Drug Delivery Performance and Fugitive Emission Comparison of Two Commercially Available Nebulizer Systems

Abstract

Background: Delivery of inhaled medications by nebulizer for the treatment of respiratory disease is widespread. Important factors to consider in a delivery system are amount and consistency of drug delivered to the lungs as well as the amount of drug/droplets that are emitted to the local environment (Fugitive Emissions).

Methodology: Nebulizers (AEROECLIPSE* II Breath Actuated Nebulizer (BAN) and Aerogen* Ultra) were evaluated with 2.5mg/3.0mL fill of salbutamol and connected to a breathing simulator mimicking adult tidal volume (500-ml) with I/E ratios of 1:1, 1:2 and 1:3. Emitted aerosol was captured by filter at 1-minute intervals until sputtering to determine total mass (TM_sal). The percentage of drug mass lost to the environment (EL_sal) was determined by combining the TM_sal recovered from the inhalation filters along with the residual mass recovered from the nebulizer and subtracting that from the initial 2.5mg salbutamol placed in the nebulizer. Salbutamol assay was undertaken by HPLC. Fine droplet mass (FDM_Sal µg) was determined by laser diffractometry as the product of TM_sal and fine droplet fraction (%<4.7µm)

Results: Average +/- SD FDM_sal and EL_sal at extended I/E ratios are reported in the table.

Conclusions: Higher and more consistent delivery was achieved by BAN as well as lower fugitive emissions. Clinicians should be aware of the ability to get increased amounts of medication to the lungs while maintaining a safer work environment for staff with use of the BAN.