In the clinical practice we focus on the effect, not on the mechanics of action.

As mechanism of action might not be well known in many indications. And it’s not wise to search for the understanding of mechanisms while you have a patient to treat. So, you should focus on searching for the best evidence to give the most appropriate dosing regimen.

And theoretically, change in frequency will affect the accumulation of the dose in the body, keeping it’s level higher or lower according to increasing or decreasing the frequency.

Usually half life is a factor, of many, that can be used to predict the appropriate dose and frequency, however, the final say is according to the clinical evidence, starting from the smallest clinical studies to the clinical guidelines.

For the dosing in asthma it will be as follows:

Asthma exacerbation: Limited data available: Infants, Children, and Adolescents: Oral, IM, IV: 0.6 mg/kg once daily as a single dose or once daily for 2 days; maximum dose: 16 mg/dose (AAP [Shenoi 2020]; GINA 2020; Keeney 2014; Qureshi 2001); single dose regimens as low as 0.3 mg/kg/dose and as high as 1.7 mg/kg/dose have also been reported (Keeney 2014; Qureshi 2001; Shefrin 2009). Note: Duration >2 days is not recommended due to increased risk of metabolic effects (GINA 2020).