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Internal mouthpiece designs as a future perspective for enhanced aerosol deposition. Comparative results for aerosol chemotherapy and aerosol antibiotics
Authors:Paul Zarogoulidis  Dimitris Petridis  Christos Ritzoulis  Kaid Darwiche  Ioannis Kioumis  Konstantinos Porpodis  Dionysios Spyratos  Wolfgang Hohenforst-Schmidt  Lonny Yarmus  Haidong Huang  Qiang Li  Lutz Freitag  Konstantinos Zarogoulidis
Institution:1. Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;2. Department of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital, University Duisburg-Essen, Essen, Germany;3. Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece;4. II Medical Department, “Coburg” Regional Clinic, University of Wuerzburg, Coburg, Germany;5. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, USA;6. Department of Respiratory Diseases Shanghai Hospital, II Military University Hospital, Shanghai, China
Abstract:

Background

In an effort to identify factors producing a finest mist from Jet-Nebulizers we designed 2 mouthpieces with 4 different internal designs and 1–3 compartments.

Materials and methods

Ten different drugs previous used with their “ideal” combination of jet-nebulizer, residual-cup and loading were used. For each drug the mass median aerodynamic diameter size had been established along with their “ideal” combination.

Results

For both mouthpiece, drug was the most important factor due the high F-values (Flarge = 251.7, p < 0.001 and Fsmall = 60.1, p < 0.001) produced. The design affected the droplet size but only for large mouthpiece (Flarge = 5.99, p = 0.001, Fsmall = 1.72, p = 0.178). Cross designs create the smallest droplets (2.271) so differing from the other designs whose mean droplets were greater and equal ranging between 2.39 and 2.447. The number of compartments in the two devices regarding the 10 drugs was found not statistically significant (p-values 0.768 and 0.532 respectively). Interaction effects between drugs and design were statistically significant for both devices (Flarge = 8.87, p < 0.001, Fsmall = 5.33, p < 0.001).

Conclusion

Based on our experiment we conclude that further improvement of the drugs intended for aerosol production is needed. In addition, the mouthpiece design and size play an important role in further enhancing the fine mist production and therefore further experimentation is needed.
Keywords:Aztreonam (PubChem CID: 5742832)  Gentamycin (PubChem CID: 3467)  Tobramycin (PubChem CID: 36294)  Ciprofloxacin (PubChem CID: 2764)  Cisplatin (PubChem CID: 84093)  Carboplatin (PubChem CID: 10339178)  Paclitaxel (PubChem CID: 36314)  Docetaxel (PubChem CID: 148124)  Gemcitabine (PubChem CID: 60750)  Doxorubicin (PubChem CID: 31703)
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