Intranasal Drug Delivery: An Alternative to Intravenous Administration in Selected Emergency Cases

Abstract

Nasal transmucosal medication delivery is an active area of research, both in new drug development by the pharmaceutical industry and by clinicians using already available intravenous medications. The nasal mucosa is an attractive area in which to deliver medications because the procedure is painless and needleless, which eliminates the risk of needle-stick injuries and reduces patient discomfort. The delivery system does not require sterile technique or intravenous catheters, and the route is immediately available in all patients. In addition, the nasal mucosa offers a large absorptive surface that has considerable blood flow, allowing rapid drug absorption into the bloodstream and cerebral spinal fluid. 1. Chien Y.W. Su K.S.E. Chang S.F. Nasal systemic drug delivery. in: Anatomy and physiology of the nose. Dekker, New York1989: 1-26 Google Scholar , 2. Stanley T.H. Anesthesia for the 21st century. BUMC Proceedings. 2000; 13: 7-10 Google Scholar In addition, because intranasal drug delivery results in direct medication absorption, gastrointestinal destruction and hepatic first-pass metabolism (ie, destruction of drugs by the liver enzymes) are avoided, allowing more drug to be available more rapidly than if it were administered orally. 1. Chien Y.W. Su K.S.E. Chang S.F. Nasal systemic drug delivery. in: Anatomy and physiology of the nose. Dekker, New York1989: 1-26 Google Scholar The result is that many medications delivered intranasally achieve absorption rates and plasma concentrations comparable with that obtained by intravenous administration. 1. Chien Y.W. Su K.S.E. Chang S.F. Nasal systemic drug delivery. in: Anatomy and physiology of the nose. Dekker, New York1989: 1-26 Google Scholar