Summary

After a brief explanation of the factors governing deposition of aerosol particles in the lung, the common methods of administration of inhalation aerosols have been described. The drugs most frequently delivered by this route are bronchodilators. Correct administration and the use of inhaler accessories, such as spacer devices, enhance the efficacy of inhaled drugs. It is essential that the patient be instructed in the correct use of the devices to optimize the therapeutic effect.

The discussion of products has deliberately been restricted to those that have been commercialized. There are several reasons for doing this. Firstly, this is consistent with the title of the chapter. Secondly, the author does not have to immerse himself in the plethora of information on technologies under development. Lastly, the reader has not been introduced to technologies that may be short-lived and ultimately irrelevant to progress in the field. Indeed, the benefit of having a decade between this edition and the last is that some technologies that were emerging in the early 1990s have since faded and the reader has no reason to be concerned about them.

The introduction of new drugs (salmeterol, fluticasone, budesonide, formoterol, for example) has caused a number of new aerosol systems to be introduced in each of the categories of propellant-driven metered-dose inhalers, dry powder inhalers, and nebulizers. Since existing nebulizers can be employed to deliver new drugs and metered-dose inhaler technology improvements are not apparent to the observer (changes in gasket materials, can coatings, etc.), the most prominent changes would seem to be evident in the emergence of new dry powder inhaler systems, mostly developed on a drug-specific basis. While a surprisingly small number of new products have been commercialized recently, the research since the early 1990s will give rise to a variety of new products hitherto not seen by patients and healthcare professionals.

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