Budesonide has a systemic clearance of approximately L/min in 4-6 years old asthmatic children. Per kg body weight children have a clearance which is approximately 50% greater than in adults. The terminal half-life of budesonide after inhalation is approximately hours in asthmatic children. This is about the same as in healthy adults. In 4-6 years old asthmatic children, the systemic availability of budesonide following administration of Budesonide Nebuliser Suspension via a jet nebuliser (Pari LC Jet Plus® with Pari Master® compressor) is approximately 6% of the nominal dose and 26% of the dose delivered to the patients. The systemic availability in children is about half of that in healthy adults. The maximal plasma concentration, occurring approximately 20 min after start of nebulisation is approximately nmol/L in 4-6 years old asthmatic children after a 1 mg dose. The exposure (Cmax and AUC) of budesonide following administration of a single 1 mg dose by nebulisation to 4-6 year old children is comparable to that in healthy adults given the same delivered dose by the same nebuliser system.
I like Apoquel. The benefits of Apoquel include: rapid onset of action, low likelihood of GI side effects, rare side effects with long term use, no withdrawal needed for skin testing, and decent price. The downsides include: increased infections, monitoring needed for bone marrow suppression, does not work for many pets, and we do not have long term data. It is a wonderful option for those dogs who do not tolerate steroids or cyclosporine. Allergy testing and shots remains the only effective management of allergies that does not involve immune suppression.
Anyone taking oral steroids or a high dose of inhaled steroids for more than three weeks should be given a steroid treatment card . Small enough to keep in your purse or wallet, this card has room to record the details of your dose and your condition(s). This is so that if you ever need any medical treatment and you're not able to communicate (you're having an asthma attack, for example), the people treating you know you're taking prednisolone and can plan your treatment accordingly. If you are taking oral steroids, or high-dose inhaled steroids, for more than three weeks then you should never suddenly stop them.