The Intranasal Route as an Alternative Method of Medication Administration

2018 ◽  
Vol 38 (5) ◽  
pp. 26-31 ◽  
Author(s):  
Calvin Tucker ◽  
Lyn Tucker ◽  
Kyle Brown
Keyword(s):  
Intranasal Administration ◽  
Pediatric Patients ◽  
Medication Administration ◽  
Intravenous Route ◽  
Appropriate Use ◽  
Intranasal Route ◽  
Superior Efficacy ◽  
Invasive Method ◽  
Correct Technique ◽  
Intranasal Drug Administration

Intranasal drug administration is a less invasive method of drug delivery that is easily accessible for adult and pediatric patients. Medications administered by the intranasal route have efficacy comparable to intravenous administration and typically have superior efficacy to subcutaneous or intramuscular routes. The intranasal route is beneficial in emergent situations when the intravenous route is not available. The intranasal route is safe and effective in various indications, and therapeutic systemic concentrations of medication can be attained via this route. As the evidence for and comfort with intranasal administration continue to grow, guidance on correct technique, medications, and dosing is vital for appropriate use. This article reviews the process and practices of appropriate intranasal medication administration.

scholarly journals Bioavailability of butorphanol after intranasal administration to horses

2020 ◽  
Vol 23 (4) ◽  
pp. 443-447
Author(s):  
V. Ferreira ◽  
M. Velloso ◽  
M. Landoni
Keyword(s):  
Intranasal Administration ◽  
Peak Plasma ◽  
Peak Plasma Concentration ◽  
Plasma Concentrations ◽  
Volume Of Distribution ◽  
Intravenous Route ◽  
Liquid Chromatography Mass Spectrometry ◽  
Intranasal Route ◽  
Predetermined Time ◽  
Mass Spectrometry Assay

The aim of the present study was to describe butorphanol pharmacokinetics and bioavailability following intranasal administration to horses. Six adult horses received 0.05 mg/kg butorphanol, in a randomised crossover design, by either intravenous or intranasal route. Plasma concentrations of butorphanol were measured at predetermined time points using liquid chromatography/mass spectrometry assay. After intravenous injection, mean ±SD butorphanol steady-state volume of distribution and clearance was 3.20 ± 1.77 l/kg and 3.18 ± 1.47 L/kg/h, respectively. Terminal half-lives for butorphanol after intravenous and intranasal administrations were 0.68 ± 0.17 h and 1.79 ± 1.43 h. For intranasal administration, absorption half-life and peak plasma concentration were 0.43 ± 0.33 h and 1.95 ± 1.7 ng/mL, respectively. Bioavailability was 54.45 ± 20.09%. Intranasal butorphanol administration in horses is practical, not stressful and well tolerated. Therefore, it might be a substitute to the intravenous route in adult horses

scholarly journals Effect of hydration therapy on oligohydramnios

2017 ◽  
Vol 6 (5) ◽  
pp. 1800
Author(s):  
Cicily T. J. ◽  
Sherin Sams ◽  
Anitha K. Gopal
Keyword(s):  
Perinatal Outcome ◽  
Intervention Group ◽  
Randomised Control Trial ◽  
Intravenous Route ◽  
Perinatal Complications ◽  
Fixed Amount ◽  
Medical College ◽  
Invasive Method ◽  
The Impact ◽  
Hydration Therapy

Background: Oligamnios is defined as an AFI <5cm, SDP <2cms or an AFI below the 5th centile for the gestational age and is associated with many maternal and perinatal complications. An effective, non-invasive method of increasing AFV is the hydration therapy. The objective of present study was to determine the impact of hydration therapy in patients complicated by oligamnios and to measure the maternal and perinatal outcome in oligamnios corrected by Intravenous hydration therapy.Methods: It is a randomised control trial done at Government Medical College, Kottayam, Kerala, India from Jan 2012 to May 2013. 136 singleton pregnant females with gestation age >34 weeks with AFI <5 cms were randomised into an Intervention group who receive 1 litre of ringer lactate i.v given daily for 5 days and nonintervention group who were kept under observation by serial ultrasound and antepartum fetal surveillance. All were followed-up till delivery to obtain maternal and perinatal outcomes.Results: Among the 68 who were given intervention, 61 responded and 7 were non responders. With hydration therapy, mean increase in AFI was 4 cm and minimum duration needed for improvement was one week. Hydration therapy showed significant improvement in the maternal and fetal outcomes. Intravenous route of maternal hydration has the advantage that a fixed amount of fluid can be infused at a relatively constant rate with ensured compliance.Conclusions: From the study, it was concluded that Hydration therapy is an excellent method to improve AFI in Oligohydramnios and maternal and perinatal outcome.

Bi-functional sterically hindered phenol lipid-based delivery systems as potential multi-target agents against Alzheimer's disease via an intranasal route

Nanoscale ◽  
2020 ◽  
Vol 12 (25) ◽  
pp. 13757-13770
Author(s):  
Evgenia A. Burilova ◽  
Tatiana N. Pashirova ◽  
Irina V. Zueva ◽  
Elmira M. Gibadullina ◽  
Sofya V. Lushchekina ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Intranasal Administration ◽  
Delivery Systems ◽  
Sterically Hindered Phenols ◽  
Intranasal Route ◽  
Sterically Hindered Phenol ◽  
Hindered Phenols ◽  
Hindered Phenol ◽  
Sterically Hindered

New lipid-based nanomaterials based on sterically hindered phenols were developed as potential drugs against Alzheimer's disease via intranasal administration.

scholarly journals Development, Implementation, and Use of a Neurology Therapeutics Committee

2019 ◽  
Vol 6 ◽  
pp. 2329048X1983047
Author(s):  
Edward B. Clark ◽  
Russell J. Butterfield ◽  
Francis M. Filloux ◽  
Joshua L. Bonkowsky
Keyword(s):  
Neurological Disorders ◽  
Therapeutic Agent ◽  
Pediatric Patients ◽  
Third Party ◽  
Insurance Companies ◽  
Clinical Implementation ◽  
Appropriate Use ◽  
Therapy Choice ◽  
Financial Burdens ◽  
Therapeutics Committee

Innovative therapeutics are transforming care of children with previously untreatable neurological disorders. However, there are challenges in the use of new therapies: the medicine may not be effective in all patients, administration may not be tolerated, and matching therapy choice to patient is complex. Finally, costs are high, which imposes financial burdens on insurance companies, families, and the health-care system. Our objective was to address challenges for clinical implementation of the new therapeutics. We sought to develop a process that would be personalized for patient and disease, encourage appropriate use of a therapeutic agent while mitigating pressure on a clinician to prescribe the therapy in all instances, and assist third-party payers in approving therapeutic use based on safety and efficacy. We report our creation of a Neurology Therapeutics Committee for pediatric patients. We review the committee’s mechanisms, describe its use and report outcomes, and suggest the Neurology Therapeutics Committee’s broader applicability.

Enteral and parenteral nutrition considerations in pediatric patients

2019 ◽  
Vol 76 (19) ◽  
pp. 1492-1510
Author(s):  
Mary Petrea Cober ◽  
Kathleen M Gura
Keyword(s):  
Best Practices ◽  
Parenteral Nutrition ◽  
Pediatric Patients ◽  
Medication Administration ◽  
Nutrition Support ◽  
Disease States ◽  
Pediatric Populations ◽  
Enteral And Parenteral Nutrition ◽  
Indications For Use ◽  
Selection Of

Abstract Purpose Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. Summary The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. Conclusion The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.

COMPARISON OF PLASMA LEVELS OF LUTEINIZING HORMONE RELEASING HORMONE IN MEN AFTER INTRAVENOUS OR INTRANASAL ADMINISTRATION

1974 ◽  
Vol 63 (2) ◽  
pp. 351-360 ◽  
Author(s):  
G. FINK ◽  
G. GENNSER ◽  
P. LIEDHOLM ◽  
J. THORELL ◽  
J. MULDER
Keyword(s):  
Luteinizing Hormone ◽  
Intranasal Administration ◽  
Intravenous Route ◽  
Metabolic Clearance ◽  
Luteinizing Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Disappearance Curve ◽  
Lh Rh ◽  
Dose Dependent Increase ◽  
Dose Dependent

SUMMARY The concentrations of luteinizing hormone releasing hormone (LH-RH) and luteinizing hormone (LH) were determined by radioimmunoassay in blood samples taken at intervals after the administration of different doses of synthetic LH-RH administered either intravenously or intranasally in healthy fertile men. Intranasal administration of LH-RH caused a dose-dependent increase of plasma LH with the peak occurring later than that after intravenous injection. The intravenous route was approximately 100 times more effective than the intranasal route in terms of the dose of LH-RH necessary to achieve an LH response of similar magnitude, but the route through the nasal mucosa seems a safe and convenient way for LH-RH administration. The characteristics of the disappearance curve, metabolic clearance rate and volumes of distribution of LH-RH in man are compared with those found by others.

Treatment of Migraine Attacks with Intranasal Alniditan: An Open Study

Cephalalgia ◽  
2001 ◽  
Vol 21 (2) ◽  
pp. 140-144 ◽  
Author(s):  
HC Diener ◽  
P Louis ◽  
R Schellens ◽  
F De Beukelaar ◽  
Keyword(s):  
Open Study ◽  
Migraine Headache ◽  
Intranasal Administration ◽  
Receptor Agonist ◽  
Intranasal Route ◽  
Taste Disturbance ◽  
Migraine Headaches ◽  
Nasal Irritation ◽  
Severe Intensity ◽  
Time To Onset

In this open phase-II clinical tolerability trial 17 neurologists enrolled a total of 112 patients and instructed them to administer a maximum of two doses of intranasal alniditan, a 5-HT1B/D receptor agonist, for the treatment of three consecutive migraine attacks of moderate to severe intensity. A second dose of the trial medication was allowed within 1–24 h after the first administration. At 1 h after intranasal administration, 70/103 (68%) patients had responded to treatment (reduction from severe or moderate headache before treatment to mild or no headache) after their first migraine attack, 65/94 (69%) after their second and 52/75 (71%) after their third. In 187/270 (69%) of all attacks, patients were considered responders at 1 h. The median time to onset of effect was 30 min. The migraine headache recurred in 44% (attack 1), 55% (attack 2) and 44% (attack 3) after 4–5 h. Sixty-eight per cent of the patients reported nasal irritation, 19% taste disturbance and 44% throat irritation. Alniditan 2 mg, administered via the intranasal route, was effective in relieving migraine headaches in over two-thirds of the patients at 1 h.

scholarly journals Training on intravenous medication administration in pediatric nursing: a before-after study

2021 ◽  
Vol 55 ◽  
Author(s):  
Ires Lopes Custódio ◽  
Francisca Elisângela Teixeira Lima ◽  
Lívia Maia Pascoal ◽  
Lorena Pinheiro Barbosa ◽  
Rhanna Emanuela Fontenele Lima de Carvalho ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Medication Administration ◽  
Training Data ◽  
Positive Effects ◽  
Significant Difference ◽  
Post Test ◽  
Quasi Experimental ◽  
Response Method ◽  
Nursing Professionals ◽  
Intravenous Medication

ABSTRACT Objective: To evaluate the effect of training on intravenous medication administration in pediatric patients on nursing staff ’s learning and response. Method: This is a quasi-experimental study (pre- and post-test), with 38 nursing professionals who participated in training on administration of intravenous (IV) medication in pediatric patients with heart disease. For data collection, a questionnaire with 19 items was applied to evaluate participants’ learning before (pre-test) and after (post-test) training. Data were analyzed by descriptive and analytical statistics (binomial and Friedman tests). Results: Nurses predominated (52.6%), mean age 41.2 years and 9.8 years of professional experience in pediatrics. For learning evaluation, there was an increase in the rate of hits from the pre-test to the post-test in 13 items, with a significant difference (p < 0.05) in the items: removing adornments to sanitize hands; wearing gloves when administering medication; administering medication with gloves, mask and goggles; and checking patient name by asking their companion. Conclusion: Training had positive effects on nursing professionals’ learning and reaction.

scholarly journals Injectable Ammonium Chloride Used Enterally for the Treatment of Persistent Metabolic Alkalosis in Three Pediatric Patients

2012 ◽  
Vol 17 (1) ◽  
pp. 98-103
Author(s):  
Jennie T Mathew ◽  
Laura L Bio
Keyword(s):  
Adverse Effects ◽  
Ammonium Chloride ◽  
Metabolic Alkalosis ◽  
Pediatric Patients ◽  
Case Series ◽  
Male Infant ◽  
Female Infant ◽  
Intravenous Route ◽  
Enteral Administration ◽  
Effective Option

Enteral administration of injectable ammonium chloride may offer an effective method for the treatment of persistent metabolic alkalosis, without the adverse effects associated with the intravenous route. This case series describes 3 pediatric patients who received ammonium chloride enterally for the treatment of persistent metabolic alkalosis. The patients were a 2-month-old female infant, a 6-week-old male infant, and a 3-year-old male toddler. Four to 18 doses of ammonium chloride were administered enterally (range, 3-144 mEq/dose). Two of the 3 patients achieved resolution of metabolic alkalosis with ammonium chloride, while 1 patient's condition was refractory to treatment. Resolution of metabolic alkalosis occurred at 4 and 8 days, which required a total weight-based dose of 10.7 mEq/kg and 18 mEq/kg, respectively. No adverse effects were recorded. The use of ammonium chloride injection administered enterally was a safe and effective option in 2 of the 3 pediatric patients with persistent metabolic alkalosis.

scholarly journals Intranasal Methylprednisolone Effectively Reduces Neuroinflammation in Mice With Experimental Autoimmune Encephalitis

2019 ◽  
Vol 79 (2) ◽  
pp. 226-237
Author(s):  
Dunia Rassy ◽  
Brandon Bárcena ◽  
Iván Nicolás Pérez-Osorio ◽  
Alejandro Espinosa ◽  
Alberto N Peón ◽  
...  
Keyword(s):  
Intranasal Administration ◽  
Immune Cell ◽  
Autoimmune Encephalitis ◽  
Systemic Exposure ◽  
Intravenous Route ◽  
Histopathological Analysis ◽  
Intranasal Delivery ◽  
Disease Modifying Therapy ◽  
The Central Nervous System ◽  
Experimental Autoimmune

Abstract Relapsing-remitting multiple sclerosis, the most common form, is characterized by acute neuroinflammatory episodes. In addition to continuous disease-modifying therapy, these relapses require treatment to prevent lesion accumulation and progression of disability. Intravenous methylprednisolone (1–2 g for 3–5 days) is the standard treatment for relapses. However, this treatment is invasive, requires hospitalization, leads to substantial systemic exposure of glucocorticoids, and can only reach modest concentrations in the central nervous system (CNS). Intranasal delivery may represent an alternative to deliver relapse treatment directly to the CNS with higher concentrations and reducing side effects. Histopathological analysis revealed that intranasal administration of methylprednisolone to mice with experimental autoimmune encephalomyelitis (EAE) suppressed the neuroinflammatory peak, and reduced immune cell infiltration and demyelination in the CNS similarly to intravenous administration. Treatment also downregulated Iba1 and GFAP expression. A similar significant reduction of IL-1β, IL-6, IL-17, IFN-γ, and TNF-α levels in the spinal cord was attained in both intranasal and intravenously treated mice. No damage in the nasal cavity was found after intranasal administration. This study demonstrates that intranasal delivery of methylprednisolone is as efficient as the intravenous route to treat neuroinflammation in EAE.

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