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Open Access Journal Article

Performance of breath-actuated (Qvar) pressurize metered dose inhaler with different spacers: In-vitro study

by Mohammed Almeziny 1,* ,  Brian Clark 2  and  Henry Chrystyn 3
1
Consultant Clinical Pharmacist, Prince Sultan Military Medical City (PSMMC), Riyadh, KSA
2
Institute of Pharmaceutical Innovation, School of Pharmacy, University of Bradford, UK
3
Inhalation Consultancy Ltd, Leeds, UK
*
Author to whom correspondence should be addressed.
IJCMR  2025 3(3):59; https://doi.org/10.61466/ijcmr3030004
Received: 3 March 2025 / Accepted: 29 April 2025 / Published Online: 4 May 2025
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Abstract

Background

Spacers are commonly used especially for paediatric and elderly patients. However, there is a considerable discussion about their use and operation. The purpose of this study was to examine the performance of different types of spacers with Qvar breath actuated pressurize metered dose inhaler (pMDI) containing Beclometasone with fine particles.

Methods

The dose evaluation method for pMDIs in the British Pharmacopoeia (BP) was used to find out the total emitted dose (TED) and particle size distribution of Qvar pMDI. The study looked at pMDI alone and with three different spacers (Optimizer, Aerochamber Plus, and Aerochamber MAX) at a flow of 28.3 L/min and 4 L inhalation volume to mimic adults. At different times, from the first to the last actuation, the average amount of drug in each pMDI alone and connected to the three different spacers was evaluated.

Results

The pMDI by itself had the highest TED, which was significantly higher than all pMDI-spacer combinations (p < 0.05). The spacers also had higher fine particle dose, and fine particle fraction (p<5 µg) then pMDI alone. No significant different was observed in mass median aerodynamic diameter between the four tested combinations. No significant difference was observed between the three evaluated spacer.

Conclusions

These results show that there are improving effects on aerodynamic characterisation and the amount of drug available for inhalation when spacers are used as inhalational aids to pMDI. That support the GINA recommendation regarding the use of spacer with all patients using pMDI even the breath actuated pMDIs.

Keywords: in-vitro; aerodynamic particle size distribution; Qvar pressurize metered dose inhaler; Optimizer; Aerochamber Plus; and Aerochamber MAX;
Copyright: © 2025 by Almeziny, Clark and Chrystyn. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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ACS Style
Almeziny, M.; Clark, B.; Chrystyn, H. Performance of breath-actuated (Qvar) pressurize metered dose inhaler with different spacers: In-vitro study. International Journal of Clinical Medical Research, 2025, 3, 59. doi:10.61466/ijcmr3030004
AMA Style
Almeziny M, Clark B, Chrystyn H. Performance of breath-actuated (Qvar) pressurize metered dose inhaler with different spacers: In-vitro study. International Journal of Clinical Medical Research; 2025, 3(3):59. doi:10.61466/ijcmr3030004
Chicago/Turabian Style
Almeziny, Mohammed; Clark, Brian; Chrystyn, Henry 2025. "Performance of breath-actuated (Qvar) pressurize metered dose inhaler with different spacers: In-vitro study" International Journal of Clinical Medical Research 3, no.3:59. doi:10.61466/ijcmr3030004

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