Pulmonary drug delivery

Illustration of the respiratory system

Pulmonary drug delivery is a route of administration in which patients use an inhaler to inhale their medications and drugs are absorbed into the bloodstream via the lung mucous membrane. This technique is most commonly used in the treatment of lung diseases, for example, asthma and chronic obstructive pulmonary disease (COPD). Different types of inhalers include metered-dose inhalers (MDI), dry powder inhalers (DPI), soft mist inhalers (SMI) and nebulizers. The rate and efficacy of pulmonary drug delivery are affected by drug particle properties, breathing patterns and respiratory tract geometry.

Pulmonary drug delivery minimizes systemic side effects and increases bioavailability owing to the localised absorption through the lung. The disadvantages include possible drug irritation to the lung, limited drug dissolution, relatively high drug clearance, and the drug effectiveness depends on the inhaler techniques and patients' compliance. Drug formulation can be challenging since the drug has to bypass the defence mechanisms in the respiratory tract. Pharmacokinetics and pharmacodynamics of the drug in elderly patients can also be particularly difficult to predict due to age-related changes in body composition.

Ongoing developments in inhaler device engineering, technology and drug formulations may improve the efficacy and overcome the challenges of pulmonary drug delivery. Recent advancements involve the utilization of the pulmonary route as an entry to systemic circulation for treating different diseases, as well as the development of pulmonary drug formulation and particle engineering technology to increase the efficacy of pulmonary delivery.