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How much aerosol reaches the lungs of wheezy infants and toddlers?
B Salmon1, N M Wilson, M Silverman
1Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Insights
This study found that only a small fraction of aerosolized sodium cromoglycate reaches the lungs in infants and adults. Nasal filtration significantly reduces lung deposition, impacting drug delivery effectiveness.
Area of Science:
- Pharmacology
- Pediatrics
- Respiratory Medicine
Background:
- Accurate assessment of aerosol delivery to the lungs is crucial for effective respiratory therapy.
- Sodium cromoglycate is a non-toxic marker used to evaluate drug deposition.
- Wheezy infants and healthy adults represent key populations for aerosol delivery studies.
Purpose of the Study:
- To quantify lung deposition of aerosolized sodium cromoglycate in wheezy infants and healthy adults.
- To investigate the impact of delivery devices and breathing patterns on aerosol deposition.
- To identify factors influencing the efficacy of inhaled medications.
Main Methods:
- Utilized sodium cromoglycate as a non-toxic marker for aerosol delivery assessment.
- Administered medication via metered dose inhaler with a spacer and nebulizer to infants and adults.
- Measured urinary sodium cromoglycate concentrations to estimate lung absorption and deposition.
Main Results:
- Detected only 0.13% to 0.61% of the nominal dose in urine, indicating 0.3% to 1.5% lung deposition.
- Nasal breathing significantly reduced the amount of aerosol reaching the lungs.
- Variability in deposition was observed between delivery methods and participant groups.
Conclusions:
- Lung deposition of inhaled aerosols is generally low in both infants and adults.
- Nasal filtration plays a critical role in limiting aerosol deposition in the lungs.
- Optimizing inhaler technique and device selection is essential for improving therapeutic outcomes in respiratory conditions.
Abstract:
Using sodium cromoglycate as a non-toxic marker, we assessed the delivery of aerosol to nine wheezy infants and seven healthy adults. The drug was delivered to the infants by face mask and spacer device from a metered dose inhaler, and by face mask and nebuliser to the infants and the adults who breathed though their noses. The concentration of sodium cromoglycate was estimated in timed urine collections to find out how much of the dose was absorbed from the lung. Only 0.13% to 0.61% of the 20 mg nominal dose was detected in the urine, representing an estimated 0.3% to 1.5% deposited in the lung. Nasal filtration of aerosol could be a critical factor in reducing lung deposition.