Did you know the intranasal route is right behind intravenous (IV) for speed of effect? Ongoing research efforts in the pharmaceutical industry have created easier delivery routes. Wouldn’t it be great to take your medicine through your nose instead of an IV or another way?
There are only a limited number of medication available for intranasal drug delivery. Yet, new research is showing promise in creating medications that are easier to take. Continue reading to learn more.
1. Advantages of Intranasal Drugs
The intranasal route has received more attention recently. The nasal cavity offers several advantages for systemic medication absorption.
- Large mucosal surface and abundance of blood vessels enhances absorption
- Patient convenience and improved adherence to the prescribed dosing
- Rapid achievement of therapeutic blood levels
- Avoids exposure to the unhospitable gastrointestinal tract
- Does not undergo first-pass metabolism in the liver
- Potential medication delivery straight to the brain
- Direct delivery of vaccines to the lymphatic tissue
The nasal medications rely on the rapid onset of action via this route. Examples of these drugs include corticosteroids, antihistamines, anticholinergics, and vasoconstrictors. Some pain medications are also given by this nasal route.
2. Intranasal Drug Delivery to Brain
The nasal cavity offers a route for delivering drugs to the parenchyma of the brain. When the drug molecules reach the olfactory or trigeminal nerves, they move to the cerebrum and pons. From there, they can move throughout the brain.
The molecules moved across the blood-brain barrier (BBB) and into the cerebrospinal fluid. This allows the drug to work in the brain via a rapid delivery route.
With Alzheimer’s Disease, the drug routes have ranged from oral to injections into the brain. These routes are often less effective, expensive, and painful.
The intranasal route provides an option that’s non-invasive. It affords increased concentrations of the drug in the brain since it passes through the BBB. Patients have fewer systemic side effects and are more comfortable.
Researchers continue to evaluate intranasal medications for Parkinson’s disease as well.
3. Intranasal Medications
Intranasal drug preparations are now available in many forms. Examples include solutions, gels, suspensions, powders, emulsions, liposomes, and microparticles. Liquid formulations represent the most dominate type.
The liquid preparation provides humidification to fight dryness and crusting. One limitation found is that some medications may lose stability when dissolved.
The powder form offers greater stability and often doesn’t need a preservative. Yet, the powder can stick to the cilia. Including bioadhesive excipients in the drug can slow, the ciliary action. This reduces clearance rates and improves absorption.
4. Intranasal Drug Delivery
There are several delivery systems for intranasal medications. The following describes some of these systems.
LMA® MAD™ Nasal
This device includes an atomizer and a 3 mL syringe. The liquid medication is first drawn up in the syringe.
A nosepiece containing a spray tip is placed on the syringe. It's then sprayed into the nose. Topical steroids have been administered using this style device.
Pari Respiratory SinuStar™
This product offers a reusable nebulizer that has a nasal adapter. Its design provides nasal and intranasal aerosol delivery to the upper airway. This system also creates small molecules that easily move through the nasal cavity.
Some nasal preparation delivery methods use droppers. Proper administration requires a head-down and extreme neck extension body position. This allows the drops to travel into the nose using gravity.
Often, patients have not followed these instructions. Rhinosinusitis patients report an increase in headaches and discomfort when assuming this position.
Many over-the-counter decongestants use a squeeze bottle with an air-filled section. When the bottle is squeezed, the medication atomizes and travels via a jet outlet.
Metered Spray Pump
The most popular nasal delivery method today is the metered spray pump. They deliver a highly consistent dose of the medication.
A new development is the nasal atomizer which uses pressurized nitrogen gas. This allows the delivery of medication through the nose and to the brain.
Breath-powered Bi-Directional™ Technology
One new concept undergoing phase 3 clinical trials uses the body’s upper airway function. The hope is to overcome some of the current limitations. This device has a mouthpiece and a sealing nosepiece.
The patient places a sealing nosepiece inside one nostril. This creates a soft, flexible seal inside of the nostril. It then enlarges the nasal triangular valve.
Next, the patient exhales through the mouthpiece. During exhalation, the soft palate raises and isolates the nasal cavity from the respiratory system. This opens a path behind the nasal septum between the two nostrils.
The spray enters one nostril, goes behind the nasal septum, and leaves through the other nostril. This allows the medication to move past the nasal valve and not go into the lungs. The molecules land in place without leaving the nostril.
5. Disadvantages of Intranasal Medications
While the intranasal route offers many benefits, it also has some disadvantages. For some drugs, the protective mucociliary clearance may impact drug delivery. As it works to rid the nose of harmful substances, it can remove the drug.
If the patient has nasal congestion, this may impede the delivery of the medication. Only certain drugs can use this route due to the limited volume that may be delivered in the nose.
When the nasal route requires frequent dosing, this may cause topical problems. The nasal mucosal can become irritated leading to damage of the membranes.
Medical researchers have yet to fully understand the mechanism of drug transport. Thus studies continue to test the benefits, risks, and short- and long-term side effects.
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Everyday medical research evolves and improves the delivery of healthcare. It’s important to remain educated about the newest developments. Articles like this one about intranasal drug delivery, offer insights into medical advances.
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