Document Detail


Estimation of the dose of fluticasone propionate inhaled by infants after bronchiolitis: Effect on urinary cortisol excretion.
MedLine Citation:
PMID:  12417880     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Information on the dose of steroid infants inhale from spacer devices and its potential effect on adrenal suppression is limited. OBJECTIVE: We sought to determine the total dose of fluticasone propionate (FP) inhaled from a spacer device (Babyhaler) with face mask attachment by infants recovering from acute bronchiolitis and the effect of inhaled FP on the infants' overnight urinary cortisol/creatinine ratios (UCCRs). METHODS: Infants studied were recovering from acute bronchiolitis. In study 1, 22 infants inhaled 150 microg of FP through the Babyhaler. The likely inhaled dose was estimated by trapping it on a filter held within the face mask. In study 2, 40 infants had UCCRs measured before and during 3 months of treatment with either FP (150 microg twice daily, n = 20) or placebo (n = 20). RESULTS: In study 1 the mean +/- SD dose of captured FP was 12.8 +/- 6.9 microg (ie, 2.1 +/- 1.2 microg/kg). In study 2 the pretreatment UCCR medians (interquartile ranges) were as follows: FP, 22.8 (23.0) nmol/mmol; placebo, 24.0 (28.3) nmol/mmol. Within-group UCCR changes (median and interquartile range DeltaUCCR) were significantly different in the FP group (-8.9 and -20.6 nmol/mmol at 6 weeks and -12.6 and -25.9 nmol/mmol at 12 weeks, respectively; P =.0008) but not in the placebo group ( -5.8 and -10.7 nmol/mmol at 6 weeks and +0.3 and -17.9 nmol/mmol at 12 weeks, respectively; P =.45). Intergroup changes were insignificant in the follow-up period (6 weeks, P =.52; 12 weeks, P =.19). CONCLUSION: After bronchiolitis, infants are likely to inhale approximately 8 % of the nominal steroid dose from the Babyhaler. UCCRs can be used to monitor the bioavailability of inhaled steroids in young infants.
Authors:
Jackson Wong; Tim Davies; Christopher O'Callaghan
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  110     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-05     Completed Date:  2002-12-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  721-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Child Health and Institute of Lung Health, University of Leicester, Clinical Sciences Building, Leicester Royal Infirmary, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Administration, Inhalation
Androstadienes / administration & dosage*,  pharmacokinetics*,  therapeutic use
Anti-Inflammatory Agents / administration & dosage*,  pharmacokinetics*,  therapeutic use
Bronchiolitis / drug therapy*,  urine
Creatinine / urine
Double-Blind Method
Humans
Hydrocortisone / urine*
Infant
Infant, Newborn
Metered Dose Inhalers
Time Factors
Chemical
Reg. No./Substance:
0/Androstadienes; 0/Anti-Inflammatory Agents; 50-23-7/Hydrocortisone; 60-27-5/Creatinine; 90566-53-3/fluticasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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