AEROSOL AEROSOL INTAKE IN THE AIRWAYS

INHALATION THERAPY HISTORY

PNEUMATIC NEBULIZERS

ULTRASONIC NEBULIZERS

PULMONARY DISEASES ASTHMA

BPCO

OTHERS

DELIVERY SYSTEMS METERED INHALERS

Inhalation TherapyThe inhalation therapy has the advantage of delivering the drug directly to the target, thus

bypassing the blood stream. It allows both a quicker action and a decreased risk of side effects.

HistoryAerosol intake in the airways

Drugs administered by inhalation

• ß2 agonists• Muscarinic blockers• Cromones• Topical steroids• Mucolytic drugs• Other drugs

Devices

• Electrical inhalers• Pressurized Metered Dose Inhalers (pMDIs)• pMDIs with expansion chambers• Dry Powder Inhalers (DPIs)

Most side effects arerelated to the systemicabsorption.

Serum

Pneumaticnebulizer

Ultrasonicnebulizer

Inhalers

Swallowed fraction

>80%

Hepaticinactivation

Urine

Drugs and Delivery Systems

Aerosol

Ultrasonicnebulizers

Pneumaticnebulizers

DeliverySystems

Drugs andDelivery Systems

© Editoriale Fernando Folini

Aerosols in pneumology have not only a therapeutical function but also a diagnostic one. The main diagnostic and therapeutic uses are:

@&D’Amato G. Glucocorticoidi inalatori nella

terapia dell’asma bronchiale. MomentoMedico. 1997.

Earis JE, Pearson MG. Illustrated CaseHistories. Pneumologia. Mosby Italia.1997.

Kohler D, Fleisher W. Established facts ininhalation therapy. Arcis Verlag, Munchen.1991.

Reggiani C, Polla B, Caramori G, Conson-ni D. Delivery Systems e Protocollo diMontreal. Editoriale Fernando Folini.1997.

Terzano C, Mannino F. Aerosol. Caratteristi-che, analisi, applicazioni terapeutiche.McGraw-Hill.1997.

Todisco T, Dottorini M. Gli aerosoli in terapiainalatoria ed in patologia ambientale.Biofisica, tecnologia per le applicazioni,diagnostica e terapia. Piccin.1996.

Vaghi A. Aerosol terapia nelle patologiedell’apparato respiratorio. Consigli pratici.Syntagma Edizioni. 1995.

DiagnosisVentilatory lung scintigraphyMucociliary clearanceSpecific and non specific bronchostimulation testsSputum inductionBronchial epithelium permeabilityCough threshold

TherapyBronchial obstruction treatmentPreventive and therapeutic treatment of acute and cronic bronchial infectionsMucolytic treatment

Lung absorption is greater at alveo-lar epithelium level rather than atbronchial level. It has been demon-strated that the highest serum levelsof steroids, ß2 agonists and sodiumcromoglycate are detectable ca. onehour after inhaling the drug. Thedelivery of the drug from the epi-thelium to the blood stream dependson the type of molecule used, on itshydroliposolubility and on the pK.Smokers, people exposed to envi-ronmental pollutants and patientssuffering from diseases such assarcoidosis, Adult Respiratory Di-stress Syndrome (ARDS), and infec-tions associated with Pneumocystiscarinii (Kohler, 1990) show increasedlevels of steroids, ß2 agonists andsodium cromoglycate.