Abstract
Drug delivery by inhalation is the principal strategy to treat obstructive lung diseases, which affect about 15% of the population in the United States. Aerosol delivery devices have evolved over more than 60 years from the basic pressurized metered-dose inhaler and nebulizer to numerous types of inhalers and devices, including valved holder chambers, dry powder inhalers, soft mist inhalers, as well as smart inhalers and nebulizers. Although these devices improve a patient's ability to self-administer medication, many problems with optimal delivery still exist. Appropriate selection and repeated patient education can help lessen the problems with these devices. Aerosol science is evolving, with methods of measurement that include radio-scintigraphy and magnetic resonance imaging, to provide a better understanding of aerosol delivery and effects. Understanding the science and clinical application of aerosol drug delivery can substantially aid clinicians in optimizing these therapies for their patients.
- inhalational therapies
- COPD
- asthma
- dry powder inhalers
- metered-dose inhalers
- nebulization
- patient education
- smart inhalers
- lung deposition
Footnotes
- Correspondence: Dean R Hess PhD RRT FAARC, Respiratory Care, Massachusetts General Hospital, Boston, MA 02114. E-mail: dhess{at}mgh.harvard.edu.
Dr Pleasants discloses relationships with Astra Zeneca, Boehringer Ingelheim, GlaxoSmithKline, Sunovion, and Teva. Dr Hess discloses relationships with Philips Respironics, Ventec Life Systems, McGraw-Hill, Jones and Bartlett, UpToDate, Daedalus Enterprises, and the American Board of Internal Medicine.
Dr Pleasants presented a version of this paper at the 56th Respiratory Care Journal Conference, Respiratory Medications for COPD and Adult Asthma: Pharmacologic Actions to Clinical Applications, held June 22–23, 2017, in St Petersburg, Florida.
↵* Michael T Newhouse MD, invited discussant. Dr Newhouse is the chief medical officer for InspiRx.
↵† Dean R Hess PhD RRT FAARC, discussant. Dr Hess is Managing Editor of Respiratory Care.
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