Nebulisation: an effective approach for delivering drugs to the heart

Pulmonary nebulisation represents an efficacious method for administering medications as inhalable microparticles, facilitating targeted drug delivery to the heart via lung-mediated pathways. This technique offers a promising alternative to intravenous administration, which is constrained by rapid drug degradation, high systemic doses, and off-target effects. Nebulisation enhances drug bioavailability, reduces required dosages, and minimises systemic side effects by utilising the lungs' extensive absorptive surface and efficient circulatory distribution. Historically, nebulised therapies have been investigated for cardiac applications, including fibrinolytic agents, vasodilators, and antibiotics, with potential benefits in conditions such as coronary obstructions, arrhythmias, and right ventricular dysfunction. However, challenges persist in optimising drug deposition, ensuring precise dosing, and comparing efficacy against conventional routes. Advances in nebulisation technology, such as dry powder formulations and focused aerosol systems, may improve delivery efficiency while preserving the capability to administer combination therapies. Emerging evidence suggests that nebulised drugs can mitigate cardiac dysfunction, reduce inflammation, and prevent heart failure, particularly in high-risk populations. The cardiopulmonary interface offers a unique therapeutic target, with inhaled medications exerting both pulmonary and systemic cardioprotective effects. Despite progress, further research is necessary to establish standardised protocols, validate clinical efficacy, and refine delivery mechanisms. Nebulised cardiac therapy represents a minimally invasive, rapidly acting intervention with significant potential, though large-scale trials are essential to confirm its advantages over existing treatments.