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首页> 外文期刊>Canadian Respiratory Journal >Inhaled Therapy in Respiratory Disease: The Complex Interplay of Pulmonary Kinetic Processes
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Inhaled Therapy in Respiratory Disease: The Complex Interplay of Pulmonary Kinetic Processes

机译：呼吸系统疾病的吸入疗法：肺动力学过程的复杂相互作用。

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The inhalation route is frequently used to administer drugs for the management of respiratory diseases such as asthma or chronic obstructive pulmonary disease. Compared with other routes of administration, inhalation offers a number of advantages in the treatment of these diseases. For example, via inhalation, a drug is directly delivered to the target organ, conferring high pulmonary drug concentrations and low systemic drug concentrations. Therefore, drug inhalation is typically associated with high pulmonary efficacy and minimal systemic side effects. The lung, as a target, represents an organ with a complex structure and multiple pulmonary-specific pharmacokinetic processes, including (1) drug particle/droplet deposition; (2) pulmonary drug dissolution; (3) mucociliary and macrophage clearance; (4) absorption to lung tissue; (5) pulmonary tissue retention and tissue metabolism; and (6) absorptive drug clearance to the systemic perfusion. In this review, we describe these pharmacokinetic processes and explain how they may be influenced by drug-, formulation- and device-, and patient-related factors. Furthermore, we highlight the complex interplay between these processes and describe, using the examples of inhaled albuterol, fluticasone propionate, budesonide, and olodaterol, how various sequential or parallel pulmonary processes should be considered in order to comprehend the pulmonary fate of inhaled drugs.
机译：吸入途径通常用于管理呼吸道疾病（例如哮喘或慢性阻塞性肺病）的药物。与其他给药途径相比，吸入疗法在治疗这些疾病方面具有许多优势。例如，通过吸入，药物被直接递送至靶器官，从而赋予了高的肺部药物浓度和低的全身性药物浓度。因此，药物吸入通常与高肺功效和最小的全身性副作用有关。肺作为靶标，代表具有复杂结构和多种肺特异性药代动力学过程的器官，包括（1）药物颗粒/液滴沉积; （2）肺部药物溶解; （3）粘膜纤毛和巨噬细胞清除; （4）对肺组织的吸收; （5）肺组织保留和组织代谢; （6）对全身灌注的吸收性药物清除。在这篇综述中，我们描述了这些药代动力学过程，并解释了它们如何受到药物，制剂和设备以及患者相关因素的影响。此外，我们强调了这些过程之间的复杂相互作用，并以吸入型沙丁胺醇，丙酸氟替卡松，布地奈德和奥洛他特罗为例进行了描述，应如何考虑各种顺序或平行的肺部过程，以了解吸入药物的肺命运。

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