[Changes in osmolarity during inhalation with various IPPB and ultrasound devices]. 1993

U H Cegla, and W Pluta
Hufeland-Klinik, Zentrum f. Pneumologie und Allergologie, Taunusallee, Bad Ems.

Inhalation of slightly hyperosmolar solutions may result in asthma attacks. "Evaporation" and hence increase of the concentration of the aerosol in continuous atomisation by ultrasound has been known for a long time. The present study aimed at finding out to what extent an osmolarity increase can be detected even with commercial home inhalation devices with an inhalation period of between 3 and 5 minutes. We examined the following instruments: Heyer Sekundant, Bird-Mark 7, Respirator IPPB (supplier: Stephan) Pari-Inahalierboy, Heyer-Prodomo and the compressed-air driven inhalators FT 51 (Heyer) and the ultrasound device US-77 supplied by Heyer. Osmolality was measured with the osmometer Osmomat-030 supplied by Gonoteck. We atomised a mixture of 5 drops Berodual with physiological saline solution and isotonic brine (salt water) from the German spa Bad Ems. All inhalation devices showed after a short time an increase in osmolarity that was lowest with the Inhalierboy and Heyer Prodomo. The Heyer Sekundant and Bird-Mark 7 models showed increases that were a cause for concern. It is recommended on the basis of the results obtained that suppliers should state on their inhalation equipment not only the droplet size and aerosol density but also the increase in osmolarity on atomisation of a reference substance after 3 or 5 minutes, respectively. It would be desirable, in the interests of safe therapy, that the data given for an inhalation equipment should include over and above the usual characteristics the increase in osmolarity per unit of time under defined environmental conditions (see above) on atomisation of a reference solution.

UI MeSH Term Description Entries
D007384 Intermittent Positive-Pressure Breathing Application of positive pressure to the inspiratory phase of spontaneous respiration. IPPB,Inspiratory Positive-Pressure Breathing,Intermittent Positive Pressure Breathing (IPPB),Breathing, Inspiratory Positive-Pressure,Breathing, Intermittent Positive-Pressure,Inspiratory Positive Pressure Breathing,Intermittent Positive Pressure Breathing,Positive-Pressure Breathing, Inspiratory,Positive-Pressure Breathing, Intermittent
D009241 Ipratropium A muscarinic antagonist structurally related to ATROPINE but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic. N-Isopropylatropine,(endo,syn)-(+-)-3-(3-Hydroxy-1-oxo-2-phenylpropoxy)-8-methyl-8-(1-methylethyl)-8-azoniabicyclo(3.2.1)octane,Atrovent,Ipratropium Bromide,Ipratropium Bromide Anhydrous,Ipratropium Bromide Monohydrate,Ipratropium Bromide, (endo,anti)-Isomer,Ipratropium Bromide, (exo,syn)-Isomer,Ipratropium Bromide, endo-Isomer,Itrop,Sch-1000,Sch-1178,N Isopropylatropine,Sch 1000,Sch 1178,Sch1000,Sch1178
D009330 Nebulizers and Vaporizers Devices that cause a liquid or solid to be converted into an aerosol (spray) or a vapor. It is used in drug administration by inhalation, humidification of ambient air, and in certain analytical instruments. Atomizers,Inhalation Devices,Inhalators,Inhalers,Vaporizers,Nebulizers,Vaporizers and Nebulizers,Atomizer,Device, Inhalation,Devices, Inhalation,Inhalation Device,Inhalator,Inhaler,Nebulizer,Vaporizer
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D001985 Bronchial Provocation Tests Tests involving inhalation of allergens (nebulized or in dust form), nebulized pharmacologically active solutions (e.g., histamine, methacholine), or control solutions, followed by assessment of respiratory function. These tests are used in the diagnosis of asthma. Allergen Bronchial Provocation Tests,Allergen Challenge, Endobronchial,Antigen Bronchial Provocation Tests,Bronchial Allergen Challenge,Bronchial Challenge Tests,Inhalation Provocation Tests,Provocation Tests, Bronchial,Endobronchial Challenge Tests,Allergen Challenge, Bronchial,Allergen Challenges, Bronchial,Allergen Challenges, Endobronchial,Bronchial Allergen Challenges,Bronchial Challenge Test,Bronchial Provocation Test,Challenge Test, Bronchial,Challenge Test, Endobronchial,Challenge Tests, Bronchial,Challenge Tests, Endobronchial,Challenge, Bronchial Allergen,Challenge, Endobronchial Allergen,Challenges, Bronchial Allergen,Challenges, Endobronchial Allergen,Endobronchial Allergen Challenge,Endobronchial Allergen Challenges,Endobronchial Challenge Test,Inhalation Provocation Test,Provocation Test, Bronchial,Provocation Test, Inhalation,Provocation Tests, Inhalation,Test, Bronchial Challenge,Test, Bronchial Provocation,Test, Endobronchial Challenge,Test, Inhalation Provocation,Tests, Bronchial Challenge,Tests, Bronchial Provocation,Tests, Endobronchial Challenge,Tests, Inhalation Provocation
D001993 Bronchodilator Agents Agents that cause an increase in the expansion of a bronchus or bronchial tubes. Bronchial-Dilating Agents,Bronchodilator,Bronchodilator Agent,Broncholytic Agent,Bronchodilator Effect,Bronchodilator Effects,Bronchodilators,Broncholytic Agents,Broncholytic Effect,Broncholytic Effects,Agent, Bronchodilator,Agent, Broncholytic,Agents, Bronchial-Dilating,Agents, Bronchodilator,Agents, Broncholytic,Bronchial Dilating Agents,Effect, Bronchodilator,Effect, Broncholytic,Effects, Bronchodilator,Effects, Broncholytic
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D005280 Fenoterol A synthetic adrenergic beta-2 agonist that is used as a bronchodilator and tocolytic. Berotec,Berotek,Fenoterol Hydrobromide,Fenoterol Hydrochloride,Partusisten,Phenoterol,Th-1165a,p-Hydroxyphenyl-orciprenaline,p-Hydroxyphenylorciprenaline,Hydrochloride, Fenoterol,Th 1165a,Th1165a,p Hydroxyphenyl orciprenaline,p Hydroxyphenylorciprenaline
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000336 Aerosols Colloids with a gaseous dispersing phase and either liquid (fog) or solid (smoke) dispersed phase; used in fumigation or in inhalation therapy; may contain propellant agents. Aerosol

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