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Efficacy and safety of increasing doses of inhaled albuterol administered by metered dose inhalers in children with acute wheezing episodes

Abstract

Metered dose inhalers with spacers are devices capable of providing higher rates of lung deposition of drugs such as beta agonists when compared to conventional nebulizers, but there is no consensus about the optimal dose when this is the device of choice and there is evidence that younger children need proportionally higher doses of albuterol (in µg/kg) when compared to older children. Other factors that may interfere with response to albuterol treatment include the genetics of the beta adrenergic receptor (ADRB2) and infectious etiology of the wheezing attack. This study will assess the effectiveness of a dose regimen that prioritizes higher doses of albuterol, with doses in µg/kg higher for younger children. Security of this new dosing regimen will be assessed by monitoring clinical side effects and serum levels of albuterol, but we will also investigate the presence of 12 different respiratory viruses in these patients and evaluate the influence of ADRB2 receptor genetics in the response to albuterol. The primary outcome measure will be the need for hospitalization. Secondary outcomes will include a change in clinical score, respiratory rate and forced expiratory volume in the first second, the need for additional treatments and length of stay in the emergency room for those not hospitalized. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FÁBIO PEREIRA MUCHÃO; ANDRÉA VIEIRA DE SOUZA; JULIANA MIGUITA E SOUZA; LUIZ VICENTE RIBEIRO FERREIRA DA SILVA FILHO. Association between beta-2 adrenergic receptor variants and clinical outcomes in children and adolescents with acute asthma. Einstein (São Paulo), v. 20, . (10/14848-3)

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