title: Can Patients with Parkinson's Disease Use Dry Powder Inhalers during Off Periods?
abstract: Because of its rapid onset of action, pulmonary administration of levodopa is an interesting alternative to oral administration for the rescue treatment of Parkinson's disease patients in an off period. We studied the ability of Parkinson's disease patients to operate a dry powder inhaler (DPI) correctly during an off period. We used an instrumented test inhaler with three different resistances to air flow to record flow curves and computed various inhalation parameters. We observed that all (13) patients were able to generate pressure drops > 2 kPa over the highest resistance and 10 out of 13 patients achieved at least 4 kPa. Inhaled volumes (all resistances) varied from 1.2 L to 3.5 L. Total inhalation time and the time to peak inspiratory flow rate both decreased with decreasing inhaler resistance. Twelve out of thirteen patients could hold their breath for at least five seconds after inhalation and nine could extend this time to ten seconds. The data from this study indicate that patients with Parkinson's disease will indeed be able to use a dry powder inhaler during an off period and they provide an adequate starting point for the development of a levodopa powder inhaler to treat this particular patient group.
authors.affiliation: Department of Clinical Pharmacy, Martini Hospital, Groningen, The Netherlands; Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Luinstra
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Martini Hospital, Groningen, The Netherlands.
authors.forename: A W F
authors.initials: AW
authors.lastname: Rutgers
authors.affiliation: Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Dijkstra
authors.affiliation: Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Grasmeijer
authors.affiliation: Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Hagedoorn
authors.affiliation: Department of Clinical Pharmacy, Martini Hospital, Groningen, The Netherlands.
authors.forename: J M J
authors.initials: JM
authors.lastname: Vogelzang
authors.affiliation: Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: Frijlink
authors.affiliation: Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: A H
authors.initials: AH
authors.lastname: de Boer
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000369:Aged, 80 and over; D000403:Airway Resistance; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D058995:Dry Powder Inhalers / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology; D007980:Levodopa / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D011312:Pressure
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa