Abstract

This chapter offers an introduction to the pharmacology of the lung. Section 2.1 primes readers by detailing the respiratory tract structure and function in order to integrate the location of target drug receptors within the different zones of the lung. Section 2.2 delivers an overview of common respiratory illnesses that require aerosol drug delivery, including asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. Section 2.3 reviews mechanisms of inhalational drug delivery, discussing the significance of particle size and deposition. This section further assesses the advantages and limitations of various inhaler devices, including the pressurized metered-dose inhaler, dry powder inhaler, soft mist inhaler, and three categories of nebulizers. In order to optimize drug delivery and the therapeutic effects of the administered drug, the section highlights the significance of proper provider and patient education. Section 2.4 highlights the classes of drugs commonly used in the management of airway diseases, including β2 adrenergic agonists, muscarinic receptor antagonists (anticholinergics), and corticosteroids. Incorporated are the pathological indications for each therapy. To gain an understanding of the common side effects associated with each drug category, the section covers drug target receptor type, and receptor location (localized and systemic). Section 2.5 highlights oral therapies commonly specified for pulmonary diseases, including an overview of mucolytics/expectorants, phosphodiesterase (PDE) inhibitors, macrolides, and leukotriene modifiers. Section 2.6 dives deeper into the goals of the recommended pharmacological therapies for the two most prevalent obstructive pulmonary diseases, asthma, and COPD. Lastly, Section 2.6 touches on the emerging practice of utilizing the lungs as a method for systemic drug delivery through inhaled medications.