Pulmonary system

There is no such thing as a safe drug. All drugs have the ability to cause injury. 

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Ammonia is a strong local irritant which also has a corrosive effect on the eyes and the membranes of the pulmonary system. Vapor concentrations of 10,000 ppm are mildly irritating to the skin, whereas 30,000 ppm may cause bums. The physiological effects from inhalation are described in Table 16. Prolonged, intentional exposure to high levels of ammonia is unlikely because its characteristic odor can be detected at levels as low as 1 —5 ppm (94). The real danger occurs when escape is impossible, or the exposure victim has lost consciousness. 

Health effects attributed to sulfur oxides are likely due to exposure to sulfur dioxide, sulfate aerosols, and sulfur dioxide adsorbed onto particulate matter. Alone, sulfur dioxide will dissolve in the watery fluids of the upper respiratory system and be absorbed into the bloodstream. Sulfur dioxide reacts with other substances in the atmosphere to form sulfate aerosols. Since most sulfate aerosols are part of PMj 5, they may have an important role in the health impacts associated with fine particulates. However, sulfate aerosols can be transported long distances through the atmosphere before deposition actually occurs. Average sulfate aerosol concentrations are about 40% of average fine particulate levels in regions where fuels with high sulfur content are commonly used. Sulfur dioxide adsorbed on particles can be carried deep into the pulmonary system. Therefore, reducing concentrations of particulate matter may also reduce the health impacts of sulfur dioxide. Acid aerosols affect respiratory and sensory functions. 

The pathophysiologic mechanisms of portal hypertension and of cirrhosis itself are entwined with the mechanisms of ascites (Fig. 19-3). Cirrhotic changes and the subsequent decrease in synthetic function lead to a decrease in production of albumin (hypoalbuminemia). Albumin is the major intravascular protein involved in maintaining oncotic pressure in the vascular system low serum albumin levels and increased capillary permeability allow fluid to leak from the vascular space into body tissues. This can result in peripheral edema, ascites, and fluid in the pulmonary system. The obstruction of hepatic sinusoids and... 

Influenza vaccine should be given yearly to all adults 50 years of age or older. Younger adults with chronic disorders of the cardiovascular or pulmonary systems, chronic metabolic diseases, renal dysfunction, immunosuppression, or disorders that compromise respiratory function should also be vaccinated. Women who will be pregnant during the winter months should be vaccinated against influenza. 

Toxicity to the pulmonary system is uncommon, but severe dyspnea has been reported from penicillamine-induced bronchoalveolitis. Myasthenia gravis has been induced by long-term therapy with penicillamine. 

Pulmonary dynamics, the dimension and geometry of the respiratory tract and the structure of the lungs, together with the solubility and chemical reactivity of the inhalants greatly influence the magnitude of penetration, retention, and absorption of inhaled gases, vapors (Dahl, 1990), and aerosols (Raabe, 1982 Phalen, 1984). The quantity of an inhalant effectively retained in the pulmonary system constitutes the inhaled dose that causes pharmacotoxic responses. 

The inhalation route for administering drugs into the pulmonary system for treatment of respiratory diseases eliminates many bioavailability problems such as plasma binding and first-pass metabolism, which are encountered in parenteral or oral administration. Consequently, a small inhalation dose is adequate for achieving... 

The complex functions of the lung and pulmonary system are accomplished through a series of specialized cells (more than forty types have been identified), tissues, and structures. Standard medical texts such as Gray s Anatomy (Warwick and Williams, 1973) and Functional Anatomy erf the Lung (Nagaishi, 1972) should be consulted for details, but for our purposes, we describe four features that ensure optimum lung function, before discussing the diseases that affect the system. 

Fig. 3.2 The blood-gas exchange system at the bronchioles and alveolar portions of the pulmonary system.

Inhalation of fibrous materials with evaluation of acute and chronic toxicity and carcinogenicity on the pulmonary system. 

These studies reinforce the stiking biologic and anatomic differences in the several components of the pulmonary system, each with its own potentially unique response (Lippman et al., 1980), and some of the difficulties... 

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