title: [Therapeutic approach to the distal airways in asthma].
abstract: Bronchial asthma is a chronic inflammatory disease that affects both the large-caliber airways and the smaller-caliber bronchioles. In the last few years, a major therapeutic advance has been made with the development of new systems of inhalation solutions, which produce extra-fine particles, achieving better lung deposition throughout the airways and reducing oropharyngeal deposition. These formulations have improved the effectiveness of bronchodilation and particularly the antiinflammatory effect. The use of long-acting b2-adrenergic steroids in extra-fine formulation, whether alone or in combinations of fixed doses, improves drug distribution throughout the bronchial tree, enhancing the therapeutic effect with lower doses of drugs. Leukotriene receptor antagonists have shown their effect on the small airways in asthmatic patients, both in studies of pulmonary resistance and pulmonary volumes and in imaging studies.
authors.affiliation: Servicio de Neumología, Hospital Universitario La Fe, Valencia, España. dediego_alf@gva.es
authors.forename: Alfredo
authors.initials: A
authors.lastname: de Diego Damiá
authors.forename: José María
authors.initials: JM
authors.lastname: Vega Chicote
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000402:Airway Obstruction / Q000188:drug therapy / Q000209:etiology; D056151:Airway Remodeling / Q000187:drug effects* / Q000502:physiology; D000403:Airway Resistance / Q000187:drug effects; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D001980:Bronchi / Q000187:drug effects / Q000473:pathology*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy / Q000209:etiology; D055745:Bronchioles / Q000187:drug effects / Q000473:pathology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D004867:Equipment Design; D006801:Humans; D007249:Inflammation; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D011650:Pulmonary Alveoli / Q000187:drug effects / Q000473:pathology; D014018:Tissue Distribution
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D020024:Leukotriene Antagonists