Cargando…
The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters
Nasal administration of treatments for neurologic conditions, including rescue therapies to treat seizure clusters among people with epilepsy, represents a meaningful advance in patient care. Nasal anatomy and physiology underpin the multiple advantages of nasal administration but also present chall...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829802/ https://www.ncbi.nlm.nih.gov/pubmed/36636458 http://dx.doi.org/10.1016/j.ebr.2022.100581 |
_version_ | 1784867538179457024 |
---|---|
author | Chung, Steve Peters, Jurriaan M. Detyniecki, Kamil Tatum, William Rabinowicz, Adrian L. Carrazana, Enrique |
author_facet | Chung, Steve Peters, Jurriaan M. Detyniecki, Kamil Tatum, William Rabinowicz, Adrian L. Carrazana, Enrique |
author_sort | Chung, Steve |
collection | PubMed |
description | Nasal administration of treatments for neurologic conditions, including rescue therapies to treat seizure clusters among people with epilepsy, represents a meaningful advance in patient care. Nasal anatomy and physiology underpin the multiple advantages of nasal administration but also present challenges that must be addressed in any successful nasal formulation. Nasal cavity anatomy is complex, with a modest surface area for absorption that limits the dose volume of an intranasal formulation. The mucociliary clearance mechanism and natural barriers of the nasal epithelia must be overcome for adequate absorption. An extensive vasculature and the presence of olfactory nerves in the nasal cavity enable both systemic and direct-to-brain delivery of drugs targeting the central nervous system. Two intranasal benzodiazepine rescue therapies have been approved by the US Food and Drug Administration for seizure-cluster treatment, in addition to the traditional rectal formulation. Nasal sprays are easy to use and offer the potential for quick and consistent bioavailability. This review aims to increase the clinician’s understanding of nasal anatomy and physiology and of the formulation of intranasal rescue therapies and to facilitate patient education and incorporate intranasal rescue therapies for seizure clusters (also known as acute repetitive seizures) into their seizure action plans. |
format | Online Article Text |
id | pubmed-9829802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-98298022023-01-11 The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters Chung, Steve Peters, Jurriaan M. Detyniecki, Kamil Tatum, William Rabinowicz, Adrian L. Carrazana, Enrique Epilepsy Behav Rep Article Nasal administration of treatments for neurologic conditions, including rescue therapies to treat seizure clusters among people with epilepsy, represents a meaningful advance in patient care. Nasal anatomy and physiology underpin the multiple advantages of nasal administration but also present challenges that must be addressed in any successful nasal formulation. Nasal cavity anatomy is complex, with a modest surface area for absorption that limits the dose volume of an intranasal formulation. The mucociliary clearance mechanism and natural barriers of the nasal epithelia must be overcome for adequate absorption. An extensive vasculature and the presence of olfactory nerves in the nasal cavity enable both systemic and direct-to-brain delivery of drugs targeting the central nervous system. Two intranasal benzodiazepine rescue therapies have been approved by the US Food and Drug Administration for seizure-cluster treatment, in addition to the traditional rectal formulation. Nasal sprays are easy to use and offer the potential for quick and consistent bioavailability. This review aims to increase the clinician’s understanding of nasal anatomy and physiology and of the formulation of intranasal rescue therapies and to facilitate patient education and incorporate intranasal rescue therapies for seizure clusters (also known as acute repetitive seizures) into their seizure action plans. Elsevier 2022-12-28 /pmc/articles/PMC9829802/ /pubmed/36636458 http://dx.doi.org/10.1016/j.ebr.2022.100581 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Chung, Steve Peters, Jurriaan M. Detyniecki, Kamil Tatum, William Rabinowicz, Adrian L. Carrazana, Enrique The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title | The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title_full | The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title_fullStr | The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title_full_unstemmed | The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title_short | The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
title_sort | nose has it: opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829802/ https://www.ncbi.nlm.nih.gov/pubmed/36636458 http://dx.doi.org/10.1016/j.ebr.2022.100581 |
work_keys_str_mv | AT chungsteve thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT petersjurriaanm thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT detynieckikamil thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT tatumwilliam thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT rabinowiczadrianl thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT carrazanaenrique thenosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT chungsteve nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT petersjurriaanm nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT detynieckikamil nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT tatumwilliam nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT rabinowiczadrianl nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters AT carrazanaenrique nosehasitopportunitiesandchallengesforintranasaldrugadministrationforneurologicconditionsincludingseizureclusters |