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Do smaller children need smaller doses of ß-agonist inhalers?


To Ed Snelson and Vinci Ho, there is one aspect which is not mentioned, and needs a slight caution: Giving all those extra doses to a child to achieve sufficient in the airways, has a side effect of delivering a whopping over-excess to the oropharynx of the child, yes, far greater per kg than in adults. However, child tolerate this extreme Beta-agonist excess extremely well, compared to adults, and here is the caution: In encouraging the child to take 10 or 20 puffs (which gives hardly any side effects other than possibly a little insomnia), DO NOT have the adult demonstrate by themselves taking anything like this amount, as it is likely, especially in a non-asthmatic adult, to cause considerable adrenergic side effects (tremor, intense fear) despite being, per kg, and very much smaller dose! PS did you notice the same is true for opioids - the child BNF dose per kg for a 12 year old works out at MUCH more than you would think of giving to a 30-yr old even at twice the body weight! And whilst this seems to have very little sedative effect on a 2-12 yr old, the equivalent dose in an older adult can result in a panicky hunt for the Naloxone supplies..... Aren't children wonderful.

Posted date

07 Mar 2018

Posted time