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M9490644.TXT
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1994-09-24
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Document 0644
DOCN M9490644
TI Pulmonary deposition of aerosolised pentamidine using a new nebuliser:
efficiency measurements in vitro and in vivo.
DT 9411
AU Ferretti PP; Versari A; Gafa SI; Becquemin MH; Barchi E; Serafini D; Roy
M; Salvo D; Bouchikhi A; Servizio di Fisica Sanitaria, Arcispedale S.
Maria Nuova, Reggio; Emilia, Italy.
SO Eur J Nucl Med. 1994 May;21(5):399-406. Unique Identifier : AIDSLINE
MED/94341283
AB The therapeutic efficacy of nebulised pentamidine in the prophylaxis of
Pneumocystis carinii pneumonia (PCP) depends on the absolute pulmonary
deposition of the drug. We studied the performance of a new nebuliser
(Pentasave) by comparison both in vitro and in vivo with a standard
nebuliser (Respirgard II). In vitro, deposition of pentamidine labelled
with technetium-99m human serum albumin was measured indirectly by
capturing inhaled particles on an absolute filter and measuring
radioactivity with a gamma camera. The nebulisers were initially
assessed with a pentamidine dose of 100 mg in 5 ml at 44 psi and an air
flow of 10 l/min for Respirgard II and 16 l/min for Pentasave. Nebuliser
output, expressed as the percentage of the initial nebuliser
radioactivity captured by the inhalation filter, was 15% +/- 2% (mean
+/- SD) for Respirgard II, and significantly increased to 23% +/- 3% for
an initial version and to 33% +/- 2% for the final version of Pentasave.
Measurements with a gamma camera in a group of ten patients with human
immunodeficiency virus infection were made in vivo. The results revealed
that pulmonary drug distributions are good using both Respirgard II and
Pentasave. The literature reports that once-monthly pulmonary deposition
of 9 mg pentamidine seems enough to produce prophylactic effects against
Pneumocystis carinii. We measured pulmonary pentamidine deposition of
20.22 +/- 4.31 mg (mean +/- SD) using Respirgard II (with 300 mg in 5
ml) and of 16.00 +/- 7.18 mg using Pentasave (with 150 mg in 6 ml).
These findings show that the therapeutic dose of pentamidine (9 mg) was
widely exceeded with both nebulisers. Further investigations might
demonstrate that about 200 mg and 125 mg pentamidine for Respirgard II
and Pentasave, respectively, will achieve a pulmonary deposition of
therapeutic dose, allowing significant savings in terms of drug and
expense.
DE Administration, Inhalation Adult Comparative Study Female Human In
Vitro Lung/*METABOLISM/RADIONUCLIDE IMAGING Male Models, Structural
*Nebulizers and Vaporizers Pentamidine/*ADMINISTRATION &
DOSAGE/PHARMACOKINETICS Pneumonia, Pneumocystis carinii/PREVENTION &
CONTROL Technetium Tc 99m Aggregated Albumin/DIAGNOSTIC USE JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).