title: Differences in output from corticosteroid inhalers used with a volumatic spacer.
abstract: Corticosteroid inhaler therapy using a spacer device is commonly used as an important part of asthma management. Increasingly, generic corticosteroid inhalers are being used with spacer devices. We have therefore tested whether these generic inhalers yield equivalence in dose when compared to the established inhalers. We measured the in vitro output, discharged into a Volumatic spacer from beclomethasone dipropionate inhalers (250 micrograms.puff-1) made by three manufacturers, Allen & Hanburys, 3M and Baker Norton. The output from 20 of each type of inhaler was sampled, in random order, by a computer driven pump system. Beclomethasone was absorbed onto a coded filter, which was analysed independently for drug content. The output per puff differed significantly between the inhalers of each manufacturer, with a 36% difference between the highest output from the Allen & Hanburys device and the lowest output device. We conclude that there are important differences in output from these inhalers when used with a spacer, and that substitution of one device with another will not necessarily give equivalent therapy to the patient.
authors.affiliation: Dept of Medicine, University of Birmingham, Good Hope NHS Trust, Sutton Coldfield, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Miller
authors.forename: P
authors.initials: P
authors.lastname: Bright
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001507:Beclomethasone / Q000008:administration & dosage*; D005069:Evaluation Studies as Topic; D009330:Nebulizers and Vaporizers / Q000592:standards
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D001507:Beclomethasone