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Published on: December 17, 2017
Age dependent systemic exposure to inhaled salbutamol
Klaus Bønnelykke1, Jakob Jessing Jespersen, Hans Bisgaard
1Danish Pediatric Asthma Center; Copenhagen University Hospital, Gentofte, Copenhagen, Denmark. kb@copsac.dk
Dosing of inhaled salbutamol (albuterol) in children requires age-specific adjustments for optimal systemic exposure. A fixed microgram per kilogram dose may lead to suboptimal or excessive exposure in younger children.
Area of Science:
- Pediatric Pharmacology
- Respiratory Medicine
- Pharmacokinetics
Background:
- Inhaled salbutamol is a common bronchodilator for pediatric asthma.
- Systemic exposure to inhaled medications can vary significantly with age.
- Optimal dosing strategies are crucial for effective and safe treatment in children.
Purpose of the Study:
- To evaluate the impact of age on the systemic exposure of inhaled salbutamol in pediatric patients.
- To compare different dosing strategies (age-adjusted vs. fixed dose) regarding systemic exposure.
Main Methods:
- Fifty-eight children with asthma (aged 3-16 years) received 400 microg of salbutamol via a metered-dose inhaler with a spacer.
- Serum concentrations were analyzed over a 20-minute period to determine pharmacokinetic profiles.
- Data were analyzed to compare systemic exposure based on age-adjusted and fixed nominal doses.
Main Results:
- Dosing based on a microgram per kilogram (microg kg(-1)) basis resulted in lower systemic exposure in younger children compared to older children (Cmax ratio 0.55).
- A fixed nominal dose, irrespective of weight or age, led to higher systemic exposure in younger children (Cmax ratio 1.7).
Conclusions:
- Age or size-based adjustments are necessary for achieving consistent systemic exposure to inhaled salbutamol in children.
- A fixed microg kg(-1) dosing approach may result in suboptimal or excessive systemic exposure, particularly in younger children.
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