title: Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children.
abstract: The aim of the present study was to measure airway, oropharyngeal and gastrointestinal deposition of (99m)Tc-labelled hydrofluoroalkane-beclomethasone dipropionate after inhalation via a pressurised metered-dose inhaler and spacer (Aerochamber Plus) in asthmatic children. A group of 24 children (aged 5-17 yrs) with mild asthma inhaled the labelled drug. A total of 12 children took five tidal breaths after each actuation (tidal group). The other 12 children used a slow maximal inhalation followed by a 5 - 10-s breath-hold (breath-hold group). Simultaneous anterior and posterior planar gamma-scintigraphic scans (120-s acquisition) were recorded. For the tidal group, mean+/-sd lung deposition (% ex-actuator, attenuation corrected) was 35.4+/-18.3, 47.5+/-13.0 and 54.9+/-11.2 in patients aged 5-7 (n = 4), 8-10 (n = 4) and 11-17 yrs (n = 4), respectively. Oropharyngeal and gastrointestinal deposition was 24.0+/-10.5, 10.3+/-4.4 and 10.1+/-6.2. With the breath-hold technique, lung deposition was 58.1+/-6.7, 56.6+/-5.2 and 58.4+/-9.2. Oropharyngeal and gastrointestinal deposition was 12.9+/-3.2, 20.1+/-9.5 and 20.8+/-8.8. Inhalation of the extrafine formulation with the breath-hold technique showed significantly improved lung deposition compared with tidal breathing across all ages. Oropharyngeal and gastrointestinal deposition was markedly decreased, regardless of which inhalation technique was applied, compared with a previous paediatric study using the same formulation delivered via a breath-actuated metered-dose inhaler.
authors.affiliation: UWA School of Paediatrics and Child Health, Princess Margaret Hospital for Children, GPO D184 Perth, Western Australia 6840, Australia. croller@meddent.uwa.edu.au
authors.forename: C M
authors.initials: CM
authors.lastname: Roller
authors.forename: G
authors.initials: G
authors.lastname: Zhang
authors.forename: R G
authors.initials: RG
authors.lastname: Troedson
authors.forename: C L
authors.initials: CL
authors.lastname: Leach
authors.forename: P N
authors.initials: PN
authors.lastname: Le Souëf
authors.forename: S G
authors.initials: SG
authors.lastname: Devadason
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000336:Aerosols; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000032:analysis / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D005260:Female; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D036501:Metered Dose Inhalers; D009960:Oropharynx / Q000000981:diagnostic imaging / Q000378:metabolism; D011877:Radionuclide Imaging; D014018:Tissue Distribution
chemical_list: D000336:Aerosols; D018927:Anti-Asthmatic Agents; D001507:Beclomethasone