Delivery of inhaled medication in children
- Robert H Moore, MD
Robert H Moore, MD
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Gregory Redding, MD
Gregory Redding, MD
- Section Editor — Pediatric Pulmonology
- Professor of Pediatrics
- University of Washington School of Medicine
- Robert A Wood, MD
Robert A Wood, MD
- Editor-in-Chief — Allergy and Immunology
- Section Editor — Pediatric Allergy
- Professor of Pediatrics
- Johns Hopkins University School of Medicine
The delivery of aerosolized medication is an important component of treatment for many respiratory disorders and is a critical aspect of asthma management in children. Glucocorticoids, bronchodilators, antibiotics, and mucolytic agents can be administered via aerosol using a range of aerosol generating devices [1-4]. In addition, indications for aerosol therapy will broaden as novel macromolecular medications are delivered via the respiratory tract for the treatment of both pulmonary and systemic disorders [5,6]. (See "Delivery of inhaled medication in adults".)
The delivery of aerosolized medication to infants and children is complicated by anatomic and physiologic differences in their respiratory systems compared with adults [7-9]. Thus, a basic knowledge of the uses and limitations of aerosol delivery systems, the properties of effective aerosols, and the anatomic considerations affecting aerosol delivery in infants and children is essential to the optimal use of this therapeutic modality [10,11]. An overview of the delivery of inhaled medication in children will be presented here; specific aspects of medication delivery using nebulizers, pressurized metered dose inhalers (MDIs), and dry powder inhalers (DPIs) are discussed separately. (See "Use of medication nebulizers in children" and "The use of inhaler devices in children".)
ADVANTAGES OF AEROSOLIZED DRUG DELIVERY
There are several advantages to delivering drugs by aerosol rather than systemically:
●Delivery of agents directly to their sites of action decreases the dose required for therapeutic effect.
●Faster onset of action (compared with intravenous delivery) of bronchodilating medications allows more rapid reversal of acute bronchoconstriction.
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- ADVANTAGES OF AEROSOLIZED DRUG DELIVERY
- TYPES OF AEROSOL DELIVERY DEVICES
- LUNG DISEASES MANAGED USING AEROSOL THERAPY
- PROPERTIES OF AN IDEAL AEROSOL THERAPY DEVICE
- FACTORS AFFECTING DRUG DEPOSITION
- Properties of the device
- Aerosol properties
- Properties of medication to be delivered
- Disease state and ventilatory pattern
- Patient technique, acceptance, and preference
- SPECIAL CONSIDERATIONS IN INFANTS AND YOUNG CHILDREN
- Respiratory pattern
- INFORMATION FOR PATIENTS