Institute for Continuing Education

Pulmonary Pharmacology: Delivery Devices and Medications

Course Objectives

Upon successful completion of this module, you will be able to:

• Module 1: Foundations of Pulmonary Pharmacology
  • Describe the basic principles of pharmacokinetics and pharmacodynamics as applied to respiratory medications.
  • Explain the anatomy and physiology of the respiratory system relevant to drug delivery.
  • Identify the factors affecting pulmonary drug deposition and absorption.
• Module 2: Aerosol Therapy and Delivery Systems
  • Compare the mechanisms, advantages, and limitations of metered-dose inhalers (MDIs), dry powder inhalers (DPIs), soft mist inhalers (SMIs), and nebulizers.
  • Demonstrate proper technique for administering medications via each delivery device.
  • Discuss the role of smart inhaler technology and digital adherence monitoring.
  • Identify common device-related errors and strategies for patient education.
• Module 3: Humidification and Airway Hydration
  • Explain the physiological principles of humidity and water vapor content in inspired air.
  • Describe the types and clinical applications of humidification devices.
  • Apply humidity therapy principles to various clinical scenarios.
• Module 4: Bronchodilator Therapy
  • Differentiate the mechanisms of action, indications, and adverse effects of beta-2 adrenergic agonists.
  • Compare short-acting and long-acting beta-agonists (SABA vs. LABA) and their appropriate clinical use per current guidelines.
  • Describe the pharmacology and current role of anticholinergic bronchodilators (SAMA and LAMA).
  • Discuss the limited role of methylxanthines (theophylline) in contemporary practice.
• Module 5: Anti-Inflammatory Agents
  • Explain the mechanisms, formulations, and clinical applications of inhaled corticosteroids (ICS).
  • Describe the rationale for ICS-formoterol combination therapy per GINA 2024-2025 guidelines.
  • Identify strategies to minimize local and systemic adverse effects of corticosteroids.
  • Discuss the role of leukotriene receptor antagonists and mast cell stabilizers.
• Module 6: Biologic Therapies for Severe Asthma and COPD
  • Classify the six FDA-approved biologics for severe asthma by mechanism and target pathway.
  • Apply biomarker-guided selection criteria for initiating biologic therapy.
  • Describe the emerging role of biologics in COPD with Type 2 inflammation.
• Module 7: Mucoactive Agents
  • Differentiate among mucolytics, mucokinetics, mucoregulators, and expectorants.
  • Discuss the clinical evidence for N-acetylcysteine, dornase alfa, and hypertonic saline.
  • Apply appropriate mucoactive therapy to cystic fibrosis, bronchiectasis, and COPD.
• Module 8: Pulmonary Anti-Infective Agents
  • Describe the indications, delivery methods, and monitoring for inhaled antibiotics.
  • Discuss the role of inhaled antifungal and antiviral agents in respiratory disease.
  • Identify key considerations for aerosolized antimicrobial therapy in special populations.
• Module 9: Pulmonary Surfactant Therapy
  • Explain the composition, function, and clinical indications for exogenous surfactants.
  • Compare surfactant administration techniques including LISA and InSurE methods.
  • Discuss emerging applications of surfactant therapy in adult ARDS.
• Module 10: Smoking Cessation Pharmacotherapy
  • Compare the efficacy and safety profiles of varenicline, bupropion, and nicotine replacement therapy.
  • Develop evidence-based smoking cessation protocols for respiratory patients.
  • Identify barriers to cessation and strategies to improve adherence.
• Module 11: GINA and GOLD Guidelines Application
  • Apply the GINA 2024-2025 stepwise approach to asthma management.
  • Implement the GOLD 2025 pharmacotherapy algorithm for COPD.
  • Recognize when escalation to advanced therapies is indicated.
• Module 12: Emerging Therapies and Future Directions
  • Describe emerging drug classes including ensifentrine (PDE3/4 inhibitor) and novel biologics.
  • Discuss the role of pharmacogenomics in personalized respiratory medicine.
  • Identify key clinical trials shaping future practice.

Course Information

Pulmonary pharmacology involves the therapeutic use of drugs that affect the lungs and are delivered by a variety of modalities. RCPs need to have a general knowledge of the drugs (agents) most commonly used to treat respiratory problems, an in-depth knowledge of airway pharmacology and the equipment utilized for delivery of the medications.

The care of patients with pulmonary diseases involves utilizing a wide spectrum of drugs to provide everything from emergency interventions for acutely and critically ill persons, to administering maintenance support for a relatively stable patient.

RCPs are primarily involved in administering drugs that are specifically designed to treat the so-called pathological triad of pulmonary disease: bronchospasm, airway inflammation, and retained secretions. However, since the respiratory system cannot be disassociated from cardiac and vascular systems, respiratory care pharmacology necessarily involves a relatively broad scope of drug classes.

The front line arsenal for treating pulmonary diseases consists of bronchodilators, antimuscarinics, corticosteroids, mucokinetics, mucolytics, and decongestants. There are also a variety of other agents available for treating pulmonary ailments, including oxygen, antibiotics, local anesthetics, respiratory stimulants, and muscle relaxants. Because of the inter-connectedness of the body systems, additional groups of drugs that may be administered to patients with respiratory diseases include anti-infectives, CNS drugs, antiarrhythmic agents, anticoagulants, antihypertensives, and diuretics.

In this course you will be asked to complete a multiple choice final exam, and several case studies involving clinical scenarios. Unless you complete all of these, you cannot receive the full unit credit for this course.

The course includes detailed discussions of aerosol therapy, nebulizers, humidifiers, and a variety of medications used in the treatment of respiratory disorders and diseases. Therapeutic procedures and medication functions are also examined in this valuable continuing education unit. The resources drawn upon and synthesized for the following material can be found in the References sections.