Intranasal

Respiratory inhalant use asthma Intranasal use seasonal or perennial rhinitis, prevention of recurrence of nasal polyps after surgical removal... 

Intranasal 2 sprays each nostril BID (maximum dosage, 8 sprays/d)... 

The more common adverse reactions associated witii die mast cell stabilizers include headache, dizziness, nausea, fatigue, hypotension, or unpleasant taste in the mouth. These dm may cause nasal or throat irritation when given intranasally or by inhalation. A more complete listing of the adverse reactions associated with the mast cell stabilizers is found in the Summary Drug Table Antiastiima Dru i. 

Desmopressin may be given orally, intranasally, SC, or IV. The oral dose must be determined for each individual patient and adjusted according to the patient s response to therapy. When the drug is administered nasally, a nasal tube is used for administration. The nasal tube delivery system comes with a flexible calibrated plastic tube called a rhinyle. The solution is drawn into the rhinyle. One end is inserted into the nostril and the patient (if condition allows) blows the other end to deposit solution deep into the nasal cavity. A nasal spray pump may also be used. Most adults require 0.2 mL daily in two divided doses to control diabetes insipidus. The drug may also be administered via the SC route or direct IV injection. 

Educating the Patient and Family If lypressin or desmopressin is to be used in the form of a nasal spray or is to be instilled intranasally usingthe nasal tube delivery system, the nurse demonstrates the technique of instillation (see Fhtient and Family Teaching Checklist Self-Adnrinistering Nasal Vasopressin). The nurse includes illustrated patient instructions with the drug and reviews them with the patient. If possible, the nurse lias the patient demonstrate the technique of administration. The nurse should discuss the need to take the drug only as directed by the primary health care provider. The patient should not increase the dosage (ie, the number or frequency of sprays) unless advised to do so by the primary health care provider. 

Oxytocin is contraindicated in patients with known hypersensitivity to the drug, cephalopelvic disproportion, unfavorable fetal position or presentation, in obstetric emergencies, situations of fetal distress when delivery is not imminent, severe toxemia (preeclampsia, eclampsia), hypertonic uterus, during pregnancy (intranasal administration), when there is total placenta previa, or to induce labor when vaginal delivery is contraindicated. Oxytocin is not expected to be a risk to the fetus when administered as indicated. When oxytocin is administered with vasopressors, severe hypertension may occur. 

When administering oxytocin intranasally to facilitate the letdown of milk, the nurse places the patient in an upright position, and with the squeeze bottle held upright, administers the prescribed number of sprays to one or both nostrils. The patient then waits 2 to 3 minutes before breastfeeding the infant or pumping the breasts. If a breast pump is being used, the nurse records the amount of milk pumped from the breasts. 

The nasal tissue is highly vascularized and provides efficient systemic absorption. Compared with oral or subcutaneous administration, nasal administration enhances bioavailability and improves safety and efficacy. Chitosan enhances the absorption of proteins and peptide drugs across nasal and intestinal epithelia. Gogev et al. demonstrated that the soluble formulation of glycol chitosan has potential usefulness as an intranasal adjuvant for recombinant viral vector vaccines in cattle [276]. 

Ketamine is a cyclohexane human and veterinary injectable anesthetic that is also known by the slang names K, special K, vitamin K, and cat Valium (Bobo and Miller 2002). It is produced in a liquid form or as a white powder and is usually ingested orally or intranasally but is occasionally administered intramuscularly. Ketamine is a phencyclidine (PCP) analog that was first developed in 1962. 

Further SAR studies on the cyclopentane scaffold have included variation of the hydrophobic side-chain to incorporate a carboxamide substituent (Chand et al. 2004), equivalent to the C6-carboxamide derivatives of zanamivir, and extension of the length of the hydrophobic side-chains (Chand et al. 2005a). Analogues that incorporate a longer 4-heptyl side-chain showed comparable efficacy to 34 upon oral and intranasal administration in mice, and comparable or better efficacy than oseltamivir and zanamivir (Chand et al. 2005a). 

PhUlpotts RJ, Higgins PG, WUlman JS, Tyrrell DA, Freestone DS, Shepherd WM (1984) Intranasal lymphoblastoid interferon ( WeUferon ) prophylaxis against rhinovirus and influenza virus in volunteers. J Interferon Res 4 535-541... 

Besides the inhalative use, the development of a drug formulation for A9-THC has to address other bioavailabihty questions. A major problem is the hpophiUcity and poor solubiUty in water, hmiting oral uptake when given orally. Because of this, other parenteral routes of apphcation are imder investigation like puhnonal uptake by vaporization, subUngual or intranasal administration, and apphcation by injection of A9-THC incorporated in hpo-somes. 

D 2-4 meg IV/SQ daily administered as a single daily dose or in two divided doses n 10-40 meg in 1-3 divided doses intranasally daily... 

Pharmacotherapy for early treatment of ACS is outlined in Fig. 5-3. According to the ACC/AHA ST-segment elevation ACS practice guidelines, in addition to reperfusion therapy, early pharmacotherapy of STE should include intranasal oxygen... 

Up to 80% of asthmatics have symptoms of rhinitis, and inflammation of the upper airways may increase AHR.1,3 Treatment of rhinitis with intranasal corticosteroids may improve asthma symptoms and is recommended for asthma patients with rhinitis. 

Desmopressin (DDAVP) increases the release of factor VIII (von Willebrand factor) from endothelial tissue in the vessel wall. Bleeding time is promptly reduced, within 1 hour of administration, and is sustained for 4 to 8 hours.42 Doses used for uremic bleeding are 0.3 to 0.4 mcg/kg intravenously over 20 to 30 minutes, 0.3 mcg/kg subcutaneously, or 2 to 3 mcg/kg intranasally. Repeated doses can cause tachyphylaxis by... 

Intranasal S. aureus increases the risk of S. aureus exit-site infections, tunnel infections, peritonitis, and subsequent catheter loss.49 Several measures have been used to decrease the risk of peritonitis caused by S. aureus, including mupirocin cream applied daily around the exit site, intranasal mupirocin cream twice daily for 5 days each month, or rifampin 300 mg orally twice daily for 5 days, repeated every 3 months.49 Mupirocin use is preferred over rifampin to prevent the development of resistance to rifampin, although mupirocin resistance has also been reported.49 Other measures that have been used to decrease both S. aureus and P. aeruginosa infections include gentamicin cream applied twice daily and ciprofloxacin otic solution applied daily to the exit site.49... 

Midazolam (Versed) 0.2 mg/kg 2 mg/minute (IVP) N/A Sedation Can also be given IM, buccally, intranasally expensive... 

Midazolam (Versed) 0.2 mg/kg IV bolus followed by 0.05-0.6 mg/kg per hour continuous infusion Bolus dose may also be given intranasally, buccally, or intramuscularly... 

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