title: Inhalation device requirements for patients' inhalation maneuvers.
abstract: Inhaled drugs are the mainstay of treatment for lung diseases such as asthma and chronic obstructive pulmonary disease. However, failure to use inhalation devices correctly can lead to a poorly controlled status. A vast number of inhalation devices exist and each device has specific requirements to achieve optimum inhalation of the drug. Currently, there is no overview of inhalation requirements considering all devices. This article presents a review of the literature on different inhalation device requirements and incorporates the data into a new inhalation flow algorithm.
  
  
  
  Data from literature on commercially available inhalation devices were evaluated and parameters, such as inhalation flow rate, flow acceleration, inhalation volume, and inspiration time assessed for the required inhalation maneuver specific to the device. All agreed upon data points were used to develop an inhalation flow algorithm.
  
  
  
  The literature analysis revealed availability of robust data for the required inhalation flow characteristics for most devices and thus for the development of an algorithm. For those devices for which these parameters are not published, the minimum required flow criteria were defined based on published data regarding individual aspects of aerosol quality.
  
  
  
  This review provides an overview of inhalation devices available on the market regarding requirements for an acceptable inhalation maneuver and shows which goals should be achieved in terms of inhalation flows. The presented algorithm can be used to develop a new computer based measurement system which could help to test and train patients' individual inhalation maneuvers with their inhalation devices.
authors: Hospital Kloster Grafschaft, Germany.
authors: Peter
authors: P
authors: Haidl
authors: Bahnhofstraße 22, 82131 Gauting, Germany.
authors: Stefan
authors: S
authors: Heindl
authors: Hospital Kloster Grafschaft, Germany.
authors: Karsten
authors: K
authors: Siemon
authors: Mundipharma GmbH, Germany.
authors: Maria
authors: M
authors: Bernacka
authors: Mundipharma GmbH, Germany. Electronic address: Rolf-Michael.Cloes@mundipharma.de.
authors: Rolf Michael
authors: RM
authors: Cloes
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols / Q000592:standards; D000465:Algorithms; D001249:Asthma / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation*; D004867:Equipment Design / Q000592:standards*; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D009330:Nebulizers and Vaporizers / Q000592:standards* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
chemical_list: D000336:Aerosols
keywords: Drug delivery; Inhalation device; Inhalation maneuver; Inhalation maneuver quality; Inspiratory flow rate