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On the other hand, direct delivery of low concentrations of drugs to the target site produces the greatest accumulation of therapeutic effects through minimum doses and reduces the risk of toxicity and systemic exposure ( via inhalation has emerged as a useful delivery route for the treatment of ARDS since 2017 ( Although aerosolized inhaled nanomedicine shows promising prospects for its better future clinical application, the objective evaluation of the potential pitfalls is warranted

For comparison, the FDA's 2003 guidance on pharmacokinetics in patients with impaired hepatic function recommends that drugs primarily cleared by the liver undergo dedicated studies across Child-Pugh categories A, B, and C [9]

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