Miscellaneous intranasal medications
The number of potential applications for intranasal medications is enormous. Potential uses that may enhance or provide alternative treatment modalities include headache therapy,[1-15, 32] antinausea medication delivery in patients intolerant of oral medications,[16-19] chronic pain therapy,[20-25] insulin therapy (avoid multiple daily shots), vaccine administration (enhance immune response by delivery via a more natural exposure route),[27-29] antipsychotic medications (reduce chance or injury to patient and provider), prevention of abnormal nasal blood vessel growth (Avastin) and even the delivery of medications and drug antidotes such as hydroxocobalamin (antidote to cyanide poisoning)[11, 30, 31]. Another topic investigated in intranasal B-2 agonists for asthma - something that could use further investigation. 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 (click here for an article on the topic). Intranasal insulin is being investigated for treatment of Alzheimer's disease. Intranasal ketamine is being investigated for treatment of depression and bipolar disorder, while Intranasal oxycontin is being investigated for alcohol withdrawal.
Some of these concepts are fully developed and commercially available pharmaceutical products are already available on the market such as intranasal dihydroergotamine for headaches and nasal vaccines for influenza.[27-29] Other concepts, such as intranasal hydroxocobalamin are purely conjecture and may or may not be viable concepts.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.
Link to separate web site listing ongoing intranasal research into many drugs - insulin, viral particles, glucagon, flu, etc - click here
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31. van Asselt, D.Z., et al., Nasal absorption of hydroxocobalamin in healthy elderly adults. Br J Clin Pharmacol, 1998. 45(1): p. 83-6.
32. Giraud, P, et al. "Cluster Headache During Pregnancy: Case Report and Literature Review." Headache Jan 2009: 136-139
33. Weksler, N., S. Brill, et al. (1999). "Intranasal salbutamol instillation in asthma attack." Am J Emerg Med 17(7): 686-688.
34. Papolos, D. F., M. H. Teicher, et al. (2013). "Clinical experience using intranasal ketamine in the treatment of pediatric bipolar disorder/fear of harm phenotype." J Affect Disord 147(1-3): 431-436.
35. Pedersen, C. A., K. L. Smedley, et al. (2013). "Intranasal oxytocin blocks alcohol withdrawal in human subjects." Alcohol Clin Exp Res 37(3): 484-489.