Aerosols and the Lung (eBook)

Front Cover 1
Aerosols and the Lung: Clinical and Experimental Aspects 4
Copyright Page 5
Table of Contents 10
Preface 6
Contributors 8
Abbreviations and symbols 12
Chapter 1. Anatomy and physiology of the human lung: aspects relevant to aerosols 16
Introduction 16
Anatomy of the upper and lower airways 16
The nose 17
The larynx 19
The lower airways—development and anatomy 20
Lung models 22
The pulmonary bronchial arterial systems 24
Lung volumes 26
Complex (static) lung volumes 27
Ventilation, aerosol deposition and uptake 30
Airways obstruction and receptor location 31
Conclusions 32
References 32
Chapter 2. Lung secretions 34
Introduction 34
Tracheobronchial secretion 34
Bronchiolar secretion 50
Alveolar secretion 52
Lung secretions in disease 55
References 60
Chapter 3. Physical properties and mechanisms of deposition of aerosols 64
Aerosols 64
Particle deposition in the upper airways 68
Particle deposition in the lungs 69
Patterns of aerosol deposition in the lung 72
Effect of bronchoconstriction 78
The concept of 'alveolar deposition' 79
Measurement of 'alveolar deposition' 81
Summary 83
References 83
Chapter 4. Production of radioaerosols 86
Choice of particles and radiolabel 86
Nebulizers 88
Spinning disc generator 93
A system for radioaerosol production using the spinning disc technique 97
Other techniques for making monodisperse radioaerosols 99
Pressurized aerosols 100
Dry powder inhalers 102
Radiation dosimetry 103
References 104
Chapter 5. Aerosol contributions to the investigation of lung structure and ventilatory function 107
Introduction 107
Gas mixing and airspace dimensions 108
Radioaerosol deposition in relationship to airways obstruction 116
Ventilation imaging with radioaerosols 126
References 139
Chapter 6. Lung mucociliary clearance 142
Introduction 142
Measurement of lung mucociliary clearance 143
Physiological factors 153
Environmental pollutants 155
Effects of disease on lung mucociliary clearance (Wanner, 1977) 156
Effects of pharmacological agents on lung mucociliary clearance(Sackner, 1978) 160
References 167
Chapter 7. Chest physiotherapy and cough 171
Introduction 171
Background 172
Cough 174
Forced expiration technique 175
Radioaerosol studies of chest physiotherapy 176
Summary 181
References 182
Chapter 8. Clearance of inhaled particles from the alveoli 185
Introduction 185
Structure and function of the alveolar capillary interface 186
Alveolar clearance mechanisms 194
References 208
Chapter 9. Therapeutic aerosols 212
The inhaled route for respiratory drugs 212
Preliminary considerations 214
Nebulizers 219
Metered dose inhalers 223
Dry powder inhalers 234
Discussion 235
References 236
Chapter 10. Aerosol challenge in lung diseases 240
Introduction 240
Measurement of lung function for bronchial provocation testing 240
Types of reaction 242
Standardization of aerosol challenge with soluble agents 247
Setting up occupational type bronchial provocation tests 250
Problems with bronchial provocation testing 254
Bronchial challenge testing in drug assessment 255
Bronchial provocation tests for the assessment of antitussive drugs 257
Effect of drugs on bronchial provocation tests 258
Mechanisms of asthmatic reactions induced by bronchial provocation testing 260
Interpretation and use of bronchial provocation tests 261
References 262
Chapter 11. Occupational lung disease and aerosols 266
Introduction 266
Theories and classification of disease 266
Reactions to occupational aerosols in the airways 267
Reactions to occupational aerosols in the alveoli 270
The pneumoconioses 271
Assessment and methods of investigation 273
Degree of disability 274
Legislative bodies and protection 275
Conclusion 276
References 276
Index 278