Application aspects of medications for inhalation at the prehospital stage of medical evacuation

This study aimed to determine the aspects of inhalation application of drugs as medical means of protection against lesions by factors of radiation, chemical, and biological nature at the prehospital stage of medical evacuation. Advantages of inhalation administration of drugs and use of individual inhalers of portable type over parenteral and oral administration methods are described. The existing drugs that are most suitable for inhalation at the prehospital stage of medical evacuation include emergency prevention and treatment of toxic pulmonary edema, analgesics, antiradiation, drugs for arresting radiation primary reaction, agents for accelerated radionuclides elimination, and antibacterial and antiviral agents. This list is conditioned by the rapid achievement of the protective effect of the drug during inhalation, both due to the local action in the area of the “entrance gate” of the intake of damaging agents and the accelerated absorption and systemic action on target organs. This study presents data on existing and promising inhalation drugs (antidotes for warfare agents, recombinant forms of acetyl- and butyrylcholinesterase) and technical means of their delivery (a metered aerosol inhaler, a metered dry powder inhaler) in the Armed Forces of the European North Atlantic Treaty Organization bloc and the United States for the prevention and treatment of damage e to chemical agents, as well as the prospects of radiomitigator usage (granulocyte-macrophage colony-stimulating factor) by inhalations for acute radiation syndrome treatment and inhalation of complexones of radioactive isotopes. The prospects of inhalation in combination with bronchodilators in the development of acute respiratory failure and toxic pulmonary edema on the background of poisoning with the use of a metered-dose powder inhaler are described. The introduction and use of a metered-dose dry powder inhaler at the prehospital stage of medical evacuation determines the need for its development, taking into account the specifics of the drug usage, as well as the need to unify the dosage form of drugs in combination with one type of inhaler (single-dose or multi-dose).