Seizing child recieving IN treatmentTherapeutic Intranasal Drug Delivery

Needleless treatment options for medical problems

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Intranasal Drug Delivery - Full Length Peer Reviewed Medical Articles:

Please see bibliography section for abstracts of all references listed in this web site. This section contains full articles and web links to full articles.


Intranasal Midazolam for seizures

Holsti, Prehospital intranasal midazolam for the treatment of pediatric seizures, Ped Emerg Care 2007 (click here for web site link)

Klein-Kremer, Intranasal midazolam for the treatment of seizures in children in the Emergency setting, Isreali J EM 2007 (click here) - PDF 0.13 MB

Lahat, IN midazolam for seizures, BMJ 2000 (click here) - PDF 0.25 MB

Krykou, IN midazolam for community seizure therapy, Epilepsy Australia 2006 (click here) - PDF 0.44 MB

Segal, An alternate route of drug administration in acute convulsions, IMAJ 2000 (click here) - PDF 0.09 MB

Bhattacharyya, Intranasal midazolam vs rectal diazepam in acute childhood seizures, Pediatr Neurol 2006

Whitesell, IN midazolam vs rectal diazepam - synthesis of the evidence, J Ped Healthcare 2009 abstract

Ma, Clinical Guidelines on Management of Prolonged Seizures, HK J Paediatrics 2010 - MS word file

Intranasal Lorazepam for seizures

Ahmad, Intranasal lorazepam vs intramuscular paraldehyde for prolonged convulsions, Lancet 2006

French JA.. Benzo vs Benzo: And the winner is.. Epilepsy Curr 2011;11(5):143-144

Lissauer, S., J. Kenny, et al. (2015). "Buccal, intranasal or intravenous lorazepam for the treatment of acute convulsions in children in Malawi: An open randomized trial." African Journal o f Emergency Medicine 5: 120-126.


Intranasal Midazolam for sedation

Al-Rakaf, Intra-nasal midazolam for conscious sedation of pediatric dental patients, Int J Ped Dentistry 2001 (click here) -  PDF 0.32 MB

Manley, IN and IV midazolam for sedation in adults with learning disability, Br Dent Journal 2008. - PDF 0.18 MB

Morgans-Perri, MAD for IN midazolam pre-op, J Perianesthtic Nursing 2009 abstract

Koppal R, Adarsh ES, Ambi U, Anilkumar G. Comparison of the midazolam transnasal atomizer and oral midazolam for sedative premedication in paediatric cases. JCDR 2011;5:932-934

Intranasal ketamine for sedation

Kazemi, Intranasal ketamine versus intranasal midazolam for preoperative sedation in children, Pak J Med Sci 2005 (click here) - PDF 0.12 MB

Gharde, IN ketamine and IN midazolam for sedation of children with Tetralogy of Fallot, Ann Cardiac Anesth 1996 (click for web site link)

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.

Buonsenso, IN ketamine and midazolam for pediatric gastric aspiration, BMC Peds 2014

Intranasal Dexmedetomidine for sedation and premedication before anesthesia

Yuen, Sedative effects of intranasal dexmetetomidine, Anesth Analg 2007

Sundaram, A comparative evaluation of intranasal dexmedetomidine and intranasal midazolam for premedication in children: A double blind RCT. JIDA 2011;5(7):777-781. (Free Access)

Hitt, IN sufentanil and DME for pediatric dental sedation, Pharmaceutics 2014 (open access)

Sulton, The use of intranasal dexmedetomidine for pediatric sedation: A report from the pediatric sedation research consortium. 2014 abstract

Intranasal clonidine for sedation and premedication before anesthesia


Sokoloff, Time to analgesia reduces ED LOS, BMJOpen 2014 open access

Intranasal Morphine for pain

Fitzgibbon, Nasal Morphine for breakthrough pain, Pain  2003 (click here) - PDF 0.15 MB

Maroli, IN ketorolac for dental pain, J INt Oral 2014 open access

Intranasal Fentanyl for pain

Borland, A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department, Ann Emerg Med 2007 (click here for web site link)

Rickard, A randomized controlled trial of intranasal fentanyl vs intravenous morphine for analgesia in the prehospital setting, 2007 (click here for web site link)

Borland, Intranasal fentanyl vs oral morphine prior to dressing changes for pediatric burns, Burns 2005

Finn, RCT of intranasal fentanyl vs oral morphine prior to dressing changes in adult burn unit, Burns 2004

Striebel, Intranasal fentanyl PCINA to treat post operative pain, Anesth Analg 1996 (click here for web site link)

McLean, IN fentanyl use in ski resort, WMJ 2009

Chaplin, Instanyl for breakthrough pain, Prescriber 2010

Prommer, Intranasal fentanyl for pain control, current status with focus on patient preference. Patient preference and adherence 2011

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

Intranasal Sufentanil for pain

Heshmati, Intranasal sufentanil for postoperative pain control in lower abdominal pediatric surgery, IJPT 2006 (click here) - PDF 0.14 MB

Matheiu, Intranasal sufentanil is effective for postoperative analgesia in adults, Can J Anaesthesia 2006 (click here) - PDF 0.32 MB

Helmers, Comparison of intravenous and intranasal sufentanil absorption and sedation, Can J Anaesth 1989 (click here) - PDF 0.39 MB

Jackson, Intranasal sufentanil for breakthrough pain - preliminary trial, J Pain and Symptom Management 2002

Liang, IN sufentanil or fentanyl for emergence agitation, Pak J Sci 2014 open access

Intranasal Diamorphine for pain

Kendall, Multicenter RCT of nasal diamorphine for analgesia in children and teenagers with clinical fractures, BMJ 2001 (click here) - PDF 0.28 MB

Atkinson, Pain management and sedation for children seen in the emergency room, BMJ 2009

NHS IN diamorphine protocol 2010

British association for emergency medicine pediatric pain protocol (click here).

Intranasal Ketamine for pain

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.


Intranasal Naloxone (Narcan)

Barton, Intranasal naloxone as a needleless alternative for treatment of opiate overdose in the prehospital setting, J Emerg Med 2005 (Click here for web site link)

Kelly, A randomized trial of intranasal versus intramuscular naloxone for prehospital treatment of suspected opiate overdose, Med J Aust 2005 (click here) - PDF 0.23 MB

Kerr, Effectiveness and safety of IN naloxone versus IM naloxone for treatment of heroin overdoses, Addiction 2009

Maryland House bill 368 approving home use of IN naloxone to reduce heroin overdose deaths (click here) - (PDF)

Doe-Simkins, M., et al., Saved by the nose: bystander-administered intranasal naloxone hydrochloride for opioid overdose. Am J Public Health, 2009

Project Lazarus

Kim, Expanded access to naloxone, Am J Public Health 2009

Dasgupta, Opioid OD - a prescription for harm prevention, Am J Lifestyle Med 2009

Wermeling, Opioid Harm Reduction strategies: Expanding access to intranasal naloxone, Pharmacotherapy 2010

 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.

Davis, C.S., et al., Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts. Am J Public Health, 2014. 104(8): p. e7-9.

Doe-Simkins, M., et al., Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: a retrospective cohort study. BMC Public Health, 2014. 14: p. 297.

Samuels, E., Emergency department naloxone distribution: a rhode island department of health, recovery community, and emergency department partnership to reduce opioid overdose deaths. R I Med J (2013), 2014. 97(10): p. 38-9.

Wagner, K.D., et al., "I felt like a superhero": the experience of     responding to drug overdose among individuals trained in overdose prevention. Int J Drug Policy, 2014. 25(1): p. 157-65. - go to the end of the series for this document

W.H.O. (World Health Organization) 2014 recommendations regarding Community management of opioid overdose - download the PDF

Burris, Stopping an invisible epidemic - legal issues related to naloxone distribution, Temple Law 2009

Hammet, Pharmacies as providers of expanded health access for PWID, BMC Health 2014 Open access

Doyon, S., S. E. Aks, et al. (2014). "Expanding access to naloxone in the United States." J Med Toxicol 10(4): 431-434.

Intranasal Flumazenil (Anexate, Romazicon)

Heard, C., P. Creighton, and J. Lerman, Intranasal flumazenil and naloxone to reverse over-sedation in a child undergoing dental restorations. Paediatr Anaesth, 2009.


Krempl, Intranasal oxymetazoline for the treatment of epistaxis, Ann Otol Rhinol Laryngol 1995


Intranasal vasoconstrictor articles

Intranasal anesthetic articles

VHA and the National center for patient safety guide to the use of topical anesthetics (click here)  - PDF 0.2 MB

Wolfe, Atomized lidocaine prior to NG tube placement, Ann Emerg Med 2000


Intranasal glucagon articles

Pontiroli, Intranasal glucagon raises blood glucose concentrations in healthy volunteers, BMJ 1983 (click here) - PDF 0.47 MB


Tomaszewski, Off-Label: Just what the doctor ordered, J Medical Toxicology 2006 (click here) - PDF 0.13 MB


Review articles

Goldman, Intranasal drug delivery in children, Curr Drug Therapy 2006 (click here) - PDF 0.15 MB

Stanley, Anesthesia for the 21st Century, BUMC Proceedings 2000 (click here) - PDF 0.05 MB

Telegaonkar, Intranasal delivery- An approach to bypass the blood brain barrier, Ind J Pharm 2004 (click here) - PDF 0.6 MB

Wolfe, Intranasal Medications in EMS, JEMS 2003 (click here) - PDF 0.33 MB

Pires, Intranasal drug delivery - How why what for -extensive review, J Pharm Pharmaceut Sci 2009

Alsarra, Vesicular systems for IN delivery 2009.pdf

Mercus, Influence of head postion and anatomy on nasal drug deposition, Rhinology 2006.pdf

Chris Colwell MD - The Nose Knows: Intranasal Medication options are growing (presentation at Gathering of Eagles EMS conference Feb 2011)

Warrington, Use of intranasal medications in pediatrics, Pharmacology Update on Orthopedics supersite 2011

Callopy and Snyder, Intranasal drug delivery in EMS. EMS today May 2011

Wolfe and Braude, Intranasal medication delivery for children: A brief review and update. Pediatrics 2010

Nose Brain pathway

Ying, The nose may help the brain: Intranasal drug delivery for treating neurologic diseases, Future Neurology 2008 (click here) - PDF 1.4 MB

Nosy neuroprotection - discussion of the nose brain pathway

Hanson, IN drugs for neurodegenerative disorders, Policy Holder Advocate.pdf

Talegaonkar, Intranasal delivery - An approach to bypass the blood brain barrier, Indian J Pharm 2004.pdf

Westin, Olfactory transfer of analgesic drugs after nasal administration, Thesis paper 2007

Putheti, Nasal drug delivery in biotech, e-Journal Science 2009.pdf