Year: 2008
Type: article
Abstract: A large number of inhalation devices are used for delivery of asthma medication in children, and it is well known that the delivery device plays an essential role in lung dose of drug [1]. Therefore, there is a need for valid methods to estimate lung dose from different delivery devices to ensure evidence-based drug prescription in children. Rec-ommendations cannot be based on surrogatemeasures of lung dose such as the fine particle mass, since these may not be valid measures of lung dose in vivo. In adults it has been shown that early bioavailability of inhaled salbutamol can be used as an index of lung dose [2]. This is based on the fact that oropharyngeal and gas-trointestinal absorption of salbutamol is negligible in the first 20 min after inhalation,and early systemic levels there-fore reflect absorption from the lungs only [3]. However, the same may not be true for children, who often have faster absorption rates of drugs compared with adults [4]. We therefore performed a study to validate the 20-min pharmacokinetic profile as a measure of lung dose in chil-dren. The significance of oropharyngeal and early gas-trointestinal absorption was investigated by actuating the pressurized metered-dose inhaler (pMDI) directly into the mouth after maximal inspiration to ensure oropharyngeal deposition only. The resultant serum profile after oropha-ryngeal deposition was then compared with the profile after inhalation measured in a previous study [5]. The two studies were similar regarding inclusion criteria, inhaled dose, study drug, delivery device, method of drug analysis and laboratory. The serum profiles between studies could therefore be compared. Children aged 4–6 or 11–16 years,with a history of mild to moderate asthma in stable phase, were invited to par-ticipate in this study, which was approved by the Danish
Institution: Gentofte Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1982233448