Chloride deficiency syndrome due to chloride-deficient breast milk.

This study demonstrates a highly significant improvement in peak flow rate when terbutaline is given in a higher dose adjusted for weight than that used in adults. Peak plasma levels within a range known to be non-toxic in adults4 were reached 2 hours after the dose and only one patient complained of slight headache during this part of the study. The lower dose also improved PEFR but not significantly. This is contrary to the findings of Leegaard and Fjulsrud5 who used this dosage in a larger number of children. The failure to show significance in the present study may be related to the few children taking part and the fact that they were studied within 24 hours of stopping intravenous therapy for severe wheeze. Further studies are required to assess the optimum absorption of the drug in such conditions. Maximum bronchodilatation as measured by PEFR did not correspond directly to maximal plasma levels; this is not surprising since the response in the lung will relate more directly to the amount of free drug present locally and the state of reactivity of the 3 receptors, in addition to other mucosal factors within the airways. This study demonstrates that it is safe and effective to give children terbutaline in a dose of 0.25 mg/kg (maximum 5 mg) in asthma.