Abstract
ABSTRACT
The use of appropriate nebulizers is a major precondition for a successful treatment and prevention of Pneumocystis carinii pneumonia with pentamidine aerosol. The apparatus should supply a sufficient amount of pentamidine with adequate particle size. Using Fisons ultrasonic nebulizer FISO Neb, model FZV 40 BAMKI, De Vilbiss ultrasonic nebulizer, Porta-Sonic, model 8500 GB, and the Marquest Medical Products jet nebulizer Respirgard II, two pentamidine concentrations (300 mg/6 ml and 60 mg/6 ml) were compared by measuring nebulized pentamidine mass distribution and particle size distribution under in vitro conditions by means of a laser light-scattering particle sizer of the type Malvern Master sizer. It was found that there were significant differences among nebulizers. Mass distribution experiments with air flow 6 l/min showed that using FISO Neb the quantity of nebulized pentamidine was 201.4 mg and 36.7 mg, whereas using Porta-Sonic the values found decreased to 85.2 mg and 23.6 mg. Using Respirgard II the values were 80.0 mg and 10.64 mg. The measured total duration times of nebulization were 6 - 8.5 min, 12 min and 25 min for the nebulizers FISO Neb, Porta-Sonic and Respirgard II. A decomposition of pentamidine during nebulization in the case of ultrasonic nebulizers doesn't take place. The measured mass median diameters (MMD) were 5.6 - 6.9 μm, 1.96 - 3.04 μm and 1.9 - 2.5 μm for the nebulizers FISO Neb, Porta-Sonic and Respirgard II. Using 300 mg pentamidine the nebulized amounts of pentamidine containing particles sizes ≤ 2 μm predominately available for alveolar deposition were with values of about 43 mg markedly higher for Respirgard II and Porta-Sonic than the measured 10.5 mg for FISO Neb.
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