Drug delivery from the Turbuhaler and Nebuhaler pressurized metered dose inhaler to various age groups of children with asthma

A total of 198 children aged 3 to 15 years inhaled a single dose of 200 mu g budesonide from a Nebuhaler pressurized metered dose inhaler (pMDI) and a Turbuhaler dry powder inhaler in a randomized crossover study. The budeson ide dose delivered to a patient was assessed by measuring the amount of dru g deposited on a filter inserted between the inhaler outlet and the patient 's mouth. The dose of budesonide deposited on the filter and the estimated dose of particles with a mass median aerodynamic diameter (MMAD) of 5 mu m or less after inhalation from the Turbuhaler were both approximately twice the values inhaled from the pMDI Nebuhaler in children less than 5 years of age (P < 0.01). The variation in the dose delivered to the patient was sim ilar for the two inhalers in children over 5 years old. In 3- to 4-year-old children, dose delivery to the patient was higher and/or more consistent f rom the pMDI Nebuhaler than from the Turbuhaler. Filter dose after Turbuhal er treatment varied significantly from peak inspiratory Mow rate through th e Turbuhaler (PIFTbh) (P < 0.01). The percentage of children producing a PI FTbh greater than 50 L/min decreased with age (89%, 45%, and 14% in 5-, 4-, and 3-year-old children, respectively). It is concluded that drug delivery to a child with asthma varies with age and inhalation device. Further stud ies are needed to assess the clinical importance of this finding.