A Review of Electronic Devices to Assess Inhaler Technique

Multiple electronic devices exist that provide feedback on the accuracy of patient inhaler technique. Our purpose is to describe the inhaler technique feedback provided by these devices, including specific technique steps measured, how feedback is displayed, target of feedback (patient, provider, researcher), and compatibility with inhaler type (metered-dose inhaler [MDI], diskus, etc.)

Think twice about nebulizers for asthma attacks

MDIs with spacers are as effective as nebulizers for delivering beta-agonists and less likely to cause adverse effects. Practice changer: Stop ordering nebulizers to deliver beta-agonists to patients over age 2 with mild or moderate asthma exacerbations. A metered-dose inhaler (MDI) with a spacer produces the same benefits with fewer adverse effects

Dose-response to inhaled glycopyrrolate delivered with a novel Co-Suspension™ Delivery Technology metered dose inhaler (MDI) in patients with moderate-to-severe COPD

This study forms part of the first complete characterization of the dose-response curve for glycopyrrolate (GP) delivered using Co-Suspension™ Delivery Technology via a metered dose inhaler (MDI). We examined the lower GP MDI dose range to determine an optimal dose for patients with moderate-to-severe chronic obstructive pulmonary disease (COPD)

Effectiveness of Education Based Information-Motivation-Behavioral Skill (IMB) Model of Improving Knowledge, Motivation, and Performance Demonstration Metered-Dose Inhaler (MDI) to Community Pharmacists in Surabaya

Preparations in the treatment of chronic asthma inhaler is more recommended dosage, but many asthma patients are not able to use an asthma inhaler properly. Dosage forms of inhaler types of metered-dose inhaler (MDI) is the most commonly used ayng. The role of community pharmacists are crucial in educating techniques use an asthma inhaler, but pharmacists can not use its own community and pharmacists current training methods based on knowledge has not been effective. In this study tested the theory-based educational methods IMB compared with conventional educational methods knowledge of the performance of community pharmacists in educating techniques use an asthma inhaler. A total of 25 community pharmacists participate in the research. All 25 pharmacists were then divided into two, the control group (n = 13). In comparison, the use of inhaler technique education based IMB improve the ability of community pharmacists inhaler demonstration is better than knowledge-based education, but there was no difference in the improvement of knowledge and motivation between the two. Although pharmacists who intervened with IMB-based educational models can demonstrate MDI use techniques better than knowledge-based education course

Design and Development of a Non-volatile Counter for Metered Dose Inhaler (MDI)

In 2014, Global Asthma Report 2014 stated there were 334 million of people in the worldwide suffering of asthma and the population was increased 99 million compared in 2011. Asthma is the leading chronic childhood disease with albatross on affected children and their families. It occurs when the pulmonary airway is blocked or the airways become narrowed and result in difficult breathing. When asthma under attack, asthma patients normally use metered dose inhaler (MDI) to inhale the salbutamol to restore normal breathing. Therefore, MDI currently available in market unable to monitor the remaining amount of puffs available in the MDI canister and may lead problems for the user due to inability to monitor the amount of salbutamol in the MDI canister. Besides this, some manufacturers developed MDI with counter but it had the limitation such as unable to store memory of the last counting value if power failure occurs, uses non-rechargeable battery and are disposable. Hence, this paper is to present the development of a device consist of a non-volatile counter. It is designed using EEPROM to save the memory of the last counting value and to prevent data loss due to power failure. The MDI was installed with the limit switch for counter and the MDI press is attached to MDI canister so that when the user presses both simultaneously then it provides enough pressure to the limit switch to update the counter. The MDI cover is developed to protect the internal connection and to prevent the user from accidently pressing the limit switch. 7.4V Li-ion rechargeable battery was employed to supply power source for system operation. Arduino UNO (ATmega328P) act as microcontroller to control the system operation of this device. The device is capable of displaying the number of used salbutamol puff on the liquid crystal display (LCD). Furthermore, RGB LED is integrated into the device as visualization to indicate the level of salbutamol in the MDI canister. It consists of four levels indication which is high, medium, low and empty canister of used puff. The high level of used puffs is between 0 to 120 puffs with green colour indicator, medium level is between 121 to 160 puffs with yellow/orange colour indicator, low level is between 161 to 199 puffs with red colour indicator and empty canister without any colour of indicator when the used puffs reached to 200. This device could remind the user to prepare a new MDI canister since it had indicated of low level of salbutamol in the MDI canister. Besides this, it also could reduce the deaths from asthma due to the user would prepare a new MDI canister before attacked by asthma

KELENGKAPAN PENJELASAN APOTEKER DI APOTEK MENGENAI CARA PENGGUNAAN METERED-DOSE INHALER YANG MENGANDUNG IPRATROPIUM BROMIDA DI WILAYAH SURABAYA TIMUR

MDI (metered-dose inhaler) containing Ipratropium Bromide is used to control the COPD symptoms. Improper usage may trigger undesirable effects, requiring the role of the pharmacist in helping explain how to use it. The purpose of this research is to know the completeness of explanation by pharmacist in pharmacy related to the use of MDI containing ipratropium bromide. This research method is cross-sectional with purposive sampling, using observation technique in the form of checklist. The sample in this research is pharmacist in apothecary in East Surabaya. The data obtained will be processed by descriptive analysis. The sample of research is 22 pharmacists. The results showed that all pharmacists were able to explain steps 1 and 12. In addition step 5 (21 pharmacists), sub step 7b (20 pharmacists), sub steps 7a and step 8 (18 pharmacists), step 3 (15 pharmacists), step 11 14 pharmacists), step 10 (13 pharmacists), step 6 (12 pharmacists), sub step 7c and step 9 (11 pharmacists), step 2 (10 pharmacists), step 4 (5 pharmacists). But no pharmacist is able to explain step 13 and use that should be careful of the eyes. Therefore, the pharmacist's ability to explain how to use MDI containing Ipratropium Bromide should be increase

The Effect of Cromolyn Sodium and Nedocromil Sodium Administered by A pressurized Aerosol with A spacer Device on Exercise-Induced Asthma in Children

To compare the effectiveness of cromolyn sodium (CS) (10 mg) and nedocromil sodium (NS) (4 mg) administered by a metered dose inhaler (MDI) with a spacer device in preventing exercise-induced asthma (EIA), eight asthmatic children with EIA were studied in a randomized double-blind, cross-over, placebo-controlled study, CS and NS provided significant, comparable protection from EIA and both were better than placebo. We conclude that CS and NS administered by a pressurized aerosol with a spacer device provide equal protection against EIA in children

Comparison of the efficacy of budesonide by nebulizer, metered dose inhaler and dry powder inhaler in chronic stable bronchial asthma

Background: The study has been performed to evaluate the efficacy of budesonide delivery by different form of devices like nebulizer, metered dose inhaler and dry powder inhaler to adult patients of chronic stable bronchial asthma. The changes in pulmonary function test parameters have been consider for evaluation.Methods: This prospective study was undertaken to assess the relative efficiency of budesonide administered from devices like nebulizer, metered dose inhaler and dry powder inhaler in adult patients of chronic stable bronchial asthma. Fifty subjects where administered budesonide (1mg) via nebulizer, budesonide (400 microgram) by metered dose inhaler and dry powder inhaler consecutively each week for four weeks under direct supervision. To analyze the effect of budesonide delivered through different devices pulmonary function test was carried out on the subject before and one hour after administration of the drug on each visit.Results: No significant difference in Peak expiratory flow rate (P=0.77), forced expiratory volume in one second (P=0.851), forced vital capacity (P=0.178) and forced expiratory volume in one second and forced vital capacity ratio (P=0.298) was seen after giving budesonide by different devices.Conclusions: Budesonide delivered by different devices (nebulizer, metered dose inhaler, and dry powder inhaler) have similar effect on lung function in patients of chronic stable bronchial asthma. In the daily clinical practice, the correct choice of an inhaler device should be related with the patient's characteristics. They may be used interchangeably depending on availability, cost and compliance of the patients

Design and development of an automated metered dose inhaler (MDI) for asthmatic patient

To date, infant with illness associated with the pulmonary airway is treated by a doctor using a spacer device with metered dose inhaler (MDI) to allow the infant to breathe in the medication known as salbutamol. Current asthma spacer does not provide systematic way of monitoring and displaying the percentage value of the propellant. Furthermore, user non-compliance is found to contribute towards longer recovery rate. Therefore, this product is designed and developed capable of detecting the propellant level inhaled by the infant by using a MQ-6 gas sensor and monitoring its percentage value. The display of available puffs of MDI canister and the battery indicator for the system are also included in the device. The automated actuation MDI was required a push button to press the MDI canister where this project utilised Arduino Nano as the microcontroller to control the system operation and all the reading values will be displayed on the OLED. RGB LED is also used to visualise the propellant level. The obtained results of the detection of propellant in voltage from the MQ-6 gas sensors were analysed in MATLAB to make comparison through the obtained results. Without propellant, voltage recorded is 0.640±0.024V whereas high concentration of propellant displayed voltage of 1.126±0.020V. The mean standard error rate of propellant detection is 5.584%. The first design of the actuation device and interface monitoring display of automated MDI were recorded the highest percentage which is 75% and 80%. The concentration of propellant depends on the ambient temperature due to the MQ-6 gas sensor required minimum working temperature between 20oC to 22oC. The mean weight of the MDI canister for each puff is 6.257mg and the standard deviation is 3.629mg. Due to experiment conducted, the speed and pressure of pressing MDI canister causes variability in the released of salbutamol and propellant. Observation proved that ambient temperature and propellant released amount also influenced the final reading from the automated actuation MDI

A Comparative Life Cycle Assessment between a Metered Dose Inhaler and Electric Nebulizer

Life cycle assessment (LCA) evaluates the environmental impact of a product based on the materials and processes used to manufacture the item as well as the item’s use and disposal. The objective of this LCA was to evaluate and compare the environmental impact of a metered dose inhaler, specifically the Proventil® HFA inhaler (Merk & Co., Inc., Kenilworth, NJ, USA), and an electric nebulizer, specifically the DeVilbiss Pulmo-Aide® nebulizer (DeVilbiss, Port Washington, NY, USA). GaBi LCA software was used to model the global warming potential (GWP) of each product by using substantiated data and well-justified assumptions for the components, manufacturing, assembly, and use of both devices. The functional unit used to model each device was one dose of the active drug, albuterol sulfate. The inhaler’s GWP, 0.0972 kg CO2-eq, was greater than the nebulizer’s even when uncertain parameters were varied ±100x. During the use phase ofa the inhaler, which accounted for approximately 96% of the inhaler’s total GWP, HFA 134a is used as a propellant to deliver the drug. The total GWP for the electric nebulizer was 0.0294 kg CO2-eq assuming that the mouthpiece was cleaned in a dishwasher, while it was 0.0477 kg CO2-eq when the nebulizer mouthpiece was hand washed between uses. The GWP breakeven scenario between dishwashing and hand washing occurred when the mouthpiece accounted for 10% of the dishwasher load