Inhaled Medicines: Past, Present, and Future.

Area of Science:

• Pharmacology and Pharmaceutical Sciences
• Respiratory Medicine
• Drug Delivery Systems

Background:

• Orally inhaled therapies offer a targeted approach for respiratory diseases and systemic conditions.
• Over the past 50 years, numerous inhaled products have been developed and approved.
• Inhaled drug delivery is expanding beyond respiratory treatments to systemic diseases.

Purpose of the Study:

• To review essential pharmacological, pharmaceutical, and clinical aspects of orally inhaled therapies.
• To guide scientists in developing new and improved inhaled drug products.
• To cover approved products for respiratory diseases, cystic fibrosis, pulmonary arterial hypertension, and systemic delivery.

Main Methods:

• Comprehensive review of approved orally inhaled drug products over the last half-century.
• Categorization of products based on pharmacological action (e.g., beta-2 agonists, corticosteroids, antivirals).
• Analysis of new drug delivery technologies for inhalation.

Main Results:

• Key drug classes for asthma and COPD include beta-2 agonists, muscarinic antagonists, and glucocorticosteroids.
• Inhaled antivirals, antibacterials, mucoactive agents (dornase alfa, mannitol), and prostacyclins are discussed.
• Systemic delivery via inhalation for CNS diseases and diabetes (insulin) are also covered.

Conclusions:

• Understanding approved inhaled therapies aids in developing new products with optimized ingredients, formulations, and delivery systems.
• New inhalation technologies promise improved efficacy and expanded therapeutic applications.
• Judicious decisions in product development require consideration of target populations and clinical endpoints.