R: Respiratory system
ATC group R for modelers: the level 2 map with example drugs, and the inhaled-route modeling notes held at R03.
Drugs acting on the airways, centered on R03 for obstructive airway disease. The interesting part for a modeler is the inhaled route, where the target tissue is also the site of administration [1,2]. Those modeling notes live with R03, drugs for obstructive airway diseases.
In April 1955 Susie Maison asked her father George, president of Riker Laboratories, why her asthma medicine could not come in a spray can like hairspray. The first pressurized metered dose inhalers were approved on 9 March 1956 [3].
| Level 2 code | Description | In plain terms | Example drug |
|---|---|---|---|
| R01 | Nasal preparations | Mometasone (R01AD09) / fluticasone furoate (R01AD12), intranasal corticosteroids for allergic rhinitis; xylometazoline (R01AA07) for short-term decongestion | |
| R02 | Throat preparations | Symptomatic relief only. Benzydamine (R02AX03) is the best-supported topical analgesic, chlorhexidine (R02AA05) the common antiseptic lozenge | |
| R03 | Drugs for obstructive airway diseases | asthma and COPD inhalers | Budesonide with formoterol (R03AK07, listed as “formoterol and budesonide”) / salbutamol (R03AC02) |
| R05 | Cough and cold preparations | No strongly evidenced agent; acetylcysteine (R05CB01) and dextromethorphan (R05DA09) are the most used. Dornase alfa (R05CB13) is a genuine standard, but only in cystic fibrosis | |
| R06 | Antihistamines for systemic use | Cetirizine (R06AE07) / loratadine (R06AX13) | |
| R07 | Other respiratory system products | leftovers: surfactants, cystic-fibrosis drugs, nitric oxide | Ivacaftor, tezacaftor and elexacaftor (R07AX32) for cystic fibrosis; neonatal surfactant sits under natural phospholipids (R07AA02), which covers poractant alfa and beractant with no substance-specific code |
References
[1]
Borghardt JM, Kloft C, Sharma A. Inhaled therapy in respiratory disease: The complex interplay of pulmonary kinetic processes. Canadian Respiratory Journal 2018;2018:2732017. https://doi.org/10.1155/2018/2732017.
[2]
Daley-Yates PT. Inhaled corticosteroids: Potency, dose equivalence and therapeutic index. British Journal of Clinical Pharmacology 2015;80:372–80. https://doi.org/10.1111/bcp.12637.
[3]
Stein SW, Thiel CG. The history of therapeutic aerosols: A chronological review. Journal of Aerosol Medicine and Pulmonary Drug Delivery 2017;30:20–41. https://doi.org/10.1089/jamp.2016.1297.