New perspectives on inhaled drug delivery and systemic bioactivity.

Editorials New perspectives on inhaled drug delivery and systemic bioactivityThe inhaled route of administration is widely accepted as being the optimal way of giving drugs such as cortico- steroids and 32 agonists for the treatment of patients with airflow obstruction.It is possible with the inhaled route to deliver relatively small doses of drug to produce high local concentrations in the airway, and at the same time minimise absorption into the systemic circulation.There are some patients with more severe airflow obstruction who may benefit from higher than conventional doses of inhaled corticosteroid and 2 agonist, and indeed this practice appears to have gained widespread acceptance amongst many respiratory physicians.Whilst higher doses of these drugs may produce an improved airway response, it is well recognised that there is also a dose-response relationship in terms of systemic adverse effects, both for inhaled corticosteroids and for 2 agonists.12The factors which