title: High-percentage lung delivery in children from detergent-treated spacers.
abstract: Pressurized metered-dose inhalers attached to spacers are now the most common form of delivery of anti-asthma medication in children. However, no reliable data are available of how much drug reaches the lungs in children of different ages. This information is crucial, as it determines the efficacy of therapy. In this study, we present information on the amount of drug reaching the lungs in children from a pressurized metered-dose inhaler attached to a detergent-coated spacer. We studied 18 asthmatic children inhaling radiolabeled salbutamol through detergent treated spacers to minimize electrostatic charge on the spacer wall. Lung deposition was much higher than expected when using detergent-coated spacers. Mean (SD) lung deposition, expressed as a percentage of the total actuated dose (five actuations), was 16.4% (5.5) in younger children inhaling through a small volume spacer, and 28.2% (6.7) and 41.8% (3. 8) in older children inhaling with different breathing patterns through a large volume spacer. These findings have major implications for dosage regimens for inhaled anti-asthma medication in children. Lower doses may be sufficient for adequate drugs delivered through spacers treated for static to achieve a desired clinical response.
authors.affiliation: Perth Medical Aerosol Research Group, Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Western Australia, Australia. johannes.wildhaber@kispi.unizh.ch
authors.forename: J H
authors.initials: JH
authors.lastname: Wildhaber
authors.forename: H M
authors.initials: HM
authors.lastname: Janssens
authors.forename: F
authors.initials: F
authors.lastname: Piérart
authors.forename: N D
authors.initials: ND
authors.lastname: Dore
authors.forename: S G
authors.initials: SG
authors.lastname: Devadason
authors.forename: P N
authors.initials: PN
authors.lastname: LeSouëf
mesh_terms: D000280:Administration, Inhalation; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D003902:Detergents; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000187:drug effects; D008297:Male; D009330:Nebulizers and Vaporizers; D012016:Reference Values
chemical_list: D001993:Bronchodilator Agents; D003902:Detergents