Paediatric pulmonary drug delivery: considerations in asthma treatment.
Aerosol therapy, the preferred route of administration for glucocorticosteroids and short-acting beta(2)-adrenergic agonists in the treatment of paediatric asthma, may be given via nebulisers, metered-dose inhalers and dry powder inhalers. For glucocorticosteroids, therapy with aerosolised medication results in higher concentrations of drug at the target organ with minimal systemic side effects compared with oral treatments. The dose of drug that reaches the airways in children with asthma is dependent on both the delivery device and patient-related factors. Factors that affect aerosol drug delivery are reviewed briefly. Advantages and disadvantages of each device and device-specific factors that influence patient preferences are examined. Although age-based device recommendations have been made, the optimal choice for drug delivery is the one that the patient or caregiver prefers to use, can use correctly and is most likely to use consistently.
Berger
William E
WE
Allergy and Asthma Associates of Southern California, Mission Viejo, CA 92691-6410, USA. weberger@uci.edu
D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000336:Aerosols; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000592:standards; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D036501:Metered Dose Inhalers / Q000592:standards; D009330:Nebulizers and Vaporizers / Q000592:standards; D010316:Particle Size; D010349:Patient Compliance; D011208:Powders; D017410:Practice Guidelines as Topic
D000318:Adrenergic beta-Agonists; D000336:Aerosols; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids; D011208:Powders