The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

DOES USE OF A NEBULIZERRESULT IN AN INCREASE IN DRUG CONCENTRATION?

James B. Fink, MS, FAARC,Mary Simon, MS, Paul Uster, PhD. Aerogen, Inc, Sunnyvale, CA

Increasing drug concentrations duringthe process of nebulization has been identified with use of ultrasonic nebulizers,but has not been well defined with other types of nebulizers. We measured theconcentration of drug remaining in each of 5 pneumatic nebulizers (Pari LC Plus,Monaghan AeroEclipse, DeVilbiss Model 800, Allegiance Airlife Misty Neb andSalter 8900) and a novel nebulizer (Aerogen?s Aeroneb? Portable Nebulizer System)after aerosol generation was complete. Each nebulizer was filled with 2.5 mg(3 ml of 0.083%) albuterol sulfate. Upon completion of aerosol flow, the residualdrug volume was determined gravimetrically, while residual mass (mg) and concentration(percent of initial concentration) were determined using an HPLC method. Significantdifferences (p<0.05) were determined by ANOVA.

Results:

DeviceResidualVolume (mL)ResidualVolume (%)ResidualMass(mg)ConcentrationChange (%)
PariLC Plus wProNeb Turbo1.4461.3+11.2
MonaghanAeroEclipse w50 psi1.1361.3+37.4
DeVilbiss800 with Compressor2.1701.8+4.8
AirlifeMisty Neb w 50psi1.0331.2+37.0
Salter8900 w 50 psi1.7571.7+14.7
AerogenAeroneb Nebulizer*0.4130.3-2.0

*Residualvolume, % of residual volume, residual mass, and change in concentration allare statistically significantly lower with the Aeroneb Portable Nebulizer System,compared with use of any of the other nebulizers.

Discussion: All of the pneumaticnebulizers increased concentration of residual albuterol. Increased residualconcentration was inversely related to the residual volume. In contrast, theAeroneb Portable Nebulizer System did not increase residual concentration, despitea lower residual volume and mass than those resulting from the use of the pneumaticnebulizers.

Conclusion: Concentrationof residual medication increases during operation of pneumatic nebulizers, butnot with the Aeroneb Portable Nebulizer System.

OF-01-263

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