Nasal peak inspiratory flow through Turbuhaler (R) in children with symptomatic rhinitis and in healthy children

Topical treatment of allergic or vasomotor rhinitis is possible by means of pressurized metered dose inhalers, aqueous spray, or dry powder inhalers. In children, little is known about nasal drug delivery by dry powder inhala tion. The airflow through the device is critical for the drug release and a sufficient nasal inspiratory flow is needed for intranasal drug delivery f rom a dry powder inhaler. In order to investigate from what age children wi th allergic or vasomotor rhinitis can reliably use such a device, device-de pendent nasal peak inspiratory flow (DnPIF) was measured. The maximal DnPIF was measured in children aged 4-13 years making use of a dry powder inhale r (Turbuhaler(R)) connected to a spirometer (Vitalograph(R)). In the clinic ally relevant context, instructions from the doctor and one week's use of a Turbuhaler at home were found to be sufficient to obtain a good inhalation technique and were shown to improve DnPIF at least as effectively as visua l feedback training at the clinic. Children with rhinitis, as well as healt hy children from the age of 6 years, were able to generate a DnPIF sufficie nt to obtain a reliable nasal delivery of a dry powder drug dose. DnPIF val ues correlated with age. Consequently, a recommendation to use a nasal Turb uhaler from the age of 6 for topical drug delivery in the treatment of alle rgic or vasomotor rhinitis seems reasonable.