Practical handbook of nebulizer therapy by Boe Jacob, B. Ronan O'Driscoll, John H. Dennis
By Boe Jacob, B. Ronan O'Driscoll, John H. Dennis
content material: Definition of TNFa as a healing aim for Rheumatoid Arthritis, M. Feldman, F.M. Brennan, R.O. Williams, and R.N. Maini Infliximab treatment, R.N. Maini and M. Feldman Etanercept, S.Sule and J.M. Bathan Adalimumab, L. van de Putte, J. Salfeld, and S. Kaymakcalan p-55 TNF Receptor treatment, J.J. funds TNFa-Inhibition in functional administration of Rheumatoid Arthritis: the united states version, J.C. Shanahan and L.W. Moreland TNFa-inhibition in sensible administration: The UK/European version, P. Emery issues of safety with Anti-TNF brokers: Immunomodulation and an infection, J.C. Shanahan Index
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European Respiratory Society nebulizer guidelines: clinical aspects. Eur Respir Rev 2000; 10. 22. Dennis JH, Nerbrink O. New nebulizer technology. In: Bisgaard H, O’Callaghan C, Smaldone GC eds. Drug Delivery to the Lung. New York: Marcel Dekker, 2002:303–34. 40 3. NEW DEVELOPMENTS IN NEBULIZER TECHNOLOGY John H Dennis Introduction So many new nubulizer technologies are being concurrently developed around the world at present that it is inconceivable they will not significantly impact on the drug aerosol delivery market in the very near future.
42 NEW DEVELOPMENTS IN NEBULIZER TECHNOLOGY 8. Cost effective. 9. No wasted aerosol (occupational and environmental hazard from release of wasted drug aerosol). 10. No significant wasted residual drug left in device after use. 11. Environmentally friendly [no damaging propellants such as chloro-flurocarbons (CFCs) and hydrofluroalkanes (HFAs)] and ideally recyclable. This is a long list of ‘ideal’ features. Because different patient groups will require varying drug aerosol doses with different drug aerosol size ranges it is unlikely that one ‘ideal’ device is possible – although conceivably could be possible if the device could be set or programmed for different needs.
Relies on laser diffraction to estimate particle size parameters Laser sizing takes no account of solute concentrating effects, particularly in the smaller particles, and provides a volume size distribution which will invariably be larger than the solute size (dry particles) distribution which is of far greater clinical relevance and interest 4. Applies laser diffraction to size a ‘standing cloud’ Nebulized aerosols are largely aqueous and prone to rapid evaporation once in contact with drier ambient air, such as the air entrained over constant output or through breath-enhanced nebulizers (Adapted from Dennis JH et al.