Why consider PIFR (peak inspiratory
flow rate) in COPD patients?

Not an actual COPD patient.

 

With a DPI, why can PIFR be a concern?

  • DPIs rely on inspiratory flow
  • Low PIFR may lead to marked reductions in amount of fine particles/emitted dose reaching the lungs1-3
  • Low PIFR may also lead to marked reductions in lung deposition4
  • Low PIFR drives the majority of handling errors with DPIs5
  • PIFR >60 L/min may help to maximize drug delivery6-8

* Based on studies designed to measure inspiratory flow rates and drug delivery at different levels of resistance. These studies were not designed to evaluate efficacy and safety.

As with other inhaled beta2-agonists, BROVANA® (arformoterol tartrate) Inhalation Solution can produce paradoxical bronchospasm that may be life-threatening in COPD patients. If paradoxical bronchospasm occurs, BROVANA treatments should be discontinued immediately and alternative COPD therapy instituted.

BROVANA, like other beta2-agonists, can produce a clinically significant cardiovascular effect in some COPD patients as measured by increases in pulse rate, blood pressure, and/or symptoms.

Twice-daily BROVANA® (arformoterol tartrate) may be the right fit

References:

1. Al-Showair RAM, Tarsin WY, Assi KH, Pearson SB, Chrystyn H. Can all patients with COPD use the correct inhalation flow with all inhalers and does training help? Respir Med. 2007;101(11):2395-2401. 2. Virchow JC, Crompton GK, Dal Negro R, et al. Importance of inhaler devices in the management of airway disease. Respir Med. 2008;102(1):10-19. 3. Prime D, Grant AC, Slater AL, Woodhouse RN. A critical comparison of the dose delivery characteristics of four alternative inhalation devices delivering salbutamol: pressurized metered dose inhaler, Diskusinhaler, Diskhalerinhaler. 4. BorgstroÅNm L, Bondesson E, MoreÅLn F, Trofast E, Newman SP. Lung deposition of budesonide inhaled via Turbuhaler(R): a comparison with terbutalinesulphate in normal subjects. EurRespir J. 1994;7(1):69-73. 5. Wieshammer S, Dreyhaupt J. Keystones of successful aerosol therapy. Respiration. 2009;78:357-358. 6. Jarvis S, Ind PW, Shiner RJ. Inhaled therapy in elderly COPD patients; time for re-evaluation? Age Ageing. 2007;36(2):213-218. 7. Janssens W, VandenBrande P, Hardeman E, et al. Inspiratory flow rates at diff erent levels of resistance in elderly COPD patients. EurRespir J. 2008;31(1):78-83. 8. Broeders ME, Molema J, Vermue NA, Folgering HTM. In Check Dial: accuracy for Diskus and Turbuhaler. Int J Pharm. 2003;252(1-2):275-280. 9. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2011). http://www.goldcopd.org. 10. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: evidence-based guidelines. Chest. 2005;127(1):335-371.