title: Deposition pattern of radiolabeled salbutamol inhaled from a metered-dose inhaler by means of a spacer with mask in young children with airway obstruction.
abstract: BACKGROUND
  The exact amount of drug deposited in the respiratory and gastrointestinal tract in children with airway obstruction, when delivered from a metered-dose inhaler (MDI) via a spacer with mask, and its distribution in children with airway obstruction, are unknown.
  
  
  METHODS
  We studied 15 children, using salbutamol labeled with technetium 99m. Each patient was imaged with a gamma-camera immediately after one puff of labeled salbutamol was administered via a spacer with mask. Drug deposition was then analyzed to measure the distribution of the labeled spray in the oropharynx, the lungs, the stomach, and the spacer with mask (Aerochamber) itself.
  
  
  RESULTS
  Fifteen infants and children (mean age, 21 months (range, 3 months to 5 years); mean weight, 9.3 kg (range, 3.2 to 15 kg)) were studied. Mean aerosol deposition was 1.97% +/- 1.4% in the lungs, 1.28% +/- 0.77% in the oropharynx, and 1.11% +/- 2.4% in the stomach. The remainder was trapped in the spacer. Lung imaging after inhalation from an MDI via a spacer showed widespread deposition of the drug in central and peripheral intrapulmonary airways. In two adult volunteers the deposition after one puff of the same radiolabeled drug, inhaled from an MDI via a spacer with a mouthpiece, was 19% in the lungs and 2% in the stomach.
  
  
  CONCLUSIONS
  Infants and toddlers with obstructive lung disease can be reliably and safely treated with inhaled medication administered with an MDI via a spacer with mask. The doses of a drug given from an MDI to infants and toddlers when a spacer with mask is used are not yet well defined but should be higher than the currently recommended doses, perhaps as much as an adult dose.
authors.affiliation: Department of Pediatrics, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Tal
authors.forename: H
authors.initials: H
authors.lastname: Golan
authors.forename: N
authors.initials: N
authors.lastname: Grauer
authors.forename: M
authors.initials: M
authors.lastname: Aviram
authors.forename: D
authors.initials: D
authors.lastname: Albin
authors.forename: M R
authors.initials: MR
authors.lastname: Quastel
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D002675:Child, Preschool; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D009330:Nebulizers and Vaporizers; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D013670:Sodium Pertechnetate Tc 99m; D000420:Albuterol