulphate. A Malvern particle size analyzer was also employed to provide size data on the interactions between the surfactant and powder suspensions. Results. The calorimetric data revealed that surfactant adsorption to the crystalline micronised powder (78% RH and aged dry sample) produced significant exotherms, whereas adsorption to the partially amorphous micronised powder resulted in small heat responses. The differences in adsorption behaviour to the partially crystalline and crystalline surfaces resulted in changes in aggregation behaviour. Conclusions. The stability of MDIs varies depending on the water content, crystallinity and surface composition of the powder. The advantages of using isothermal titration microcalorimetry to evaluate this surface behaviour in such difficult systems was demonstrated.     

Metering performance of several metered-dose inhalers with different spacers/holding chambers.

Metered-dose inhalers (MDI) are routinely used to administer inhaled antiasthma drugs. Actuation-inhalation coordination problems are overcome and systemic side effects are reduced by using spacers/holding chambers (SP/HCHs). Many of these devices do not allow the use of the manufacturer's actuator. The objectives of this study were (a) to investigate the effect of the interaction of eight MDI products with four different SP/HCHs on their metering performance (MP); and (b) to test the hypothesis whether the MP obtained with a SP/HCH and a given drug (MDI) can be extrapolated to other MDIs, even for members of its particular drug class. The procedure outlined in The United States Pharmacopeia-The National Formulary was used (determination of canister weight changes after actuation). The SP/HCH tested were Aerochamber, Inspirease, and ACE. The MDIs tested were salmeterol xinafoate; albuterol with chlorofluorocarbons and 1,1,1,2-tetrafluoroethane as propellants; cromolyn sodium; nedocromil sodium; flunisolide; beclomethasone dipropionate; and fluticasone propionate. Only flunisolide-Inspirease presented an unacceptable MP. Although within the acceptable limits, the MP varied significantly between the following MDI-SP/HCH combinations: Optihaler-fluticasone propionate and Optihaler-cromolyn sodium < to Aerochamber-fluticasone propionate and Aerochamber-cromolyn sodium (p = 0.0015 and p = 0.0007, respectively); and Inspirease-flunisolide and Optihaler-flunisolide < Aerochamber flunisolide (p = 0.003 and p = 0.005, respectively). MP did not significantly vary when albuterol with chlorofluorocarbons or 1,1,1,2-tetrafluoroethane as propellants, salmeterol xinafoate, beclomethasone dipropionate, and nedocromil sodium were attached to any of the SP/HCHs studied. Our results emphasize the capital importance of choosing the right combination of MDI and SP/HCH for aerosol delivery. The MP obtained with a drug and a SP/HCH cannot be expected to be similar for other MDIs, even for members of its drug class. These data also suggest the need for regulatory agencies to approve an MDI to be used only with the SP/HCHs tested.