Chapter 11 - Aerosol Therapy in Infants and Children
Chapter 11.1 Indications for Aerosol Therapy in Children
byAndré Schultz, PhD, and Peter Le Souëf, MD
Indications for aerosol therapy in children are increasing with robust evidence of benefit and
low risk of side effects in an increasing range of conditions. Inhaled treatments offer targeted treatment to the airways with reduced risk of systemic side effects. The ability to deliver high drug concentrations to the airways can be useful in specific situations. Numerous inhaled therapies have been well studied in children, but many inhaled treatments are still used in pediatrics based on research findings from studies performed on adults.
This chapter focuses on evidence for aerosol therapy from pediatric studies. Specific mention is made when data from adult studies are cited. Diseases where aerosolized therapies have been well studied will be discussed, followed by conditions where inhaled drugs are used off-label, and novel applications for aerosolized drugs.
Chapter 11.2 Special Considerations
by Sunalene Devadason, PhD and Mark L. Everard, MB, ChB, DM
Delivering drugs to infants and children can be a significant challenge. The devices currently available have been developed primarily for adults and have been modified or adapted for young children. As with patients of all age groups, drugs can have adverse side effects as well as therapeutic effects, and it is important to select devices and accessories that will maximize delivery to the lungs while minimizing extra-pulmonary deposition. Numerous factors influence pulmonary drug delivery such as characteristics of the aerosol delivery system, use of the device by the patient, variations in airways geometry, and disease of the upper and lower airways. In cooperative subjects, data suggests the within-subject coefficient of variation is similar to
that seen in adults. Many of those dealing with patients are generally aware of the challenges
of optimizing drug delivery at the ...
