[0001] The present invention relates to a spacer for use with an inhaler for dispensing
powdered medicament. Such a spacer may be used to ensure that an effective dose of
a discrete amount of medicament is dispensed by the inhaler by reducing drug particles
above a predetermined size from the administered dose.
[0002] Conventionally dry powder inhalers comprise three parts: a reservoir for solid medicament
either in a dry powder form or in a form suitable for the generation of dry powder
for delivery on demand; a metering device for delivery of consistent doses of medicament
from the reservoir; and an outlet.
[0003] A patient inhaling through the outlet receives a metered dose of the medicament.
Metered dose inhalers allow the patient to administer an accurate does of medicament
when required. This is particularly useful during a sudden occurrence of respiratory
difficulty, such as an asthma attack.
[0004] One problem with dry powder inhalers is to ensure that an effective dose of the medicament
is delivered to the patient's lungs. Dispensed medicament particles tend to separate
according to size under the influence of gravity and air currents. Smaller particles,
for example less than 5-6 µm in diameter, pass through the patient's oro-pharynx and
enter the trachea, bronchi and lower airways where they are able to exert a therapeutic
effect. Larger diameter particles are more likely to be deposited in the patient's
oro-pharynx. Such oro-pharyngeal deposition is undesirable for a number of reasons.
The patient may experience an unpleasant taste when particles alight on the mucosa.
Furthermore the proportion of the dispensed dose inhaled which actually constitutes
an effective dose is reduced. Moreover unwanted deposits of certain classes of compounds
may cause undesirable side effects, eg a high incidence of
Candida infections ("thrush") has been reported in association with the administration of
corticosteroids.
[0005] In pressurised metered dose inhalers the larger droplets formed in the aerosol cloud
have been separated out by providing a "large volume spacer" to allow these larger
droplets to impinge on the spacer wall, evaporate or fall to the floor of the spacer.
Such a "large volume spacer" is unsuitable for use with a powder inhaler where the
patient's inspirational air flow withdraws the dose from the inhaler.
[0006] Alternatively impact surfaces have been used in order to break up the larger particles
of medicament. However this requires a tortuous air path. This results in a bulky
spacer and increases the inhalation force required for effective drug delivery. It
is undesirable to impose a further burden on a patient who is already experiencing
respiratory problems.
[0007] A dry powder medicament inhaler spacer according to the preamble of claim 1 is known
from the document US-A-4 841 964.
[0008] The present invention seeks to provide a compact device which reduces the large particle
dose without adversely affecting the fine particle dose and hence reduces the amount
of oro-pharyngeal deposition of large medicament particles, while allowing self-administration
of an effective dose without increasing the respiratory burden on the user.
[0009] According to a first aspect of the invention there is provided a powdered medicament
inhaler spacer, comprising:
a body defining a chamber;
an inlet communicating with the chamber; and
an outlet communicating with the chamber, in which the chamber, inlet and outlet are
adapted to provide a rotational flow path in use for an airstream passing from the
inlet through the chamber to the outlet.
[0010] The body has a slender cylindrical configuration.
[0011] The body may include an internal surface having the configuration of a closed curve.
The body is slender, that is of small width relative to its length or height.
[0012] The chamber is cylindrical, more preferably a circular cylinder having a horizontal
radial axis in use and a continuous curved internal wall with two generally flat sides.
Alternatively the cylinder may have the shape of an ellipse, ovoid or other closed
curve.
[0013] The inlet and outlet communicate with the chamber such that an airstream with powdered
medicament entrained in it may pass through the spacer, entering the chamber through
the inlet and exiting the chamber through the outlet. The positions of the inlet and
outlet are arranged within the chamber such that the airstream has to undergo at least
some degree of rotational motion within the chamber in order to pass through the spacer.
In preferred embodiments of the invention rotation through 360° occurs within the
chamber. The curved form of the body together with the slender form of the body cooperate
to constrain the possible flow paths of the airstream so that the only flow path possible
is substantially rotational, ie the geometry of the spacer body reduces motion in
a direction transverse to the body and induces rotational motion in direction parallel
to the curvature of the body. The rotational motion in general of the medicament particles
causes larger particles to be removed from the airstream.
[0014] One particular effect of the rotational motion of the powdered medicament particles
entrained in the airstream, is that it causes a centripetal force to act on the particles.
The reaction of the centripetal force causes particles to move towards the surface
of the chamber. The force acting on the particles is proportional to their mass and
consequently the more massive particles, ie those with a greater dimension, experience
a greater force and are urged towards the curved surface. As the particles impinge
on the internal surface of the walls of the body they tend to adhere to it. In this
manner particles above a certain size may be selectively removed from the airstream
as it passes through the spacer. Hence, a dose of medicament with particles of the
desired smaller sizes may be administered.
[0015] The curved body is arranged to induce rotational motion in the airstream without
increasing the respiratory effort of the user. The curved body relies on its geometric
form to induce a rotational flow path without imparting a sudden change in direction
of the airstream flow path. Hence, larger particles are caused to adhere to the inner
surface of the chamber. Fragmentation of larger particles may occur releasing further
medicament of an inhalable size.
[0016] The curved body and chamber may have a transverse or radial axis and a lateral axis.
Preferably the dimension of the transverse axis is less than the dimension of the
lateral axis, more preferably half the dimension of the lateral axis. The transverse,
ie radial dimension of the body is less than the lateral dimension of the body so
that the flow path of the airstream is constrained to be substantially rotational.
The sides of the body are disposed sufficiently close together so as to prevent substantial
transverse flow, but are sufficiently spaced apart as to provide the chamber with
a shape that does not significantly impede the passage of an airstream through the
spacer so that the spacer does not impose a respiratory burden on the user.
[0017] The flow within the spacer may be observed in conventional manner using smoke or
other opaque gaseous medicine within a spacer constructed of transparent material.
[0018] The inlet engages the curved body in a first direction and the outlet engages the
body in a second direction and the first direction and the second direction lie in
a common plane of the curved body which is perpendicular to the transverse axis. In
this way, the inlet and outlet are arranged so that they are coplanar and their common
plane is substantially perpendicular to the transverse axis of the body. Hence, only
those particles undergoing rotational motion rather than transverse motion will be
able to pass from the inlet to the outlet. The first direction and the second direction
may be parallel.
[0019] In certain embodiments of the invention the inlet tangentially engages the curved
body or enters the body tangential to the flow path within the chamber. In this way
the airstream enters the chamber and is caused to follow a rotational flow path without
having to undergo an abrupt change in direction which may cause the impedance of the
spacer to air flow to increase. The outlet preferably also tangentially engages the
curved body.
[0020] In one embodiment the inlet and outlet do not extend within the chamber. This serves
to ensure that the inlet and outlet are flush with the inner surface with the flow
of the airstream. This reduces turbulence and may avoid unnecessary surfaces to which
particles may adhere.
[0021] Alternatively one or both of the inlet or the outlet extend within the chamber. In
this way the position within the chamber at which the airstream is introduced, or
the position at which the airstream leaves the chamber may be selected. This serves
to facilitate the delivery of medicament particles within a selected range of sizes
to the patient. However, the ends of the inlet and the outlet need not overlap if
the distance between them is such that the momentum of the medicament particles in
the airstream is sufficient to prevent any direct non-rotational flow from the inlet
to the outlet.
[0022] The end of the inlet within the chamber and the end of the outlet within the chamber
may co-terminate. Preferably the end of the inlet within the chamber and the end of
the outlet within the chamber overlap. The relative positions of the ends of the inlet
and outlet within the chamber may be chosen so as to enhance the removal of medicament
particles above a selected size from the airstream.
[0023] One or more internal surfaces of the body may be roughened so as to facilitate deposition
of the unwanted larger particles. In this way the effectiveness of the spacer in selectively
removing larger medicament particles may be increased.
[0024] The selectively extracted particles may be larger than a predetermined size. Preferably,
the predetermined size is about 10 µm, more preferably about 6 µm, most preferably
about 2 µm.
[0025] An end of the inlet external to the chamber may be adapted to connect to a medicament
delivery outlet of the powdered medicament inhaler. An erd of the outlet external
to the chamber may include a mouthpiece.
[0026] The inlet or outlet may have spirals or other moldings inside to give greater turbulence
to the airflow.
[0027] The spacer may be made wholly or partially of a transparent material. In this way
a user can tell when the spacer needs cleaning owing to an excessive build up of extracted
medicament. The spacer may be constructed from two parts adapted to allow the spacer
to be easily disassembled for cleaning and reassembled for use. This allows the spacer
to be easily cleaned so that optimum performance may be maintained and also ensures
that the correct effective dose of medicament is delivered.
[0028] The spacer may have one or more protuberances extending transversely across the chamber.
The presence of the formation in the chamber will help to induce further turbulence
in the airstream passing through the spacer and hence increase the amount of medicament
selectively extracted from the airstream.
[0029] The protuberances may comprise a plurality of stepped baffles disposed on the side
walls of the chamber. The stepped baffles may be opposed so as to form constrictions
to the airflow. Alternatively the baffles may be disposed in an alternate relationship
so that the airflow is caused to pass alternately from one side of the chamber to
the other.
[0030] Triangular or wedge shaped baffles may be preferred. These may be arranged to extend
inwardly from the planar faces of the cylindrical chamber. The baffles may be arranged
either clockwise or anti-clockwise so that the airstream contacts the inclined surface
or axially extending surface as desired in order to induce the selected degree of
turbulence.
[0031] When the spacer is constructed from two parts, the formation may include a fastener
to secure the two halves of the spacer together. The fastener may be in the form of
a screw co-operating with a thread in part of the formation associated with one of
the two parts. The screw may be separate to the formation or an integral part of the
formation associated with the other of the two parts of the spacer. Alternatively,
the fastener may be in the form of a releasable snap-fit device.
[0032] The spacer may be integral with the powder dispenser.
[0033] The invention will now be further described by means of example, but not in any limiting
sense, with reference to the accompanying drawings, in which:
Figure 1 shows a schematic cross-section of a spacer in accordance with this invention;
Figure 2 shows a plan view of the spacer of Figure 1;
Figure 3 shows a schematic cross-sectional view of a modified spacer;
Figure 4 shows a schematic cross-sectional view of a modified spacer;
Figures 5a and 5b show a first schematic cross-sectional view and a second schematic
cross-sectional view along the line AA' respectively of the modified spacer;
Figure 6 illustrates the dimension of a spacer in accordance with this invention;
and
Figure 7 is a perspective view of a spacer in accordance with this invention.
[0034] With reference to Figures 1 and 2, there is shown a spacer, generally designated
by reference numeral 10, for use with a powdered medicament inhaler. The spacer has
a right cylindrical body 11, with side walls 21, 24 and curved wall 25, defining a
cavity 12. The spacer has an inlet 13 with an end 14 within the chamber and an end
15 external to the chamber. The spacer has an outlet 16 with an end 17 within the
chamber and an end 18 external to the chamber.
[0035] The body has a transverse axis 19 extending across the width of the body and a lateral
axis 20 extending across the length of the sides 21, 24 of the body. The.body is slender;
ie the width of the body is small compared to the length of the side of the body.
[0036] The inlet tangentially engages the body towards the bottom of the body at point 22
and in a first direction, parallel to the sides 21, 24 of the body. The outlet 16
tangentially engages the body towards the top of the body at point 23 and in a second
direction parallel to the side of the body 21 and parallel to the inlet 13. Hence,
the inlet and outlet lie in a common plane which is perpendicular to the transverse
axis 19. The end 14 of the inlet and the end 17 of the outlet co-terminate within
the chamber; ie the ends terminate diametrically opposite each other.
[0037] The spacer may be constructed from two parts adapted to allow the spacer to be disassembled
and reassembled and may be made of a wholly or partially transparent material. this
permits the user to easily determine when the spacer needs cleaning and facilitates
cleaning of the spacer.
[0038] Use of the spacer with a powdered medicament inhaler will now be described. The spacer
is connected to a medicament delivery outlet of a powdered medicament inhaler by the
end 15 of the inlet 13. A metered dose of powdered medicament is dispensed from the
inhaler into the spacer by the user inhaling from the end 18 of the outlet. An airstream
with powdered medicament entrained in it flows into the chamber via the inlet. The
curvature of the inner surface of the wall of the body causes the airstream flow path
to be predominantly circular and to follow a path parallel to the curved wall 25 of
the body. The side walls 21, 24 act to restrict any flow along the transverse axis
and so co-operate with the curved wall 25 to induce a rotational flow path for the
airstream in a clockwise direction.
[0039] As the medicament particles entrained in the airstream are undergoing rotational
motion, a centripetal force acts upon them. The centripetal force is proportional
to their mass and hence size. The reaction to the centripetal force (the imaginary
"centrifugal force") causes the particles to move towards the inner surface of the
curved wall 25 of the body. However, only those particles of sufficient mass will
experience a force of sufficient magnitude to displace them from the airstream. Hence
particles above certain size will be selectively extracted from the airstream and
impinge on the roughened internal surface of the curved wall and accrete to it. This
results in the remaining particles entrained in the airstream being of the desired
size. These are then ingested by the user via the outlet 16 allowing the correct effective
dose to be delivered to the user.
[0040] Locating the outlet at the top of the body helps to prevent the ingestion of any
large medicament particles which may accumulate at the bottom of the spacer under
the action of gravity and otherwise be inadvertently inhaled.
[0041] A modified spacer will now be described with reference to Figure 3. The spacer, generally
designated by reference number 30, comprises a right cylindrical slender body 31 defining
a chamber 32. the spacer has an inlet 33 and an outlet 34 communicating with the chamber
32. An end of the inlet 35 within the chamber and an end of the outlet 36 within the
chamber overlap within the chamber; ie the ends of the inlet and outlet overlap in
as much as the ends do not terminate at diametrically opposite positions within the
chamber.
[0042] The spacer 30 works in a similar manner to that for the spacer 10. However, as the
ends overlap, the airstream must undergo some several within the chamber, ie a flow
path with some rotational component, before it can enter the outlet. Further as the
end 36 of the outlet is displaced away from the curved wall of the spacer it is less
likely to allow particles deposited on the wall to be inhaled and rather is positioned
well within an area of free rotational flow; ie a position in the flow path where
particles of the desired dimensions are more likely to be entrained.
[0043] A further modified spacer will now be described with reference to Figure 4. The spacer,
generally designated by reference numeral 40, has a body 41, defining a chamber 42.
the spacer has an inlet 43 with an end 45 within the chamber and an outlet 44 with
an end 46 within the chamber. The body is slender having a width small relative to
the dimensions of its sides. The body has two curved end wall portions 47, 48 joined
by two straight wall portions 49, 50. The end 45 of the inlet and the end 46 of the
outlet do not overlap within the chamber; ie there is a gap, extending in the direction
parallel to the inlet and outlet, between the ends of the inlet and outlet.
[0044] In use the spacer works in a similar manner as to that of spacers 10 and 30 described
previously, except the relatively increased volume allows for a freer airstream flow.
[0045] Regardless of whether the spacer configuration shown in Figures 1, 3 or 4 is adopted,
the invention still maintains a high fine particle fraction in the dose delivered
to the patient's lungs while suppressing the instance of oro-pharyngeal deposition
of the larger particles.
[0046] Table 1 shows a comparison for a dry powder inhaler dispensing 400 µm doses of powdered
medicament with no spacer and with various spacers conforming to the current invention.
It will be seen from Table 1 that a spacer according to the present invention provides
a high respirable fraction of fine particles whilst the deposition of large particles
in undesired regions is significantly reduced.
[0047] The equipment used was an astra draco four stage liquid impinger manufactured by
Copley Instruments of Nottingham, England.
Table 1.
| Drug Dispersion from Budesonide MDPIs (400 µg/dose) with and without Spacer |
| |
No Spacer |
Spacer A |
Spacer B |
Spacer C |
| TD(µg) |
383 |
334 |
346 |
372 |
| FD(µg) |
191 |
133 |
129 |
130 |
| FT(%) |
47 |
14 |
7 |
15 |
| FF(%) |
50 |
40 |
37 |
35 |
| TD: Total Dose per Shot FD: Fine Particle Dose |
| FT: Fraction of Drug at Throat and Stage 1 (Normally larger than 8µm) |
| FF: Fine Particle Fraction (Normally smaller than 6µm) |
[0048] With reference to Figures 5a and 5b there is shown a further modified spacer, generally
designated by reference numeral 50. The spacer is similar to that shown in Figure
1, but has a formation 51 which extends transversely across the chamber. The formation
acts to induce further turbulence in the airstream as it passes through the chamber
and so enhances the selective extraction of medicament from the airstream.
[0049] Figures 6 and 7 illustrate a preferred embodiment of the invention. Figure 7 is a
perspective view of the spacer, the dimensions of which are described with reference
to Figure 6.
[0050] The spacer has a circular cylindrical body 60 and tubular inlet 61 and outlet 62
arranged generally tangentially parallel to the cylinder 60. The opening 63 of the
inlet 61 and entrance 64 to the outlet 62 may be adjusted by movement of the inlet
61 and outlet 62 within their housings. Accordingly the inlet length 70 and outlet
length 69 may be adjusted. The inlet and outlet lengths may be adjusted so that the
openings 63, 64 lie within the same plane or may extend further so that they overlap
preventing direct flow of a particulate containing airstream between the openings
63, 64 without rotation within the chamber 60. The inlet diameter 71 is greater than
the outlet diameter 72 to minimise the resistance afforded to a user. The cyclone
diameter 68 of the chamber 60 was maintained at 48 mm in the following example.
[0051] Wedge shaped baffles 73, 74 are arranged on the planar sides of the spacer. The baffles
73, 74 may be arranged with the axially extending surfaces 75, 76 disposed either
facing or away from the direction of air flow as required to afford a desired degree
of turbulence within the airstream. The baffles may be arranged to form a series of
constrictions as shown in Figure 7 or alternatively may be arranged to present parallel
faces to the airstream to induce oscillations in an axial direction during rotation
of the airflow around the chamber.
[0052] An axial pillar may be provided to impede direct flow between the inlet 61 and outlet
62.
[0053] Tables 2 and 3 illustrate particle sizes obtained from several lengths of inlet and
outlet tube and configurations of baffles. Reduction of larger sized particles was
observed within the airstream and ministered to a patient.
[0054] The equipment used was an astra draco four stage liquid impinger manufactured by
Copley Instruments of Nottingham, England. This equipment measures the aerodynamic
particle size. Each stage of the impinger has a particular size cut-off and only particles
of defined sizes are captured in each stage. The fine particle dose is the mass of
drug captured in stages 3 and 4.
[0055] Preferred designs have as large as possible reduction in large particle dose (typically
greater than 60%) with as small as possible reduction in fine particle dose (typically
less than about 15%). Referring to tables 2 and 3, Design 1 exhibited a reduction
of 60% of larger particles and only 16% of smaller particles. Design 7 had a reduction
of 61% of larger particles and only 12% of smaller particles. Design 8 had a reduction
of 58% of larger particles and only 15% of smaller particles.
Table 3
| Design Number |
% Reduction in Fine Particle Dose |
% Reduction in Large Particle Dose |
| 1 |
16 |
60 |
| 2 |
36 |
71 |
| 3 |
48 |
66 |
| 4 |
29 |
65 |
| 5 |
21 |
58 |
| 6 |
22 |
69 |
| 7 |
12 |
61 |
| 8 |
15 |
58 |
| 9 |
25 |
65 |
| 10 |
27 |
65 |
| 11 |
39 |
63 |
1. Abstandshalter (10) für einen Trockenpulvermedikamenteninhalator, aufweisend: einen
Körper, der eine schmale zylindrische Kammer (11) definiert, die einen Einlass (13)
und einen Auslass(16), deren jeder mit der Kammer (11) in Verbindung steht, aufweist,
dadurch gekennzeichnet, dass der Einlass (13) in einer ersten Richtung in die Kammer (11) eingreift und der Auslass
(16) in einer zweiten Richtung in die Kammer (11) eingreift, wobei die erste und zweite
Richtung in einer im Wesentlichen gemeinsamen Ebene senkrecht zur Achse der zylindrischen
Kammer liegen,
so dass im Gebrauch der Einlass (13) und der Auslass (16) mit der zylindrischen
Kammer (11) in Verbindung stehen, um einen rotatorischen Luftstrom, der ein pulverförmiges
Medikament enthält, vom Einlass (13) durch die zylindrische Kammer (10) zum Auslass
(16) bereitzustellen.
2. Abstandshalter (10) nach Anspruch 1, wobei der Einlass (13) und Auslass (16) so angeordnet
sind, dass im Gebrauch der Luftstrom in der gekrümmten schmalen Kammer (11) eine Drehung
um 360° erfährt.
3. Abstandshalter (10) nach Anspruch 1 oder 2, wobei die gekrümmte schmale Kammer (11)
eine transversale Achse aufweist, die kleiner als die Abmessung der lateralen Achse
ist.
4. Abstandshalter (10) nach einem der vorhergehenden Ansprüche, wobei der Einlass (13)
und Auslass (16) parallel sind.
5. Abstandshalter (10) nach einem der vorhergehenden Ansprüche, wobei sich die Enden
des Einlasses (13) und Auslasses (16) in der Kammer (11) überlappen.
1. Chambre d'inhalation (10) d'un inhalateur de médicament en poudre sèche, comprenant
un corps définissant une mince chambre cylindrique (11) pourvue d'une entrée (13)
et d'une sortie (16), communiquant chacune avec la chambre (11) ;
caractérisée en ce que l'entrée (13) pénètre dans la chambre (11) dans une première direction et la sortie
(16) pénètre dans la chambre (11) dans une deuxième direction, la première et la deuxième
direction étant situées dans un plan sensiblement commun, perpendiculaire à l'axe
de la chambre cylindrique ;
de sorte que, pendant l'utilisation, l'entrée (13) et la sortie (16) communiquent
avec la chambre cylindrique (11) pour provoquer un courant d'air rotationnel, contenant
un médicament en poudre, de l'entrée (13) en direction de la sortie (16), en passant
par la chambre cylindrique (11).
2. Chambre d'inhalation (10) selon la revendication 1, dans laquelle l'entrée (13) et
la sortie (16) sont conçues de telle sorte que, pendant l'utilisation, le courant
d'air subit une rotation de 360° à l'intérieur de la mince chambre incurvée (11).
3. Chambre d'inhalation (10) selon la revendication 1 ou 2, dans laquelle la mince chambre
incurvée (11) possède un axe transversal dont les dimensions sont inférieures à celles
de l'axe latéral.
4. Chambre d'inhalation (10) selon l'une quelconque des revendications précédentes, dans
laquelle l'entrée (13) et la sortie (16) sont parallèles.
5. Chambre d'inhalation (10) selon l'une quelconque des revendications précédentes, dans
laquelle les extrémités de l'entrée (13) et de la sortie (16) se recouvrent, dans
la chambre (11).