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Protective effect of inhaled salbutamol powder in children assessed by histamine challenge
Insights
Inhaled salbutamol powder offers dose-dependent protection against asthma triggers in children. Higher doses, like 800 micrograms, provide longer-lasting protection, suggesting current regimens may be insufficient.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Clinical Trials
Background:
- Asthma is a common chronic respiratory disease in children.
- Inhaled bronchodilators like salbutamol are mainstays of asthma management.
- Optimal dosing strategies for inhaled salbutamol powder in pediatric populations require further investigation.
Purpose of the Study:
- To evaluate the dose-response and duration of protective effect of inhaled salbutamol powder in children with asthma.
- To compare the efficacy of different inhaled salbutamol powder doses against histamine challenge.
- To assess the adequacy of current salbutamol powder dosing regimens in pediatric asthma.
Main Methods:
- A double-blind, placebo-controlled trial involving 12 children with asthma.
- Administration of inhaled salbutamol powder at doses of 100, 400, and 800 micrograms.
- Assessment of airway protection using histamine challenge at 10 minutes, 2 hours, and 4 hours post-inhalation.
Main Results:
- All tested doses of inhaled salbutamol powder provided protection at 10 minutes.
- Significant protection persisted up to 4 hours only with the 800-microgram dose (p < 0.01).
- A clear dose-related effect was observed, with higher doses increasing both the magnitude and duration of action.
Conclusions:
- Inhaled salbutamol powder exhibits a dose-dependent effect on airway protection in children with asthma.
- To ensure continuous protection, inhaled salbutamol powder may need to be administered every four hours.
- Current recommended dosing regimens for pediatric salbutamol powder appear submaximal and may require upward adjustment.
Abstract:
A double-blind placebo-controlled trial of 100, 400, and 800 micrograms inhaled salbutamol powder was conducted on 12 children. The protective effect at 10 minutes, two hours, and four hours was assessed by histamine challenge. At 10 minutes there was good protection with all doses, but by four hours there was significant protection only with 800 micrograms (p less than 0.01). Salbutamol powder may need to be taken at least every four hours for complete protection. There was a dose-related effect with a single dose of up to 800 micrograms; increasing the dose increased the effect and duration of action. Currently advertised dose regimens of salbutamol powder for children (200 micrograms three or four times a day) are apparently submaximal. Histamine challenge is a satisfactory method of assessing the proective effect of a drug in asthmatic children.