Lung deposition of budesonide from Turbuhaler in asthmatic children

Wildhaber, Johannes H.; Devadason, SG; Wilson, Jon; Roller, Christina; Lagana, T.; Borgström, Lars; Lesouëf, Peter

doi:10.1007/s004310050990

Cited by 57 publications

(22 citation statements)

References 23 publications

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“…Although younger children (5-7 yrs) received significantly less drug than older children using this device and formulation, the lung dose was still higher than that found with other devices and formulations in this age group [14][15][16][17]. However, the combined oropharyngeal and gastrointestinal dose was higher than that found in older children, and the use of a spacer may still be indicated in this age group.…”

Section: Discussionmentioning

confidence: 64%

Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children

Devadason

Huang²,

Walker

et al. 2003

Eur Respir J

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QVAR TM , an extrafine hydrofluoroalkane/beclomethasone dipropionate formulation, has been shown to double lung deposition in adults. The aim of the present study was to assess the total body deposition and distribution of technetium99m-labelled ( 99m Tc) QVAR TM in children after inhalation via an Autohaler TM . Sixteen male asthmatic children (5-14 yrs) inhaled labelled drug (v4 MBq 99m Tc; 100 mg beclomethasone dipropionate) via an Autohaler within 30 min after salbutamol (200 mg) administration. Simultaneous anterior and posterior planar scintigraphic scans (120 s acquisition time) were collected after inhalation of labelled drug.Mean¡SD lung deposition of labelled drug (attenuation-corrected; percentage of ex-actuator dose) was 36.9¡9.2, 46.5¡11.6 and 54.1¡10.7% in children aged 5-7, 8-10 and 11-14 yrs, respectively. Combined oropharyngeal and gastrointestinal deposition was 59.7¡8.2, 48.9¡12.3 and 40.3¡11.8%. Lung deposition positively correlated with the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Gastrointestinal dose negatively correlated with the FEV1, FVC, height and age.In older children (11-14 yrs), lung deposition was almost identical to that reported in adults using QVAR TM . In children aged 5-10 yrs, lung deposition using QVAR TM was greater than the levels measured using other commercial aerosol delivery systems. Oropharygeal and gastrointestinal deposition was inversely related to age.

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Section: Discussionmentioning

confidence: 64%

Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children

Devadason

Huang²,

Walker

et al. 2003

Eur Respir J

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“…This would indicate that there is more peripheral deposition of the extrafine formulation with the breath-hold technique for this age group. The mean P:C ratio (range) in a previous deposition study with children aged 6-16 yrs inhaling radiolabelled budesonide from Turbuhaler (AstraZeneca, Lund, Sweden) was 1.7 (1.0-2.4) [28]. Children aged 5-7 yrs have a lower tidal volume and a lower inspiratory flow rate than children aged 8-17 yrs, although these parameters were not recorded.…”

Section: Discussionmentioning

confidence: 99%

Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children

Roller¹,

Zhang²,

Troedson³

et al. 2006

European Respiratory Journal

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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 TM ) 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 c-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 (n54), 8-10 (n54) and 11-17 yrs (n54), 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.

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“…Typically lung deposition from the same pMDIspacer combination could be 1-2% in infants, 4-6% in children aged 2-6 years and 12% in a 10-year old child. [17][18][19][20][21] This is also one of the reasons why young children often need almost the same inhaled dose as older children to obtain the desired clinical effect.…”

Section: Aerosol Deposition Patterns In Childrenmentioning

confidence: 99%

The ADMIT series — Issues in Inhalation Therapy. 5) Inhaler selection in children with asthma

Pedersen

Dubus

Crompton³

2010

Primary Care Respiratory Journal

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Lung deposition of budesonide from Turbuhaler in asthmatic children

Abstract: Total lung deposition of radiolabelled budesonide from a dry powder inhaler (Turbuhaler), is age dependent in children with moderate asthma. However, lung deposition is still satisfactory, even in younger children with lower peak inspiratory flows.

Cited by 57 publications

References 23 publications

Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children

Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children

Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children

The ADMIT series — Issues in Inhalation Therapy. 5) Inhaler selection in children with asthma

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Lung deposition of budesonide from Turbuhaler in asthmatic children

Abstract: Total lung deposition of radiolabelled budesonide from a dry powder inhaler (Turbuhaler), is age dependent in children with moderate asthma. However, lung deposition is still satisfactory, even in younger children with lower peak inspiratory flows.

Cited by 57 publications

References 23 publications

Distribution of technetium-99m-labelled QVARTMdelivered using an AutohalerTMdevice in children

Distribution of technetium-99m-labelled QVARTMdelivered using an AutohalerTMdevice in children

Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children

The ADMIT series — Issues in Inhalation Therapy. 5) Inhaler selection in children with asthma

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Product

Resources

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Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children

Distribution of technetium-99m-labelled QVAR^TMdelivered using an Autohaler^TMdevice in children