PrednisoloneWe reviewed the evidence for the benefits and harms of different types of intranasal in the nose steroids given to people with chronic rhinosinusitis. Chronic rhinosinusitis is a common condition that is defined as inflammation of the nose and paranasal sinuses a group of air-filled spaces behind the nose, eyes and cheeks. Patients with chronic rhinosinusitis experience at least two or more of the following symptoms for at least 12 weeks: Some people will also have intranasal corticosteroids wiki polypswhich are grape-like swellings of the intranasal corticosteroids wiki nasal lining inside the nasal passage and sinuses. Topical intranasal corticosteroids are used with the aim of reducing inflammation blood work shows low testosterone order to improve patient symptoms.
Corticosteroids | definition of corticosteroids by Medical dictionary
Nasal administration is a route of administration in which drugs are insufflated through the nose. It can be a form of either topical administration or systemic administration , as the drugs thus locally delivered can go on to have either purely local or systemic effects. Nasal sprays are locally acting drugs such as decongestants for cold and allergy treatment, whose systemic effects are usually minimal.
Examples of systemically active drugs available as nasal sprays are migraine drugs , nicotine replacement , and hormone treatments.
The nasal cavity is covered by a thin mucosa which is well vascularised. The effect is often reached within 5 min for smaller drug molecules. Nasal administration is primarily suitable for potent drugs since only a limited volume can be sprayed into the nasal cavity.
Drugs for continuous and frequent administration may be less suitable because of the risk of harmful long-term effects on the nasal epithelium. Upper airway infections may increase the variability as may the extent of sensory irritation of the nasal mucosa, differences in the amount of liquid spray that is swallowed and not kept in the nasal cavity and differences in the spray actuation process.
The area of intranasal medication delivery provides a huge opportunity for research — both for specifically developed pharmaceutical drugs designed for intranasal treatment, as well as for investigating off label uses of commonly available generic medications. Nasal sprays for local effect are quite common. Steroids, antiasthma medications such as salbutamol, ipratropium, montelukast and a large number of inhalational anaesthetic agents are being used commonly.
The recent developments in intranasal drug delivery systems are prodigious. Several antimigraine drugs, available by the trade names of Imitrex- sumatriptan; Zomig - Zolmitriptan; Migranal - Dihydroergotamine and the OTC nasal spray Sinol-M; are also currently administered by nasal administration because a fast effect is desired and oral administration can be prohibited by nausea.
The peptide analogue desmopressin is, for example, available for both nasal and oral administration, for the treatment of diabetes insipidus. The bioavailability of the commercial tablet is 0. Intranasal oxytocin is also being actively investigated for many psychiatric conditions including alcohol withdrawal, anorexia nervosa, PTSD, autism, anxiety disorders, pain sensation and schizophrenia. Intranasal Calcitonin, calcitonin-salmon is used to treat Hypercalcaemia arising out of malignancy, Paget's disease of bone, post menopausal and steroid induced osteoporosis, Phantom limb pain and other metabolic bone abnormalities, available as Rockbone, Fortical and Miacalcin Nasal Spray.
GnRH analogues like nafarelin and busurelin are used for the treatment of anovulatory infertility, hypogonadotropic hypogonadism, delayed puberty and cryptorchidism. Other potential drug candidates for nasal administration include anaesthetics, antihistamines Azelastine , antiemetics particularly metoclopramide and ondansetron and sedatives that all benefit from a fast onset of effect.
Recently, the upper part of the nasal cavity, as high as the cribriform plate, has been proposed for drug delivery to the brain. This "transcribrial route" published first in was suggested by the author Baig AM. The nasal drug administration of naloxone was found to be as effective as the intravenous route. In opioid overdoses, where hypotension and sometimes damaged veins make intravenous administration difficult, nasal naloxone offers a wide margin of safety and reduced risk of infection from vessel puncture while enabling even untrained bystanders to assist a victim.
The prevention of abnormal nasal blood vessel growth Avastin and even the delivery of medications and drug antidotes such as hydroxocobalamin antidote to cyanide poisoning are being developed via intranasal medications. More recently interest is developing on delivery of a number of peptides and other drugs to the nose for direct transport into the brain to treat neurodegenerative disorders such as Alzheimer's.
Intranasal insulin is being investigated for treatment of neurodegenerative disorders such as Alzheimer's disease. The live attenuated influenza vaccine sold under the brand names FluMist US or Fluenz Europe is delivered intranasally. Flumist is a Quadrivalent Vaccine which contains four vaccine virus strains: It has been approved by the CDC for vaccinating all eligible people between 2 and 49 years of age. There is about 20 mL capacity in the adult human nasal cavity.
The nerve cells of the olfactory epithelium project into the olfactory bulb of the brain, which provides a direct connection between the brain and the external environment.
The transfer of drugs to the brain from the blood circulation is normally hindered by the blood—brain barrier BBB , which is virtually impermeable to passive diffusion of all but small, lipophilic substances. However, if drug substances can be transferred along the olfactory nerve cells, they can bypass the BBB and enter the brain directly. The olfactory transfer of drugs into the brain is thought to occur by either slow transport inside the olfactory nerve cells to the olfactory bulb or by faster transfer along the perineural space surrounding the olfactory nerve cells into the cerebrospinal fluid surrounding the olfactory bulbs and the brain 8, 9  .
Studies have been presented that show that direct transfer of drugs is achievable   but the possibility of olfactory delivery of therapeutically relevant doses to humans remains to be demonstrated. From Wikipedia, the free encyclopedia. Upper airway physiology and the atmospheric environment, Elsevier Biomedical Press, Amsterdam, Nasal systemic drug delivery, Marcel Dekker, Inc.
Nasal delivery systems and their effect on deposition and absorption. Adv Drug Deliv Rev. Pharmacokinetics and bioavailability of single-dose intranasal hydromorphone hydrochloride in healthy volunteers.
Efficacy and acceptability of intranasal 17 beta-oestradiol for menopausal symptoms: Minirin nasal spray, Minirin Freeze-dried tablet and Minirin tablet, Novel chemotherapeutic strategies in the management of primary amoebic meningoencephalitis due to Naegleria fowleri.
The Science and Practice of Pharmacy. Nasal route for direct delivery of solutes to the central nervous system: Is nose-to-brain transport of drugs in man a reality? Epub Aug Direct nose-to-brain transfer of morphine after nasal administration to rats. Routes of administration , dosage forms. Mouthwash Toothpaste Ointment Oral spray.
Smoking device Dry-powder inhaler DPI. Oxygen mask and Nasal cannula Oxygen concentrator Anaesthetic machine Relative analgesia machine. Intradermal Subcutaneous Transdermal implant. Intracavernous Intravitreal Intra-articular injection Transscleral.
Skin Intradermal Subcutaneous Transdermal implant.