Nasal drug delivery is one of the more overlooked methods of drug administration. Research is just starting to catch up to the widespread prescribing of nasal sprays by physicians. The nasal sprays most patients will be familiar with are things like decongestants for cold symptom relief and antihistamines for relief of allergy symptoms. However there are many other conditions that can be treated with nasally administered medications.
History of Nasal Drug Delivery
The first nasal spray devices looked a lot like perfume bottles and involved a bulb-shaped pump that forced the medication through a nozzle. Nasal spray bottles have been available commercially for many years to help with congestion and allergies. You can see an example of a nasal spray bottle from the 1950s here, which contained phenylephrine for decongestion.
It is only recently that the nasal delivery method has become more popular. Research into nasal drug delivery is increasing as new intranasal drugs are brought to market. In the meantime, compounding pharmacies are helping patients get the nasal medications they need that are not yet commercially available.
Systemic vs. Local Effects
The goal of many nasal spray treatments is to target the nasal passages and sinuses while minimizing systemic effects. Larger particle sizes will not penetrate to the lungs, ensuring the medication stays in the area being treated. Some nasal sprays with small particle sizes are meant to have systemic effects, and can be used as an alternative to oral or injectable delivery methods. The flu vaccine nasal spray is an example of this.
Locally administered nasal sprays generally limit the risk of producing systemic effects. They are often given in low doses intended only to affect the targeted area. Particles above a certain range (usually about 10 micrometers), will not enter the lungs. This is essential to prevent systemic effects from drugs meant to only affect the nasal area.
Uses for Local Nasal Sprays
Nasal sprays intended to affect just the nasal passages and sinuses may include antibiotic, antifungals, antihistamines, chelating agents, and more. Patients suffering from chronic rhinosinusitis are often prescribed a topical nasal spray to help manage their symptoms. A liquid solution is ideal as nasal conditions can often cause dryness. A nasal spray can both effectively deliver medication and also cleanse the nasal passages.
Local nasal spray delivery devices like atomizers may be used with a simple saline rinse as well. A non-medicated rinse can help cleanse the nasal passages to improve comfort and breathing. The majority of breathing occurs through the nose, and oral breathing usually only comes in during intense exercise or when the nasal passages are blocked. That is why it is essential to ensure the nasal passages are clear when a patient is experiencing rhinosinusitis.
Intranasal Drug Devices
Locally administered nasal medications can be applied with a variety of devices. Most often they are administered with a metered-dose nasal spray bottle or an automated device. A battery-powered atomizer device like the Rhino Clear Sprint sends a spray of medication that can reach the sinus passages. The NasaTouch was a popular atomizer device for several years but is no longer manufactured. It has now been replaced with the Rhino Clear as the preferred atomized nasal device. The Rhino Clear can be purchased here. The high-intensity spray of the Rhino Clear is able to penetrate deeply into the sinuses.
With nasal spray bottles, it is often advisable to administer the medication in a supine position. This can help the medication reach into the sinuses. The patient should then briefly continue to lay in a supine position to allow the medication to reach further into the sinuses. Nasal spray bottles can deliver a consistent amount of medication with each spray.
Research
- Nasal drug delivery devices: characteristics and performance in a clinical perspective—a review – PubMed
- Rhino Clear Atomizer Website