Recent developments in respiratory care pharmacology

Bronchoactive inhaled aerosol drugs target the respiratory tract directly and seek to minimize systemic exposure and reduce side effects. Common delivery devices such as the metered dose inhaler, the small volume nebulizer, or the dry powder inhaler each deliver approximately the same fraction of dose (10%) to the lungs, although their dose amounts are not equivalent. Major respiratory drug groups are reviewed, and include the beta-adrenergic and anticholinergic bronchodilators, mucolytic agents, corticosteroids, mediator antagonists, anti-infective agents, and exogenous surfactants. New agents in each group are identified and briefly described, along with the clinical use and most commonly observed side effects for each class of drugs.