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background[1]=["Devices for inhalation therapy: Pressurised metered-dose inhalers (pMDIs)","12 KB","9 KB","Pressurised metered-dose inhalers (pMDIs) dispense drugs by means of a pressurised propellant. They are compact, portable, easy to use, inexpensive, and have a high market appeal.
The phased withdrawal of chlorofluorocarbon (CFC) propellants due to environmental concerns is well under way. The hydrofluoroalkanes (HFAs) are effective substitutes for CFCs.
The disadvantages of pMDIs largely arise from the need for a propellant, which produces particles that travel very fast, generating a high-velocity cloud over a short period of time. This results in deposition of most of the emitted dose in the oropharynx.
An additional problem from the generation of a high-velocity cloud is that many patients are unable to co-ordinate actuation of the inhaler with inspiration, which is crucial for proper lung deposition; consequently they do not obtain optimal therapeutic benefit from their medication.",""];
background[2]=["Devices for inhalation therapy: Dry powder inhalers (DPIs)","11 KB"," 8 KB","Dry powder inhalers (DPIs) are devices that are breath-actuated, therefore requiring no co-ordination between device actuation and inhalation. The newer multi-dose DPIs deliver a greater percentage of the inhaled drug dose to the lungs compared with pMDIs.
However, drug particles that are fine enough to deposit in the lung are often difficult to handle in the manufacturing process. Such drugs have to go through an aggregation process involving binding the drug to a carrier (e.g. lactose). As the material passes through the device during inhalation, the drug must dissociate into single particles to be respirable; this depends on the inspiratory effort of the patient. Consequently, the proportion of the dose inhaled as fine particles varies considerably from patient to patient; a large fraction often remains bound to the carrier and deposits in the oropharynx.
Importantly, some powder formulations are extremely moisture-sensitive; absorption of moisture decreases the generation of fine particles.",""];
background[3]=["Requirements of an inhaler device","19 KB","8 KB","Characteristics that would lead to improvements in drug delivery primarily derive from the properties of the inhaler device and the inspired cloud. An “ideal” inhaler should be designed to confer the following properties: - Cloud duration should be independent of the patient’s inspiration
- Duration of dose generation should occupy a substantial part of a slow inspiration. A generation time of =1 second will permit the patient to coordinate delivery inspiration
- The aerosol cloud should have a high fine particle fraction (FPF) (particles <5 µm in size)
- The velocity of the cloud should be low to reduce oropharyngeal deposition.
","Ganderton D. Targeted delivery of inhaled drugs: current challenges and future goals.J Aerosol Med 1999; 12 (Suppl. 1): S3–8."];
background[4]=["What is Respimat® Soft Mist™ Inhaler?","65 KB","220 KB","Respimat® Soft Mist™ Inhaler (SMI) is a new generation, propellant-free inhaler developed by Boehringer Ingelheim as an innovative approach to inhalation therapy. The concept behind the development of Respimat® SMI was to produce a propellant-free device that could generate an aerosol cloud with superior properties to other devices.Respimat® SMI improves lung deposition, is easy to use and is preferred by patients compared with conventional pMDIs and DPIs.",""];
background[5]=["Schematic diagram of Respimat® SMI","182 KB","312 KB","Schematic illustration of the final version of Respimat® SMI showing the key components of the device.
Medication to be delivered by Respimat® SMI is stored as a solution in the drug cartridge. The ability to generate an aerosol from a solution avoids the problems of moisture absorption and powder aggregation that occur with some DPIs. Additionally, the use of a solution, rather than a suspension, ensures that the metered dose delivered with each actuation remains uniform.
The cartridge is a sealed container (acting as a moisture barrier) containing a collapsible bag, which contracts as the medication is drawn from the cartridge.",""];
background[6]=["Respimat® SMI: The uniblock","131 KB","560 KB","The uniblock is the key element of Respimat® SMI and consists of an extremely fine nozzle that is manufactured using principles developed for the microchip technology industry.In the initial prototype of Respimat® SMI, the nozzle openings were tiny holes pierced into a stainless steel disk; however, this design was not suitable for mass production. The problem was overcome by the development of a miniature ‘sandwich’ concept, the uniblock, consisting of a silicon wafer bonded to a small rectangle (2 x 2.5 mm) of glass. Filter channels, which prevent the nozzle from becoming blocked, and inlet and outlet channels are etched into the silicon wafer using a highly innovative technique that stems from microchip technology.
This technique allows the units to be produced on a large scale with high precision and accuracy; approximately 2000 identical nozzles can be produced simultaneously. The channel configuration is optimised to produce a high proportion of the dose in the FPF (droplets of =5.8 µm in diameter).",""];
background[7]=["How does Respimat® SMI work?","12 KB ","8 KB","The energy from a 180o twist of the device base compresses the spring. This transfers a pre-defined metered volume of the drug from the drug cartridge, through a capillary tube, to the dosing chamber.
When the patient depresses the dose-release button, the mechanical power from the spring forces a micro-piston into the dosing chamber. This operation drives the metered volume of drug solution through the uniblock.The metered dose is forced through the small channels of the uniblock, producing two fine jets of liquid at the outlet that converge at a precisely set angle and collide outside the nozzle.
As a result of this collision the liquid is aerolised, generating a slow-moving cloud, or Soft Mist™, of inhalable particles.",""];
background[8]=["Video clip animation showing the mechanism of action of Respimat® SMI","","43 KB","",""];
background[9]=["How does Respimat® SMI differ from other inhalers?","18 KB","10 KB","The Soft Mist™ generated by Respimat® SMI has a much slower velocity and lasts much longer than the aerosol clouds from pMDIs and DPIs.
hese characteristics result in high lung deposition and low oropharyngeal deposition.Furthermore, Respimat® SMI facilitates hand–lung co-ordination.
The Soft Mist™ has a high proportion of the dose in the FPF (droplets of ≦ 5.8 µm in diameter); these particles are small enough to penetrate into, and be absorbed by, the lungs after inhalation.","1. Hochrainer D, Hölz H, Kreher C, et al. Comparison of the aerosol velocity and spray duration of Respimat® Soft Mist™ Inhaler and pressurised metered dose inhalers. J Aerosol Med 2005; accepted for publication.
2. Zierenberg B. Optimizing the in vitro performance of Respimat®. J Aerosol Med 1999; 12 (Suppl. 1): S19–24.
3. Newman SP, Steed KP, Reader SJ, et al. Efficient delivery to the lungs of flunisolide aerosol from a new portable hand-held multidose nebulizer. J Pharm Sci 1996; 85: 960–4.
4. Data on file.
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