II. Indications
III. Mechanism
- Nasal mucosa is well vascularized with rapid medication absorption
- Bioavailability is typically better than oral medications, as the nasal route bypasses first pass metabolism
- Ideal intranasal medications are lipophilic and small in molecular size
- Intranasal medications are best tolerated and absorbed at pH 4.5 to 6.5
- Maximal amount that may be absorbed intranasally is 0.3 ml
- Typical drug delivery is via a Mucosal Atomization Device (MAD Atomizer)
- Device has 0.1 ml dead space (draw up extra 0.1 ml medication)
- Alternatives when atomizer is unavailable
- Slow drip into the nose via syringe
- Syringe with angiocatheter plastic tip with slow drips into the nose
- Technique
- Blow nose before administration (Rhinorrhea and mucous may interfere with absorption)
- Direct the MAD Atomizer toward the occiput or ipsilateral eye (not up)
IV. Preparations: Intranasal medications for analgesia and sedation
- See Procedural Sedation and Analgesia for dosing
- Intranasal route administration uses intravenous medication preparations
- Analgesia
- Sedation