Seizing child recieving IN treatmentTherapeutic Intranasal Drug Delivery

Needleless treatment options for medical problems

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Featured new articles and web site sections related to intranasal drug delivery - Contents:

January - December 2020 (Click for link)

          Bouida, W., K. Bel Haj Ali, et al. (2020). "Effect on Opioids Requirement of Early Administration of Intranasal Ketamine for Acute Traumatic Pain." Clin J Pain 36(6): 458-462.

Crawshaw, A. A. and H. R. Cock (2020). "Medical management of status epilepticus: Emergency room to intensive care unit." Seizure 75: 145-152.

Domany, Y., J. Lord, et al. (2020). "Intranasal Ketamine for Alleviation of Acute Suicidal Ideation. An Emergency Department, Trans-Diagnostic Approach: Randomized, Double-Blind, Placebo-Controlled, Proof-of-Concept Trial " SSRN

Huebinger, R. M., H. Q. Zaidi, et al. (2020). "Retrospective Study of Midazolam Protocol for Prehospital Behavioral Emergencies." West J Emerg Med 21(3): 677-683.

Khalil, W. and N. Raslan (2020). "The effectiveness of topical lidocaine in relieving pain related to intranasal midazolam sedation: a randomized, placebo-controlled clinical trial." Quintessence Int 51(2): 162-167.

Sindhur, M., H. Balasubramanian, et al. (2020). "Intranasal fentanyl for pain management during screening for retinopathy of prematurity in preterm infants: a randomized controlled trial." J Perinatol 40(6): 881-887.

January - December 2019 (Click for link)

Akkan, S., S. K. Corbacioglu, et al. (2019). "Evaluating Effectiveness of Nasal Compression With Tranexamic Acid Compared With Simple Nasal Compression and Merocel Packing: A Randomized Controlled Trial." Ann Emerg Med 74(1): 72-78.

Dietze, P., M. Jauncey, et al. (2019). "Effect of Intranasal vs Intramuscular Naloxone on Opioid Overdose: A Randomized Clinical Trial." JAMA Netw Open 2(11): e1914977.

Pruyn, S., J. Frey, et al. (2019). "Quality Assessment of Expired Naloxone Products from First-Responders' Supplies." Prehosp Emerg Care 23(5): 647-653.

Andolfatto, G., K. Innes, et al. (2019). "Prehospital Analgesia With Intranasal Ketamine (PAIN-K): A Randomized Double-Blind Trial in Adults." Ann Emerg Med 74(2): 241-250.

Blancher, M., M. Maignan, et al. (2019). "Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study." PLoS Med 16(7): e1002849.

Lemoel, F., J. Contenti, et al. (2019). "Intranasal sufentanil given in the emergency department triage zone for severe acute traumatic pain: a randomized double-blind controlled trial." Intern Emerg Med 14(4): 571-579.

Sin, B., I. Jeffrey, et al. (2019). "Intranasal Sufentanil Versus Intravenous Morphine for Acute Pain in the Emergency Department: A Randomized Pilot Trial." J Emerg Med 56(3): 301-307.

Frey, T. M., T. A. Florin, et al. (2019). "Effect of Intranasal Ketamine vs Fentanyl on Pain Reduction for Extremity Injuries in Children: The PRIME Randomized Clinical Trial." JAMA Pediatr 173(2): 140-146.

Mozafari, J., M. Maleki Verki, et al. (2019). "Comparing intranasal ketamine with intravenous fentanyl in reducing pain in patients with renal colic: A double-blind randomized clinical trial." Am J Emerg Med.

Nazemian, N., M. Torabi, et al. (2019). "Atomized intranasal vs intravenous fentanyl in severe renal colic pain management: A randomized single-blinded clinical trial." Am J Emerg Med: 158483.

Bregstein, J. S., A. M. Wagh, et al. (2019). "Intranasal Lorazepam for Treatment of Severe Agitation in a Pediatric Behavioral Health Patient in the Emergency Department." Ann Emerg Med.

Khalil, W. and N. Raslan (2019). "The effectiveness of topical lidocaine in relieving pain related to intranasal midazolam sedation: a randomized, placebo-controlled clinical trial." Quintessence Int: 2-7.

Malia, L., V. M. Laurich, et al. (2019). "Adverse events and satisfaction with use of intranasal midazolam for emergency department procedures in children." Am J Emerg Med 37(1): 85-88.

Ryan, P. M., A. J. Kienstra, et al. (2019). "Safety and effectiveness of intranasal midazolam and fentanyl used in combination in the pediatric emergency department." Am J Emerg Med 37(2): 237-240.

Gu, H. B., Y. A. Song, et al. (2019). "Median Effective Dose of Intranasal Dexmedetomidine for Transthoracic Echocardiography in Children with Kawasaki Disease Who Have a History of Repeated Sedation." Med Sci Monit 25: 381-388.

Yang, F., S. Li, et al. (2019). "Fifty Percent Effective Dose of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children With Cyanotic and Acyanotic Congenital Heart Disease." J Cardiothorac Vasc Anesth.

Liu, H., M. Sun, et al. (2019). "Determination of the 90% effective dose of intranasal dexmedetomidine for sedation during electroencephalography in children." Acta Anaesthesiol Scand 63(7): 847-852.

Lei, H., L. Chao, et al. (2019). "Incidence and risk factors of bradycardia in pediatric patients undergoing intranasal dexmedetomidine sedation." Acta Anaesthesiol Scand.

Yang, F., Y. Liu, et al. (2019). "Analysis of 17 948 pediatric patients undergoing procedural sedation with a combination of intranasal dexmedetomidine and ketamine." Paediatr Anaesth 29(1): 85-91.

Owusu, K. A., M. B. Dhakar, et al. (2019). "Comparison of intranasal midazolam versus intravenous lorazepam for seizure termination and prevention of seizure clusters in the adult epilepsy monitoring unit." Epilepsy Behav 98(Pt A): 161-167.

January - December 2018 (Click for link)

Frey, T. M., T. A. Florin, et al. (2018). "Effect of Intranasal Ketamine vs Fentanyl on Pain Reduction for Extremity Injuries in Children: The PRIME Randomized Clinical Trial." JAMA Pediatr.

Kelly, G. S., R. W. Stewart, et al. (2018). "Intranasal fentanyl improves time to analgesic delivery in sickle cell pain crises." Am J Emerg Med 36(7): 1305-1307.

Nunley, S., P. Glynn, et al. (2018). "Healthcare Utilization Characteristics for Intranasal Midazolam Versus Rectal Diazepam." J Child Neurol 33(2): 158-163.

Ostendorf, A. P., K. Merison, et al. (2018). "Decreasing Seizure Treatment Time Through Quality Improvement Reduces Critical Care Utilization." Pediatr Neurol 85: 58-66.

Milesi, C., J. Baleine, et al. (2018). "Nasal midazolam vs ketamine for neonatal intubation in the delivery room: a randomised trial." Arch Dis Child Fetal Neonatal Ed 103(3): F221-F226.

Olgun, G. and M. H. Ali (2018). "Use of Intranasal Dexmedetomidine as a Solo Sedative for MRI of Infants." Hosp Pediatr.

Reynolds, J. and D. J. Sedillo (2018). "The Evolving Role of Intranasal Dexmedetomidine for Pediatric Procedural Sedation." Hosp Pediatr.

January - December 2017 (click for link)

Adelgais, K. M., A. Brent, et al. (2017). "Intranasal Fentanyl and Quality of Pediatric Acute Care." J Emerg Med.

Farnia, M. R., A. Jalali, et al. (2017). "Comparison of intranasal ketamine versus IV morphine in reducing pain in patients with renal colic." Am J Emerg Med 35(3): 434-437.

Mellion, S. A., D. Bourne, et al. (2017). "Evaluating Clinical Effectiveness and Pharmacokinetic Profile of Atomized Intranasal Midazolam in Children Undergoing Laceration Repair." J Emerg Med 53(3): 397-404.

Reynolds, S. L., K. K. Bryant, et al. (2017). "Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures." Acad Emerg Med.

Milesi, C., J. Baleine, et al. (2017). "Nasal midazolam vs ketamine for neonatal intubation in the delivery room: a randomised trial." Arch Dis Child Fetal Neonatal Ed.

Schrier, L., R. Zuiker, et al. (2017). "Pharmacokinetics and pharmacodynamics of a new highly concentrated intranasal midazolam formulation for conscious sedation." Br J Clin Pharmacol 83(4): 721-731.

Smith, D., H. Cheek, et al. (2017). "Lidocaine Pretreatment Reduces the Discomfort of Intranasal Midazolam Administration: A Randomized, Double-blind, Placebo-controlled Trial." Acad Emerg Med 24(2): 161-167.

Sanchez Fernandez, I., M. Gainza-Lein, et al. (2017). "Nonintravenous rescue medications for pediatric status epilepticus: A cost-effectiveness analysis." Epilepsia 58(8): 1349-1359.

Bailey, A. M., R. A. Baum, et al. (2017). "Review of Intranasally Administered Medications for Use in the Emergency Department." J Emerg Med 53(1): 38-48.

McBride, D. L. (2017). "Emergency Departments Increasingly Administering Medications through the Nose." J Pediatr Nurs.

Rech, M. A., B. Barbas, et al. (2017). "When to Pick the Nose: Out-of-Hospital and Emergency Department Intranasal Administration of Medications." Ann Emerg Med 70(2): 203-211.

Nemeth, M., N. Jacobsen, et al. (2017). "Intranasal Analgesia and Sedation in Pediatric Emergency Care-A Prospective Observational Study on the Implementation of an Institutional Protocol in a Tertiary Children's Hospital." Pediatr Emerg Care.

Tsze, D. S., M. Ieni, et al. (2017). "Optimal Volume of Administration of Intranasal Midazolam in Children: A Randomized Clinical Trial." Ann Emerg Med 69(5): 600-609.

Weiner, S. G., P. M. Mitchell, et al. (2017). "Use of Intranasal Naloxone by Basic Life Support Providers." Prehosp Emerg Care 21(3): 322-326.

January-December 2016 (click for link)

Smith, D., H. Cheek, et al. (2016). "Lidocaine Pretreatment Reduces the Discomfort of Intranasal Midazolam Administration: A randomized, double-blind, placebo-controlled trial." Acad Emerg Med.

Crawford, D. (2016). "Implementation of Intranasal Midazolam for Prolonged Seizures in a Child Neurology Practice." J Neurosci Nurs.

Cozzi, G., S. Lega, et al. (2016). "Intranasal Dexmedetomidine Sedation as Adjuvant Therapy in Acute Asthma Exacerbation With Marked Anxiety and Agitation." Ann Emerg Med.

Fenster, D. B., P. S. Dayan, et al. (2016). "Randomized Trial of Intranasal Fentanyl Versus Intravenous Morphine for Abscess Incision and Drainage." Pediatr Emerg Care.

Kurien, T., K. R. Price, et al. (2016). "Manipulation and reduction of paediatric fractures of the distal radius and forearm using intranasal diamorphine and 50% oxygen and nitrous oxide in the emergency department: a 2.5-year study." Bone Joint J 98-B(1): 131-136.

Murphy, A. P., M. Hughes, et al. (2016). "Intranasal fentanyl for the prehospital management of acute pain in children." Eur J Emerg Med.

Fisher, R., D. O'Donnell, et al. (2016). "Police Officers Can Safely and Effectively Administer Intranasal Naloxone." Prehosp Emerg Care: 1-6.

Baier, N. M., S. S. Mendez, et al. (2016). "Intranasal dexmedetomidine: an effective sedative agent for electroencephalogram and auditory brain response testing." Paediatr Anaesth 26(3): 280-285.


October-December 2015 (click for link)

Kavanagh, P. L., P. G. Sprinz, et al. (2015). "Improving the Management of Vaso-Occlusive Episodes in the Pediatric Emergency Department." Pediatrics 136(4): e1016-1025.

April-Sept 2015 (click for link)

Over the counter nasal naloxone!!

Graudins, A., R. Meek, et al. (2015). "The PICHFORK (Pain in Children Fentanyl or Ketamine) trial: a randomized controlled trial comparing intranasal ketamine and fentanyl for the relief of moderate to severe pain in children with limb injuries." Ann Emerg Med 65(3): 248-254 e241.

Schacherer, N. M., D. E. Ramirez, et al. (2015). "Expedited Delivery of Pain Medication for Long-Bone Fractures Using an Intranasal Fentanyl Clinical Pathway." Pediatr Emerg Care.

Belkouch, A., S. Zidouh, et al. (2015). "Does intranasal fentanyl provide efficient analgesia for renal colic in adults?" Pan Afr Med J 20: 407.

Dolatabadi, A. A., M. Shojaee, et al. (2015). "Intranasal sufentanil versus intravenous morphine sulfate in pain management of patients with extremity trauma." Iranian Journal of Emergency Medicine 3(2): 116-121.

Montero, J. V., E. M. Nieto, et al. (2015). "Intranasal midazolam for the emergency management of hypercyanotic spells in tetralogy of fallot." Pediatr Emerg Care 31(4): 269-271.

Brigo, F., R. Nardone, et al. (2015). "Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus: A systematic review with meta-analysis." Epilepsy Behav.

Caron, E., C. E. Wheless, et al. (2015). "The charges for seizures in the pediatric emergency room: a single center study." Pediatr Neurol 52(5): 517-520.

Rando, J., D. Broering, et al. (2015). "Intranasal naloxone administration by police first responders is associated with decreased opioid overdose deaths." Am J Emerg Med.

January-March 2015 (click for link)

Fleet J, Belan I, Jones M, Ullah S, Cyna A. A comparison of fentanyl with pethidine for pain relief during childbirth: a randomised controlled trial. BJOG : an international journal of obstetrics and gynaecology 2015.

Mukherjee A, Das A, Basunia SR, Chattopadhyay S, Kundu R, Bhattacharyya R. Emergence agitation prevention in paediatric ambulatory surgery: A comparison between intranasal Dexmedetomidine and Clonidine. Journal of research in pharmacy practice 2015;4:24-30.

Riediger C, Haschke M, Bitter C, et al. The analgesic effect of combined treatment with intranasal S-ketamine and intranasal midazolam compared with morphine patient-controlled analgesia in spinal surgery patients: a pilot study. J Pain Res 2015;8:87-94.

April-December 2014 (click for link)

Sabzghabaee, A. M., N. Eizadi-Mood, et al. (2014). "Naloxone therapy in opioid overdose patients: intranasal or intravenous? A randomized clinical trial." Arch Med Sci 10(2): 309-314.

Karlsen, A.P., et al., Safety of intranasal fentanyl in the out-of-hospital setting: a prospective observational study. Ann Emerg Med, 2014. 63(6): p. 699-703.

Tsze, D.S., et al., Treatment of tetralogy of Fallot hypoxic spell with intranasal fentanyl. Pediatrics, 2014. 134(1): p. e266-9.

Wagner, K. D., P. J. Davidson, et al. (2014). ""I felt like a superhero": the experience of responding to drug overdose among individuals trained in overdose prevention." Int J Drug Policy 25(1): 157-165.

Weiner, S. G., P. M. Mitchell, et al. (2014). "Use of intranasal naloxone by basic life support providers." Ann Emerg Med 64(4): S52 (Abstract 144).

January-March 2014 (click for link)

Baleine, J., C. Milesi, et al. (2014). "Intubation in the delivery room: experience with nasal midazolam." Early Hum Dev 90(1): 39-43.

Buonsenso, D., G. Barone, et al. (2014). "Utility of intranasal Ketamine and Midazolam to perform gastric aspirates in children: a double-blind, placebo controlled, randomized study." BMC Pediatr 14(1): 67.

Wang, S. S., M. Z. Zhang, et al. (2014). "The sedative effects and the attenuation of cardiovascular and arousal responses during anesthesia induction and intubation in pediatric patients: a randomized comparison between two different doses of preoperative intranasal dexmedetomidine." Paediatr Anaesth 24(3): 275-281.

October-December 2013 (click for link)

Andolfatto, G., E. Willman, et al. (2013). "Intranasal Ketamine for Analgesia in the Emergency Department: A Prospective Observational Series." Acad Emerg Med 20(10): 1050-1054.

Gracia, M. R., L. C. Hortelano, et al. (2013). "Intoxicación  accidental  por  fentanilo intranasal." Anales de Pediatria In press.

Mitra, S., S. Kazal, et al. (2013). "Intranasal clonidine vs midazolam as premedication in children: A randomized controlled trial." Indian Pediatr (In press).

Sharma, R. and R. Harish (2013). "Comparative study of the efficacy of intranasal midazolam vs intravenous midazolam in convulsing neonates and children." RRJMHS 2(4): 54-57.

April - September 2013 (click for link)

Humphries, L. K. and L. S. Eiland (2013). "Treatment of acute seizures: is intranasal midazolam a viable option?" J Pediatr Pharmacol Ther 18(2): 79-87.

Johansson, J., J. Sjoberg, et al. (2013). "Prehospital analgesia using nasal administration of S-ketamine--a case series." Scand J Trauma Resusc Emerg Med 21: 38.

January-March 2013 (click for link)

EMS teaching slide sets with audio embedded.

Articles reviewed:

Etteri, M. and A. Bellone, Intranasal Fentanyl for analgesia in adults with acute renal colic. Emergency Care Journal, 2012. 8(2): p. 13-18.

Coffin, P.O. and S.D. Sullivan, Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Ann Intern Med, 2013. 158(1): p. 1-9.

Compton, W.M., et al., Expanded access to opioid overdose intervention: research, practice, and policy needs. Ann Intern Med, 2013. 158(1): p. 65-6.

Yeaman F, Oakley E, Meek R, Graudins A. Sub-dissociative dose intranasal ketamine for limb injury pain in children in the emergency department: A pilot study. Emerg Med Australas 2013;25:161-7.

October-December 2012 (Click for link to abstracts, editorial and PubMed Link)

Intranasal Ketamine: New Section of the web site reviewing intranasal Ketamine for pain and for sedation - written due to increasing interest on the topic

New Slide sets: Multiple new slides sets related to intranasal drug delivery in EMS, ER, Rural care, Trauma, Hospice and safe injection are posted following a recent lecture tour presenting these topics.

July-Sept 2012 (Click for link to abstracts, editorial and PubMed link)

Stephen, R., E. Lingenfelter, et al. (2012). "Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries." J Opioid Manag 8(4): 237-241.

Thakker, A. and P. Shanbag (2012). "A randomized controlled trial of intranasal-midazolam versus intravenous-diazepam for acute childhood seizures." J Neurol.

Tsze, D. S., D. W. Steele, et al. (2012). "Intranasal Ketamine for Procedural Sedation in Pediatric Laceration Repair: A Preliminary Report." Pediatr Emerg Care 28(8): 767-770.

Sibley, T., R. Jacobsen, et al. (2012). "Successful Administration of Intranasal Glucagon in the Out-of-Hospital Environment." Prehosp Emerg Care.

Harlos, M. S., S. Stenekes, et al. (2012). "Intranasal Fentanyl in the Palliative Care of Newborns and Infants." J Pain Symptom Manage.


April - June 2012 (Click for abstracts, editorial and PubMed Link)

Steenblik, J., et al., Intranasal sufentanil for the treatment of acute pain in a winter resort clinic. Am J Emerg Med, 2012.

January - March 2012 (Click for abstracts, editorial and PubMed Link)

Anderson, M., et al., Pharmacokinetics of buccal and intranasal lorazepam in healthy adult volunteers. Eur J Clin Pharmacol, 2012. 68(2): p. 155-9.

Silbergleit, R., et al., Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med, 2012. 366(7): p. 591-600.

Hirsch, L.J., Intramuscular versus intravenous benzodiazepines for prehospital treatment of status epilepticus. N Engl J Med, 2012. 366(7): p. 659-60.

Kawanda, L., et al., Sedation with intranasal midazolam of Angolan children undergoing invasive procedures. Acta Paediatr, 2012. 101(7): p. e296-8.

Javadzadeh, M., K. Sheibani, et al. (2012). "Intranasal midazolam compared with intravenous diazepam in patients suffering from acute seizure: A randomized controlled trial." Iran J Pediatr 22(1): 1-8.

Hippard, H. K., K. Govindan, et al. (2012). "Postoperative analgesic and behavioral effects of intranasal fentanyl, intravenous morphine, and intramuscular morphine in pediatric patients undergoing bilateral myringotomy and placement of ventilating tubes." Anesth Analg 115(2): 356-363.

October - December 2011 (Click for abstracts, editorial and PubMed Link)

Pestieau, S.R., et al., The effect of dexmedetomidine during myringotomy and pressure-equalizing tube placement in children. Paediatr Anaesth, 2011. 21(11): p. 1128-35.

Antonio, C., J. Zurek, et al. (2011). "Reducing the pain of intranasal drug administration." Pediatr Dent 33(5): 415-419.

Pandey, R. K., S. K. Bahetwar, et al. (2011). "A comparative evaluation of drops versus atomized administration of intranasal ketamine for the procedural sedation of young uncooperative pediatric dental patients: a prospective crossover trial." J Clin Pediatr Dent 36(1): 79-84.


July - September 2011 (Click for abstracts, editorial and PubMed Link)

Klein, E.J., et al., A Randomized Clinical Trial Comparing Oral, Aerosolized Intranasal, and Aerosolized Buccal Midazolam. Ann Emerg Med, 2011.

Mudd, S., Intranasal Fentanyl for Pain Management in Children: A Systematic Review of the Literature. J Pediatr Health Care, 2011. 25(5): p. 316-22

Cheung, C.W., et al., Analgesic and sedative effects of intranasal dexmedetomidine in third molar surgery under local anaesthesia. Br J Anaesth, 2011. 107(3): p. 430-7.


 April - June 2011 (Click for abstracts, editorial and PubMed link)

Carpuject concept (not an article - just an idea very pertinent to this web site topic)

Borland, M., S. Milsom, et al. (2011). "Equivalency of two concentrations of fentanyl administered by the intranasal route for acute analgesia in children in a paediatric emergency department: A randomized controlled trial." Emerg Med Australas 23(2): 202-208.

Lundeberg, S. and J. A. Roelofse (2011). "Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice." Paediatr Anaesth 21(3): 274-279.

Prommer, E. and L. Thompson (2011). "Intranasal Fentanyl for pain control: current status with a focus on patient considerations." Patient Preference and Adherence (open access) 5: 157-164.

January - March 2011 (Click for abstracts, editorial and PubMed link)

Wolfe, T. R. and D. A. Braude (2010). "Intranasal medication delivery for children: a brief review and update." Pediatrics 126(3): 532-537.

Chiaretti, A., G. Barone, et al. (2011).  Intranasal lidocaine and midazolam for procedural sedation in children. Arch Dis Child 96:160-163

Arya, R., S. Gulati, et al. (2011). "Intranasal versus intravenous lorazepam for control of acute seizures in children: A randomized open-label study." Epilepsia

Bendall, J. C., P. M. Simpson, et al. (2011). "Effectiveness of Prehospital Morphine, Fentanyl, and Methoxyflurane in Pediatric Patients." Prehosp Emerg Care.

Johnston, S., G. J. Wilkes, et al. (2011). "Inhaled methoxyflurane and intranasal fentanyl for prehospital management of visceral pain in an Australian ambulance service." Emerg Med J 28(1): 57-63.

Reid, C., R. Hatton, and P. Middleton, Case report: prehospital use of intranasal ketamine for paediatric burn injury. Emerg Med J, 2011. 28(4): p. 328-9.