Nasal inhalation

Decongestants are used to treat the congestion associated with rhinitis, hay fever, allergic rhinitis, sinusitis, and the common cold. In addition, they are used in adjunctive therapy of middle ear infections to decrease congestion around the eustachian tube Nasal inhalers may relieve ear block and pressure pain during air travel. Many can be administered orally as well as topically, but topical application is more effective than the oral route. 

The influenza vaccine is available in two forms, injectable and nasal inhalation. The injectable is an inactivated vaccine... 

Ophthalmic corticosteroids (high risk) Systemic corticosteroids Nasal/inhaled corticosteroids Fenoldopam... 

Schlesinger, R.B., Naumann, B.D., and Chen, L.C., Physiological and histological alterations in the bronchial mucociliary clearance system of rabbits following intermittent oral or nasal inhalation of sulfuric acid mist, J. Toxicol. Environ. Health. 12, 2-3, 441, 1983. 

Adults and children 12 years of age and older - 1 or 2 nasal inhalations (42 to 84 meg) in each nostril twice daily (total dose, 168 to 336 meg/day). 

Children 6 to 11 years of age - Start with 1 nasal inhalation in each nostril twice daily (168 meg). Patients not adequately responding or those with more severe symptoms may use 2 sprays in each nostril twice daily (336 meg/day). 

Nicotine Nasal Spray (Nicolrol NS) [Smoking Deterrent/ Cholinergic] Uses Aid to smoking cessation, relieve nicotine withdrawal Action Systemic delivery of nicotine Dose 0.5 mg/actuation 1-2 sprays/h, 10 sprays/h max Caution [D, M] Contra Life-threatening arrhythmias, unstable angina Disp Nasal inhaler SE Local irritation, tach, HA, taste p v sion Interactions T Effects W/ cimetidine, black cohosh t effects OF catecholamines, cortisol T hemodynamic AV blocking effects OF adenosine EMS See Nicotine Gum OD See Nicotine Gum... 

Acute relief of angina pectoris Nasal inhalation Place crushed capsule to nostrils for 0.18-0 3 ml inhalation of vapors. Repeat at 5-10 min intervals. No more than 3 doses in 15-30 min period. 

Long-term control of Bronchial asthma, reduces need for oral corticosteriod therapy for asthma Oral Inhalation 40-160 meg twice a day. Maximum 320 meg twice a day. Rhinitis, prevention of recurrence of nasal polyps Nasal Inhalation 1 spray in each nostril 2-4 times a day or 2 sprays twice a day. Maintenance 1 spray 3 times a day. 

The goal of treatment is to reduce bone pain and stabilize or prevent other problems such as progressive deformity, hearing loss, high-output cardiac failure, and immobilization hypercalcemia. Calcitonin and bisphosphonates are the first-line agents for this disease. Treatment failures may respond to plicamycin. Calcitonin is administered subcutaneously or intramuscularly in doses of 50-100 MRC (Medical Research Council) units every day or every other day. Nasal inhalation at 200-400 units per day is also effective. Higher or more frequent doses have been advocated when this initial regimen is ineffective. Improvement in bone pain and reduction in serum alkaline phosphatase and urine hydroxyproline levels require weeks to months. Often a patient who responds well initially loses the response to calcitonin. This refractoriness is not correlated with the development of antibodies. 

Amphetamine was once used in nasal inhalers but was banned in 1959 because abusers removed the inner filling and chewed it. Now propylhexedrine, with about half the potency of amphetamine, is used. This still causes problems in that some desperate souls will leach the compound from the inhaler s cotton wick and inject the extract (called "crank"). This presents all kinds of... 

Mucosal tolerance is a meanwhile well-accepted phenomenon, which was initially referred to as oral tolerance , because it was first recognized after feeding antigen [14], As immunological unresponsiveness - characterized by a refractory or diminished capability to develop an immune response upon systemic reexposure to the specific antigen - can also be achieved after antigen administration via the nasal, inhalative, rectal or genital route, it is now more broadly referred to as mucosal tolerance. 

Amphetamine attracted a widespread audience in 1932, when it was marketed as the nasal inhaler Benzedrine by the pharmaceutical company Smith Kline French. Amphetamine is still widely used as a bronchio dilator, allowing asthmatics to breathe more freely. 

Snuff 1) Finely powdered tobacco, whicli may be inhaled or placed in the mouth. 2) Any finely powdered drug intended for nasal inhalation. 3) To take a drug in powdered form by nasal inhalation. 

Early nasal inhalers contained strips ot paper impregnated with amphetamine. Many users experienced general stimulation from them some got high, and some became dependent. Some even broke open the containers and extracted the amphetamine in order to put it into their bodies in other ways Eventually manufacturers stopped using amphetamine in nasal inhalers, replacing It with other drugs supposed to be less stimulating and less addictive. 

Metered dose inhalers (MDIs) are pharmaceutical delivery systems designed for oral or nasal use, which deliver discrete doses of aerosolized medicament to the respiratory tract. The MDI contains the active substance, dissolved or suspended in a liquefied propellant system held in a pressurized container that is sealed with a metering valve. Actuation of the valve discharges a metered dose of medicament as an aerosol spray through an actuator during oral or nasal inhalation. 

In the form of the volatile base, propylhexedrine is used in nasal inhalers it is also a component of some liquid decongestant mixtures. When inhaled, and especially if over-used, it can cause nasal irritation, rebound congestion, and chronic rhinitis. 

Aerosols designed specifically for oral and nasal inhalation need not contain this statement.)... 

Johnson DC, Petru A, Azimi PH. Foreign body pulmonary granulomas in an abuser of nasally inhaled drugs. Pediatrics 1991 88 159-161. 

Tire following agents arc also available in nasal inhalers for the treatment of allergic rhinitis. Details are provided below for the mode of metabolic inactivation involved for each of thc.se products. Although all of these agents have much lower systemic effects th in the oral steroids, some. systemic effects, us measured by suppression of the hypotha-lamic-pituitary-adrcnal (HPA) axis, have been observed fur these products. 

Another stable derivative of PGIj, iloprosi, is intended for nasal inhalation to provide a direei vasodilaiory effect on pulmonary blood vessels and thus decrease vascular resistance. Currently available in Europe, patients inhale 6 to 8 puffs of aerosolized iluprost every 2 to 3 hours. Side effects such as coughing, headaches, and jaw pain have been reported. 

It can be squirted from a water pistol or nasal inhaler, poured on the floor or vaporized by a bomb described under stinkum. 

Amphetamine itself was synthesized in 1887 and first studied as early as 1910, but its stimulant effects were not discovered until about 1930. Amphetamine was independently resynthesized in 1927 by the noted psychopharmacologist Gordon Alles in a program to develop synthetic substitutes for ephedrine, a drug then being used as a bronchodilator for the treatment of asthma (6). The central stimulant effects of amphetamine were probably noted about 1930, when it appeared in nasal inhalers in Germany. The first medical use for amphetamine was in the treatment of... 

The CNS effects of S(+)-methamphetamine are about 10 times greater than those of R(-)-methamphetamhie, but the latter drug has greater vasoconstrictive properties than the former.Because of the minimal CNS activity and thus low abuse potential, R( )-methamphetamine is included in some nonprescription nasal inhalants (e.g., Vick s) for its vasoconstrictive properties. 

Chiral discrimination of methamphetamine isomers may be necessary to distinguish use of nonprescription nasal inhalants (R[-]-methamphetamine) from illicit use of S(-t)-methamphetamine. Some immunoassays have high specificity for S(-l-)-methamphetamine. However, definitive enantio-discrimination requires the use of a chiral derivati-zation reagent to form diastereomers of R- and S-metham-phetamine, which may be resolved using conventional GC-MS (see Figure 34-20). The Department of Defense requires chiral resolution of methamphetamine isomers. For the test to be considered positive for illicit methamphetamine use, S(-l-)-methamphetamine must be >20% of the total methamphetamine content (Table 34-8). 

Fitzgerald RL, Ramos JM Jr, Bogema SC, Poklis A. Resolution of methamphetamine stereoisomers in urine drug testing Urinary excretion of R( )-methamphetamine following use of nasal inhalers. J Anal Toxicol 1988 12 255-9. 

Table 1 Additives in Currently Manufactured Oral and Nasal Inhalants... 

Systemic corticosteroids Nasal/inhaled corticosteroids Fenoldopam... 

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