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Journal articles on the topic 'Nasal dry powder inhaler'

Author: Grafiati

Published: 4 June 2021

Last updated: 13 February 2022

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1

Farkas, Dale, Michael Hindle, Serena Bonasera, Karl Bass, and Worth Longest. "Development of an Inline Dry Powder Inhaler for Oral or Trans-Nasal Aerosol Administration to Children." Journal of Aerosol Medicine and Pulmonary Drug Delivery 33, no. 2 (April 1, 2020): 83–98. http://dx.doi.org/10.1089/jamp.2019.1540.

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2

Farkas, Dale, Michael Hindle, and P. Worth Longest. "Application of an inline dry powder inhaler to deliver high dose pharmaceutical aerosols during low flow nasal cannula therapy." International Journal of Pharmaceutics 546, no. 1-2 (July 2018): 1–9. http://dx.doi.org/10.1016/j.ijpharm.2018.05.011.

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3

Lokshina, Е. Е., and О. V. Zaytseva. "Inhalation therapy in children: new opportunities." Russian Pulmonology 29, no. 4 (October 24, 2019): 499–507. http://dx.doi.org/10.18093/0869-0189-2019-29-4-499-507.

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Inhalation therapy is widely used for treatment of acute respiratory infections and asthma in children, and provides more rapid drug delivery in the airways. Treatment success in children with respiratory diseases is defined not only by an adequate choice of the drug and the dosage regimen, but also by inhalation drug delivery system. The choice of drug delivery device in children depends on the child's age and ability to carry out instructions related to the inhalation technique. Incorrect inhalation technique is associated with inappropriate distribution of the drug in the respiratory tract and an unreasonable increase in the volume of therapy, risk of adverse effects, and the total cost of the treatment. Currently, a great number of various drug delivery systems are commercially available, such as a pressurised metered dose inhaler (MDI), a MDI with spacer and facemask, a dry powder inhaler, and a nebulizer. The most optimal inhalation drug delivery device for children is a nebulizer. In this article, the authors discussed benefits and limitations of various drug delivery systems and modern nebulizers used for treatment of the upper and the lower airways including DuoBaby nebulizer 2-in-1 with a nasal aspirator.

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4

Walther, Frans J., Monik Gupta, Michael M. Lipp, Holly Chan, John Krzewick, Larry M. Gordon, and Alan J. Waring. "Aerosol delivery of dry powder synthetic lung surfactant to surfactant-deficient rabbits and preterm lambs on non-invasive respiratory support." Gates Open Research 3 (January 14, 2019): 6. http://dx.doi.org/10.12688/gatesopenres.12899.1.

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Background: The development of synthetic lung surfactant for preterm infants has focused on peptide analogues of native surfactant proteins B and C (SP-B and SP-C). Non-invasive respiratory support with nasal continuous positive airway pressure (nCPAP) may benefit from synthetic surfactant for aerosol delivery. Methods: A total of three dry powder (DP) surfactants, consisting of phospholipids and the SP-B analogue Super Mini-B (SMB), and one negative control DP surfactant without SMB, were produced with the Acorda Therapeutics ARCUS® Pulmonary Dry Powder Technology. Structure of the DP surfactants was compared with FTIR spectroscopy, in vitro surface activity with captive bubble surfactometry, and in vivo activity in surfactant-deficient adult rabbits and preterm lambs. In the animal experiments, intratracheal (IT) aerosol delivery was compared with surfactant aerosolization during nCPAP support. Surfactant dosage was 100 mg/kg of lipids and aerosolization was performed using a low flow inhaler. Results: FTIR spectra of the three DP surfactants each showed secondary structures compatible with peptide folding as an α-helix hairpin, similar to that previously noted for surface-active SMB in other lipids. The DP surfactants with SMB demonstrated in vitro surface activity <1 mN/m. Oxygenation and lung function increased quickly after IT aerosolization of DP surfactant in both surfactant-deficient rabbits and preterm lambs, similar to improvements seen with clinical surfactant. The response to nCPAP aerosol delivery of DP surfactant was about 50% of IT aerosol delivery, but could be boosted with a second dose in the preterm lambs. Conclusions: Aerosol delivery of active DP synthetic surfactant during non-invasive respiratory support with nCPAP significantly improved oxygenation and lung function in surfactant-deficient animals and this response could be enhanced by giving a second dose. Aerosol delivery of DP synthetic lung surfactant has potential for clinical applications.

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5

Walther, Frans J., Monik Gupta, Michael M. Lipp, Holly Chan, John Krzewick, Larry M. Gordon, and Alan J. Waring. "Aerosol delivery of dry powder synthetic lung surfactant to surfactant-deficient rabbits and preterm lambs on non-invasive respiratory support." Gates Open Research 3 (March 14, 2019): 6. http://dx.doi.org/10.12688/gatesopenres.12899.2.

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Background: The development of synthetic lung surfactant for preterm infants has focused on peptide analogues of native surfactant proteins B and C (SP-B and SP-C). Non-invasive respiratory support with nasal continuous positive airway pressure (nCPAP) may benefit from synthetic surfactant for aerosol delivery. Methods: A total of three dry powder (DP) surfactants, consisting of phospholipids and the SP-B analogue Super Mini-B (SMB), and one negative control DP surfactant without SMB, were produced with the Acorda Therapeutics ARCUS® Pulmonary Dry Powder Technology. Structure of the DP surfactants was compared with FTIR spectroscopy, in vitro surface activity with captive bubble surfactometry, and in vivo activity in surfactant-deficient adult rabbits and preterm lambs. In the animal experiments, intratracheal (IT) aerosol delivery was compared with surfactant aerosolization during nCPAP support. Surfactant dosage was 100 mg/kg of lipids and aerosolization was performed using a low flow inhaler. Results: FTIR spectra of the three DP surfactants each showed secondary structures compatible with peptide folding as an α-helix hairpin, similar to that previously noted for surface-active SMB in other lipids. The DP surfactants with SMB demonstrated in vitro surface activity <1 mN/m. Oxygenation and lung function increased quickly after IT aerosolization of DP surfactant in both surfactant-deficient rabbits and preterm lambs, similar to improvements seen with clinical surfactant. The response to nCPAP aerosol delivery of DP surfactant was about 50% of IT aerosol delivery, but could be boosted with a second dose in the preterm lambs. Conclusions: Aerosol delivery of DP synthetic surfactant during non-invasive respiratory support with nCPAP significantly improved oxygenation and lung function in surfactant-deficient animals and this response could be enhanced by giving a second dose. Aerosol delivery of DP synthetic lung surfactant has potential for clinical applications.

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6

Brunaugh, Ashlee D., Hyojong Seo, Zachary Warnken, Li Ding, Sang Heui Seo, and Hugh D. C. Smyth. "Development and evaluation of inhalable composite niclosamide-lysozyme particles: A broad-spectrum, patient-adaptable treatment for coronavirus infections and sequalae." PLOS ONE 16, no. 2 (February 11, 2021): e0246803. http://dx.doi.org/10.1371/journal.pone.0246803.

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Niclosamide (NIC) has demonstrated promising in vitro antiviral efficacy against SARS-CoV-2, the causative agent of the COVID-19 pandemic. Though NIC is already FDA-approved, administration of the currently available oral formulation results in systemic drug levels that are too low for the inhibition of SARS-CoV-2. We hypothesized that the co-formulation of NIC with an endogenous protein, human lysozyme (hLYS), could enable the direct aerosol delivery of the drug to the respiratory tract as an alternative to oral delivery, thereby effectively treating COVID-19 by targeting the primary site of SARS-CoV-2 acquisition and spread. To test this hypothesis, we engineered and optimized composite particles containing NIC and hLYS suitable for delivery to the upper and lower airways via dry powder inhaler, nebulizer, and nasal spray. The novel formulation demonstrates potent in vitro and in vivo activity against two coronavirus strains, MERS-CoV and SARS-CoV-2, and may offer protection against methicillin-resistance staphylococcus aureus pneumonia and inflammatory lung damage occurring secondary to SARS-CoV-2 infections. The suitability of the formulation for all stages of the disease and low-cost development approach will ensure rapid clinical development and wide-spread utilization.

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7

Alabsi, Wafaa, Fahad A. Al-Obeidi, Robin Polt, and Heidi M. Mansour. "Organic Solution Advanced Spray-Dried Microparticulate/Nanoparticulate Dry Powders of Lactomorphin for Respiratory Delivery: Physicochemical Characterization, In Vitro Aerosol Dispersion, and Cellular Studies." Pharmaceutics 13, no. 1 (December 25, 2020): 26. http://dx.doi.org/10.3390/pharmaceutics13010026.

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The purpose of this study was to formulate Lactomorphin (MMP2200) in its pure state as spray-dried(SD) powders, and with the excipient Trehalose as co-spray-dried(co-SD) powders; for intranasal and deep lung administration with Dry Powder Inhalers (DPI). Lactomorphin is a glycopeptide which was developed for the control of moderate to severe pain. Particles were rationally designed and produced by advanced spray drying particle engineering in a closed mode from a dilute organic solution. Comprehensive physicochemical characterization using different analytical techniques was carried out to analyze the particle size, particle morphology, particle surface morphology, solid-state transitions, crystallinity/non-crystallinity, and residual water content. The particle chemical composition was confirmed using attenuated total reflectance-Fourier-transform infrared (ATR-FTIR), and Confocal Raman Microscopy (CRM) confirmed the particles’ chemical homogeneity. The solubility and Partition coefficient (LogP) of Lactomorphin were determined by the analytical and computational methodology and revealed the hydrophilicity of Lactomorphin. A thermal degradation study was performed by exposing samples of solid-state Lactomorphin to a high temperature (62 °C) combined with zero relative humidity (RH) and to a high temperature (62 °C) combined with a high RH (75%) to evaluate the stability of Lactomorphin under these two different conditions. The solid-state processed particles exhibited excellent aerosol dispersion performance with an FDA-approved human DPI device to reach lower airways. The cell viability resazurin assay showed that Lactomorphin is safe up to 1000 μg/mL on nasal epithelium cells, lung cells, endothelial, and astrocyte brain cells.

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8

Srinivasan, Ganga, and Advait Shetty. "ADVANCEMENTS IN DRY POWDER INHALER." Asian Journal of Pharmaceutical and Clinical Research 10, no. 2 (February 1, 2017): 8. http://dx.doi.org/10.22159/ajpcr.2017.v10i2.14282.

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The dry powder inhaler (DPI) has become widely known as a very attractive platform for drug delivery. DPIs are being used for the treatment of asthma and chronic obstructive pulmonary disease by many patients. There are over 20 devices presently in the DPI market. DPIs are preferred over nebulizers and pressurized metered dose inhalers. However, some of the challenges of DPI are dependence on inspiratory flow (unsuitable for young children, elderly people), systemic absorption due to deposition of drug in deep lung (unsuitable for local diseases treatment), and increase in upper airway deposition of a large fraction of coarse particles. Hence, there is a need to address these unmet issues. The interpatient variation can be minimized by developing devices independent of patient’s inspiratory flow rate or active based powder mechanism. This article reviews DPI devices currently available, advantages of newly developed devices, and formulation technologies. The platform technologies are developed to improve aerosolization and dispersion from the device and decrease the patient related factors. The DPI delivery system has been expanded to treatment of non-respiratory diseases such as migraine and diabetes. The development of innovative DPI device and formulation technologies for delivering therapeutic proteins such as insulin has been accelerated to overcome the problems associated with conventional insulin therapy.Keywords: Dry powder inhaler, Inspiratory flow rate, Insulin, Platform technologies.

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9

Chrystyn, H., and C. Niederlaender. "The Genuair® inhaler: a novel, multidose dry powder inhaler." International Journal of Clinical Practice 66, no. 3 (February 16, 2012): 309–17. http://dx.doi.org/10.1111/j.1742-1241.2011.02832.x.

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10

Lavorini, Federico, and Giovanni A. Fontana. "Inhaler technique and patient's preference for dry powder inhaler devices." Expert Opinion on Drug Delivery 11, no. 1 (October 5, 2013): 1–3. http://dx.doi.org/10.1517/17425247.2014.846907.

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11

&NA;. "Formoterol dry-powder inhaler unsuitable for children?" Inpharma Weekly &NA;, no. 1110 (October 1997): 19. http://dx.doi.org/10.2165/00128413-199711100-00034.

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12

Shetty, Nivedita, David Cipolla, Heejun Park, and Qi Tony Zhou. "Physical stability of dry powder inhaler formulations." Expert Opinion on Drug Delivery 17, no. 1 (December 13, 2019): 77–96. http://dx.doi.org/10.1080/17425247.2020.1702643.

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13

Kuziemski, Krzysztof. "Which Dry Powder Inhaler Should Be Chosen?" Respiration 78, no. 3 (2009): 356. http://dx.doi.org/10.1159/000228907.

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14

Newman, Stephen P. "The Novolizer??: A Multidose Dry Powder Inhaler." Treatments in Respiratory Medicine 4, no. 1 (2005): 70. http://dx.doi.org/10.2165/00151829-200504010-00008.

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15

Haidl, Peter. "The Novolizer??: A Multidose Dry Powder Inhaler." Treatments in Respiratory Medicine 4, no. 1 (2005): 70. http://dx.doi.org/10.2165/00151829-200504010-00009.

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16

Elborn, J. Stuart. "Ciprofloxacin dry powder inhaler in cystic fibrosis." BMJ Open Respiratory Research 3, no. 1 (January 2016): e000125. http://dx.doi.org/10.1136/bmjresp-2015-000125.

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17

Donovan, Martin J., Aileen Gibbons, Matthew J. Herpin, Stephen Marek, Shayna L. McGill, and Hugh DC Smyth. "Novel dry powder inhaler particle-dispersion systems." Therapeutic Delivery 2, no. 10 (October 2011): 1295–311. http://dx.doi.org/10.4155/tde.11.103.

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18

Karpel, Jill P. "An easy-to-use dry-powder inhaler." Advances in Therapy 17, no. 6 (November 2000): 282–86. http://dx.doi.org/10.1007/bf02850011.

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19

Rahimpour, Yahya, Maryam Kouhsoltani, and Hamed Hamishehkar. "Alternative carriers in dry powder inhaler formulations." Drug Discovery Today 19, no. 5 (May 2014): 618–26. http://dx.doi.org/10.1016/j.drudis.2013.11.013.

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20

Gillespie, Michael, Sharon Song, and Jonathan Steinfeld. "Pharmacokinetics of fluticasone propionate multidose, inhalation-driven, novel, dry powder inhaler versus a prevailing dry powder inhaler and a metered-dose inhaler." Allergy and Asthma Proceedings 36, no. 5 (September 1, 2015): 365–71. http://dx.doi.org/10.2500/aap.2015.36.3889.

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21

Moore, Alison, Kylie Riddell, Shashidhar Joshi, Robert Chan, and Rashmi Mehta. "Pharmacokinetics of Salbutamol Delivered from the Unit Dose Dry Powder Inhaler: Comparison with the Metered Dose Inhaler and Diskus Dry Powder Inhaler." Journal of Aerosol Medicine and Pulmonary Drug Delivery 30, no. 3 (June 2017): 164–72. http://dx.doi.org/10.1089/jamp.2015.1277.

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22

Lin, Yu-Wei, Jennifer Wong, Li Qu, Hak-Kim Chan, and Qi Zhou. "Powder Production and Particle Engineering for Dry Powder Inhaler Formulations." Current Pharmaceutical Design 21, no. 27 (September 17, 2015): 3902–16. http://dx.doi.org/10.2174/1381612821666150820111134.

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23

Kopsch, Thomas, Darragh Murnane, and Digby Symons. "Development of an adaptive bypass element for passive entrainment flow control in dry powder inhalers." Proceedings of the Institution of Mechanical Engineers, Part C: Journal of Mechanical Engineering Science 233, no. 15 (May 2, 2019): 5201–13. http://dx.doi.org/10.1177/0954406219845416.

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The release of drug from dry powder inhalers is strongly dependent on the patient's inhalation profile. To maximise the effect of the treatment, it is necessary to optimise dry powder inhalers to achieve drug delivery that (A) is independent of the inhalation manoeuvre and (B) is targeted to the correct site in the lung. The purpose of this study is to develop a dry powder inhaler with an adaptive bypass element that achieves desired drug delivery behaviour. Computational and experimental methods are used. First, the effect of a generic variable bypass element on entrainment behaviour is modelled. This is done by modelling a dry powder inhaler as a network of flow. Second, the behaviour of a potential variable bypass element, a flap valve, is studied both computationally and experimentally. Third, the flow resistances are optimised to achieve consistent and desired entrainment behaviour for patients with very different inhalation manoeuvres. A simulated dry powder inhaler device design was found that achieves an approximately constant entrainment flow rate of 12 L/min when total flow rates larger than 20 L/min are applied. The developed dry powder inhaler is predicted to accurately deliver drug for patients with highly different inhalation manoeuvres.

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24

Srichana, Teerapol, Siwasak Juthong, Ekawat Thawithong, Supot Supaiboonpipat, and Suchada Soorapan. "Clinical equivalence of budesonide dry powder inhaler and pressurized metered dose inhaler." Clinical Respiratory Journal 10, no. 1 (August 4, 2014): 74–82. http://dx.doi.org/10.1111/crj.12188.

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25

AHRENS, RICHARD C, LESLIE HENDELES, WILLIAM R CLARKE, ROBERT J DOCKHORN, MALCOLM R HILL, LEIGH M VAUGHAN, CHERI LUX, and SEUNG-HO HAN. "Therapeutic Equivalence of Spiros Dry Powder Inhaler and Ventolin Metered Dose Inhaler." American Journal of Respiratory and Critical Care Medicine 160, no. 4 (October 1999): 1238–43. http://dx.doi.org/10.1164/ajrccm.160.4.9806101.

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26

&NA;. "Salbutamol dry powder inhaler approved in the UK." Inpharma Weekly &NA;, no. 1048 (August 1996): 22. http://dx.doi.org/10.2165/00128413-199610480-00045.

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27

Chougule, Mahavir Bhupal, Bijay Kumar Padhi, and Ambikanandan Misra. "Nano-Liposomal Dry Powder Inhaler of Amiloride Hydrochloride." Journal of Nanoscience and Nanotechnology 6, no. 9 (September 1, 2006): 3001–9. http://dx.doi.org/10.1166/jnn.2006.405.

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The purpose of this study was to encapsulate Amiloride Hydrochloride into nano-liposomes, incorporate it into dry powder inhaler, and to provide prolonged effective concentration in airways to enhance mucociliary clearance and prevent secondary infection in cystic fibrosis. Liposomes were prepared by thin film hydration technique and then dispersion was passed through high pressure homogenizer to achieve size of nanometer range. Nano-liposomes were separated by centrifugation and were characterized. They were dispersed in phosphate buffer saline pH 7.4 containing carriers (lactose/sucrose/mannitol), and glycine as anti-adherent. The resultant dispersion was spray dried. The spray dried powders were characterized and in vitro drug release studies were performed using phosphate buffer saline pH 7.4. in vitro and in vivo drug pulmonary deposition was carried out using Andersen Cascade Impactor and by estimating drug in bronchial alveolar lavage and lung homogenate after intratracheal instillation in rats respectively. Nano-liposomes were found to have mean volume diameter of 198 ± 15 nm, and 57% ± 1.9% of drug entrapment. Mannitol based formulation was found to have low density, good flowability, particle size of 6.7 ± 0.6 μm determined by Malvern MasterSizer, maximum fine particle fraction of 67.6 ± 0.6%, mean mass aerodynamic diameter 2.3 ± 0.1 μm, and geometric standard deviation 2.4 ± 0.1. Developed formulations were found to have prolonged drug release following Higuchi's Controlled Release model and in vivo studies showed maximal retention time of drug of 12 hrs within the lungs and slow clearance from the lungs. This study provides a practical approach for direct lung delivery of Amiloride Hydrochloride encapsulated in liposomes for controlled and prolonged retention at the site of action from dry powder inhaler. It can provide a promising alternative to the presently available nebulizers in terms of prolonged pharmacological effect, reducing systemic side effects such as potassium retention due to rapid clearance of the drug from lungs in patients suffering from cystic fibrosis.

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28

Ziffels, Susanne, Norman L. Bemelmans, Phillip G. Durham, and Anthony J. Hickey. "In vitro dry powder inhaler formulation performance considerations." Journal of Controlled Release 199 (February 2015): 45–52. http://dx.doi.org/10.1016/j.jconrel.2014.11.035.

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29

Zhang, Xi, Yingliang Ma, Liqiang Zhang, Jingxu Zhu, and Fang Jin. "The development of a novel dry powder inhaler." International Journal of Pharmaceutics 431, no. 1-2 (July 2012): 45–52. http://dx.doi.org/10.1016/j.ijpharm.2012.04.019.

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30

Tuley, Rob, John Shrimpton, Matthew D. Jones, Rob Price, Mark Palmer, and Dave Prime. "Experimental observations of dry powder inhaler dose fluidisation." International Journal of Pharmaceutics 358, no. 1-2 (June 2008): 238–47. http://dx.doi.org/10.1016/j.ijpharm.2008.03.038.

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31

Rizvi, Dilshad Ali, Afroz Abidi, Abhishek Agarwal, and Ali Ahmad. "The comparison the efficacy of budesonide by nebulizer, metered dose inhaler and dry powder inhaler in chronic stable bronchial asthma." International Journal of Basic & Clinical Pharmacology 7, no. 7 (June 22, 2018): 1333. http://dx.doi.org/10.18203/2319-2003.ijbcp20182678.

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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.

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32

Mehta, Rashmi, Alison Moore, Kylie Riddell, Shashidhar Joshi, and Robert Chan. "Pharmacokinetic Comparison of a Unit Dose Dry Powder Inhaler with a Multidose Dry Powder Inhaler for Delivery of Fluticasone Furoate." Journal of Aerosol Medicine and Pulmonary Drug Delivery 30, no. 5 (October 2017): 332–38. http://dx.doi.org/10.1089/jamp.2016.1322.

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33

Sahay, Sandeep, Royanne Holy, Shirley Lyons, Edwin Parsley, Mari Maurer, and Jeffry Weers. "Impact of human behavior on inspiratory flow profiles in patients with pulmonary arterial hypertension using AOS™ dry powder inhaler device." Pulmonary Circulation 11, no. 1 (January 2021): 204589402098534. http://dx.doi.org/10.1177/2045894020985345.

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Relative to healthy subjects, patients with pulmonary arterial hypertension often present with decreased respiratory muscle strength, resulting in decreased maximum inspiratory pressure. Little is known about the impact of reduced respiratory muscle strength on the ability to achieve the peak inspiratory pressures needed for effective drug delivery when using portable dry powder inhalers (≥1.0 kPa). The objective of this study was to assess the impact of inhaler resistance and patient instruction on the inspiratory flow profiles of pulmonary arterial hypertension patients when using breath-actuated dry powder inhalers. The inspiratory flow profiles of 35 patients with pulmonary arterial hypertension were measured with variants of the RS01 dry powder inhaler. Profiles were determined with a custom inspiratory flow profile recorder. Results showed that going from the low resistance RS01 dry powder inhaler to the high resistance AOS® dry powder inhaler led to increases in mean peak inspiratory pressures for pulmonary arterial hypertension subjects from 3.7 kPa to 6.5 kPa. Instructions that ask pulmonary arterial hypertension subjects to inhale with maximal effort until their lungs are full led to a mean peak inspiratory pressures of 6.0 kPa versus 2.1 kPa when the same subjects are asked to inhale comfortably. Significant decreases in mean peak inspiratory pressures are also observed with decreases in lung function, with a mean peak inspiratory pressures of 7.2 kPa for subjects with FEV1 > 60% predicted, versus 3.3 kPa for those subjects with FEV1 < 50% predicted. In conclusion, despite having reduced respiratory muscle strength, subjects with pulmonary arterial hypertension can effectively use a breath-actuated dry powder inhaler. The probability of achieving effective dose delivery may be increased by using dry powder inhalers with increased device resistance, particularly when subjects do not follow the prescribed instructions and inhale comfortably.

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34

Miyahara, Hiroaki, Seigo Korematsu, Tomokazu Nagakura, and Tatsuro Izumi. "Efficacy of fluticasone metered-dose inhaler and dry powder inhaler for pediatric asthma." Pediatrics International 50, no. 1 (February 2008): 103–8. http://dx.doi.org/10.1111/j.1442-200x.2007.02523.x.

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35

Kondo, Tetsuri, Makoto Hibino, Toshimori Tanigaki, Motoki Ohe, and Sakurako Kato. "Exhalation immediately before inhalation optimizes dry powder inhaler use." Journal of Asthma 52, no. 9 (October 21, 2015): 935–39. http://dx.doi.org/10.3109/02770903.2015.1025408.

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36

Joshi, Mayank R., and Ambikanandhan Misra. "Liposomal budesonide for dry powder inhaler: Preparation and stabilization." AAPS PharmSciTech 2, no. 4 (December 2001): 44–53. http://dx.doi.org/10.1208/pt020425.

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37

Huang, Wen-Hua, Zhi-Jun Yang, Heng Wu, Yuen-Fan Wong, Zhong-Zhen Zhao, and Liang Liu. "Development of Liposomal Salbutamol Sulfate Dry Powder Inhaler Formulation." Biological & Pharmaceutical Bulletin 33, no. 3 (2010): 512–17. http://dx.doi.org/10.1248/bpb.33.512.

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38

Wang, Z. L., B. Grgic, and W. H. Finlay. "A Dry Powder Inhaler with Reduced Mouth–Throat Deposition." Journal of Aerosol Medicine 19, no. 2 (June 2006): 168–74. http://dx.doi.org/10.1089/jam.2006.19.168.

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39

O'Callaghan, Chris, Mark L. Everard, Andrew Bush, Elizabeth J. Hiller, Robert Ross-Russell, Peter O'Keefe, and Peter Weller. "Salbutamol dry powder inhaler: Efficacy, tolerability, and acceptability study." Pediatric Pulmonology 33, no. 3 (February 4, 2002): 189–93. http://dx.doi.org/10.1002/ppul.10048.

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40

Chaplin, Steve. "Duaklir Genuair, the latest dry powder inhaler for COPD." Prescriber 26, no. 12 (June 19, 2015): 15–17. http://dx.doi.org/10.1002/psb.1367.

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41

Donovan, Martin J., Sin Hyen Kim, Venkatramanan Raman, and Hugh D. Smyth. "Dry Powder Inhaler Device Influence on Carrier Particle Performance." Journal of Pharmaceutical Sciences 101, no. 3 (March 2012): 1097–107. http://dx.doi.org/10.1002/jps.22824.

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42

NEWMAN, S. P., and W. W. BUSSE. "Evolution of dry powder inhaler design, formulation, and performance." Respiratory Medicine 96, no. 5 (May 2002): 293–304. http://dx.doi.org/10.1053/rmed.2001.1276.

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Shah, S. P., and Ambikanandan Misra. "Development of Liposomal Amphotericin B Dry Powder Inhaler Formulation." Drug Delivery 11, no. 4 (January 2004): 247–53. http://dx.doi.org/10.1080/10717540490467375.

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Kou, Xiang, Steven T. Wereley, Paul W. S. Heng, Lai Wah Chan, and M. Teresa Carvajal. "Powder dispersion mechanisms within a dry powder inhaler using microscale particle image velocimetry." International Journal of Pharmaceutics 514, no. 2 (December 2016): 445–55. http://dx.doi.org/10.1016/j.ijpharm.2016.07.040.

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Le, V. N. P., E. Robins, and M. P. Flament. "Air permeability of powder: A potential tool for Dry Powder Inhaler formulation development." European Journal of Pharmaceutics and Biopharmaceutics 76, no. 3 (November 2010): 464–69. http://dx.doi.org/10.1016/j.ejpb.2010.09.003.

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Heng, Desmond, Sie Huey Lee, Wai Kiong Ng, Hak-Kim Chan, Jin Wang Kwek, and Reginald B. H. Tan. "Novel alternatives to reduce powder retention in the dry powder inhaler during aerosolization." International Journal of Pharmaceutics 452, no. 1-2 (August 2013): 194–200. http://dx.doi.org/10.1016/j.ijpharm.2013.05.006.

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AKDAĞ, Yağmur. "Development of dry powder inhaler formulations for drug delivery systems." Sanat Tasarim Dergisi 23, no. 6 (November 15, 2019): 973–87. http://dx.doi.org/10.35333/jrp.2019.62.

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Taymouri, Somayeh, Jaleh Varshosaz, Hamed Hamishehkar, Razieh Vatankhah, and Shadi Yaghubi. "Development of dry powder inhaler containing tadalafil-loaded PLGA nanoparticles." Research in Pharmaceutical Sciences 12, no. 3 (2017): 222. http://dx.doi.org/10.4103/1735-5362.207203.

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Suwandecha, Tan, Wibul Wongpoowarak, Kittinan Maliwan, and Teerapol Srichana. "Effect of turbulent kinetic energy on dry powder inhaler performance." Powder Technology 267 (November 2014): 381–91. http://dx.doi.org/10.1016/j.powtec.2014.07.044.

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Chougule, Mahavir, Bijay Padhi, and Ambikanandan Misra. "Development of Spray Dried Liposomal Dry Powder Inhaler of Dapsone." AAPS PharmSciTech 9, no. 1 (January 9, 2008): 47–53. http://dx.doi.org/10.1208/s12249-007-9024-6.

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