Clinical pharmacology of salbutamol in infants and children

Abstract

Inhaled β2 agonists are the bronchodilator treatment of choice in asthma because they are the most effective bronchodilators. β2 agonists may cause bronchodilation by inhibiting the release of bronchoconstrictor neurotransmitters from airway nerves. Inhaled short-acting β2 agonists are the most widely used and effective bronchodilators for the treatment of asthma due to their functional antagonisms of bronchoconstriction. Salbutamol is a short-acting β-adrenergic agonist widely used by asthmatics for its bronchodilator activity. Salbutamol is a racemic mixture of active R-salbutamoland inactive S-salbutamol. In infants, salbutamol is administered by nebulizer solution at a dose of 2.5 mg trice-daily to treat chronic lung disease. In children, salbutamol may be administered intravenously, by inhalational, nebulisation, or orally and salbutamol dose varies with the child's age. The efficacy and safety of salbutamol have been extensively studied in infants and children and salbutamol is sulphatedin-vivo in patients and in-vitro in human lung, liver, and duodenum and the sulfation-rate remarkably varies among patients and among lung, liver, and duodenum specimens. The pharmacokinetics of salbutamol have been studied in infants and children and the elimination half-life of salbutamol is 2.2 hours in infants and about 6 years in children. The treatment of infants and children with salbutamol has been extensively studied and salbutamol poorly crosses the human placenta. The aim of this study is to review the salbutamol dosing, efficacy and safety, pharmacokinetics, and treatment in infants and children and salbutamol metabolism and transfer across the human placenta.