title: Aerosols for systemic treatment.
abstract: The development of a new group of drugs (polypeptides) have recently increased the interest of alternative administration to the enteral route because of its proteolytic activity and the catabolism of the "first-pass effect." Aside from the "needle," the administration in the respiratory tract via aerosol is the method with the best efficiency. But several problems prohibited its spreading: (1) the accuracy and the reproducibility of the inhaled dose (range ca. 1:4); (2) the small amount of inhaled drug in relation to the dose in the aerosol delivery system (range ca. 1%-10%); (3) the fear of allergic reactions of the respiratory system; (4) the variability of the drug transport into the systemic circulation. New approaches and data raise hopes in reducing the problems: (1) aerosol delivery systems with defined particle spectrum and storage systems; slow vital capacity inhaling maneuver; (2) delivery systems that nebulizes nearly the total amount of drug; (3) all studies with the inhalation application of insulin, heparin, ergotamin, ribavirin, aminoglycosides, and "cigarette smoke" do not reveal any relevant allergic reaction; (4) many studies were performed in the last 10 years on the influence of substances and especially of diseases on the transport of molecules through the respiratory tract. Only a few of them are relevant (exogen allergic alveolitis, active sarcoidosis, active smoking). Aerosols for (exogen allergic alveolitis, active sarcoidosis, active smoking). Aerosols for systemic drug treatment seems to be a gained alternative to the "syringe."
authors.affiliation: Fachkrankenhaus Kloster Grafschaft, Schmallenberg, Federal Republic of Germany.
authors.forename: D
authors.initials: D
authors.lastname: Köhler
mesh_terms: D000336:Aerosols / Q000008:administration & dosage*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008171:Lung Diseases / Q000188:drug therapy; D009330:Nebulizers and Vaporizers; D010455:Peptides / Q000008:administration & dosage; D011453:Prostaglandins / Q000008:administration & dosage
chemical_list: D000336:Aerosols; D007328:Insulin; D010455:Peptides; D011453:Prostaglandins; D006493:Heparin