Therapeutic
Intranasal Drug DeliveryInformational Links Related to Intranasal medication delivery
CONTACT INFORMATION for specific questions not addressed on this web site:
E-mail address - info@intranasal.net
(Be aware that we only check this e-mail during the times we update the site - about every 2 to 4 weeks. So if you are in a hurry you may be disappointed)
INTERNET DISCUSSIONS regarding IN therapy
Reviews
Med Scape review of the article
Life in the fast lane - review of this (intranasal.net) web site
Pain discussions
- Intranasal fentanyl relieves breakthrough cancer pain
- German document on intranasal fentanyl for breakthrough pain and dyspnea
- Industry sponsored discussion of intranasal pain medications
- Intranasal fentanyl superior to oral transmucosal fentanyl for treatment of breakthrough pain in cancer patients
- Intranasal fentanyl or intravenous morphine for analgesia in adults - Best Bets evidence based topic review.
- Intranasal Fentanyl versus parenteral opiates for acute pain in children - Best Bets evidence based topic review.
- Prommer et al, Intranasal fentanyl review article 2011
- Nose Candy - IN drugs in pediatric ER practice
- Stay on top of kids pain in the ED (use IN fentanyl) - ACEP news December 2010
- Orthopedic use of intranasal medications
- Intranasal fentanyl for palliative care in neonates who are going to die.
- Comprehensive pain management (including IN fentanyl if needed) reduces children's memory of pain in the ED.
- Painfree ED
EMS links of interest
- A Call for Widespread Application of Intranasal Medication Delivery in the Prehospital Environment
-
The Nose Knows - cost effectiveness of transnasal therapy
- Australian Lay public education regarding treating seizures, calling 911 and using intranasal midazolam (PDF 0.2 MB)
- New South Wales EMS protocol for pediatric seizures (PDF 0.17 MB)
- Intranasal naloxone blog with Debra Kerr (researcher)
- Audio interview with Debra Kerr - IN naloxone researcher
- Project Lazarus - Home IN naloxone
- Legality of home naloxone - North Carolina
- Legality of home naloxone - Massachusetts
- Outpatient delivery of naloxone to reduce opioid overdose deaths
- San Diego county EMS protocol updates 2009 including discussion of nasal medication delivery
- Contra Costa EMS update 2010 (Intranasal naloxone pp 38-50)
- Intranasal fentanyl use in ski resort
- Inhaled methoxyflurane vs intranasal fentanyl for adult visceral pain in an ambulance
- Dyer, Snuffing out the overdose: The Boston BLS nasal naloxone program slide presentation (11 MB)
- BioTel (Dallas TX) presentation on EMS use of fentanyl and midazolam
- Intranasal Versed usage - Paramedic perception of Utility in urban EMS system (Columbus OH)
- Use of IN naloxone by ALS and BLS providers in Boston MA
- National public radio - Overdose rescue kits save lives
- New York City Naloxone Rescue kit directions
- Chris Colwell, MD - The Nose Knows: Intranasal Medications options are growing (Gathering of Eagles EMS conference feb 2011)
- Excited Delirium in EMS - treatment with IN midazolam, Emergency Medicine News October 2010
- Prepackaged syringes of drug ready for use with an atomizer - cool idea
- Clark County Nevada (Las Vegas) EMS protocols including intranasal medication delivery as an intermediate skill - Sept 2010 update
- Intranasal naloxone as a layperson administered procedure - the Massachusetts experience
- Intranasal fentanyl in EMS discussion (Editorial comment - the dose is too low - 1.5 to 2 mcg/kg should be used as initial dose. If you only give an adult 75 mcg you can expect it to fail so don't make this common error)
Hospice links of interest
- Palliative info web site by Mike Harlos, MD
- Lecture slides by Dr. Portenoy (Beth Isreal) regarding breakthrough Pain in hospice patients
- www.palliativedrugs.com
Sedation discussions
- Blog List serve discussion regarding intranasal Precedex (dexmedetomidine) for CT scanning in children
- Another very detailed link discussing IN Precedex for pediatric sedation in multiple settings in the hospital
- Discussion of a recent abstract that showed IN midazolam was superior to either buccal or oral midazolam
- Excited Delirium in EMS - treatment with IN midazolam, Emergency Medicine News October 2010
- Intranasal or buccal midazolam a useful alternative to oral administration in children?
- Lidocaine eliminates the burning and bitter taste associated with intranasal midazolam.
POSTED INTERNET ARTICLES (to go to peer reviewed articles for more PDF and web linked articles - click here)
Nose Brain Pathway articles
- Nosy neuroprotection - discussion of the nose brain pathway
- Hanson, IN drugs for neurodegenerative disorders, Policy Holder Advocate.pdf
Pain Articles
- Fitzgibbon, Nasal morphine for breakthrough pain, Pain 2003
- Industry sponsored articles in nasal pain medications
- British association for emergency medicine pediatric pain protocol (click here).
- Borland, IN fentanyl vs IV morphine for fractures in children randomized controlled trial, Ann Emerg Med 2007
- Sitte, IN fentanyl for episodic breathlessness, J pain sym manage 2008
- Rickard, IN fentanyl vs IV morphine for fractures in the prehospital setting, 2008
- Heshmati, IN sufentanil for postoperative pain, IJPT 2006
- Wilson, IN diamorphine for pediatric analgesia, J Accid EM 1998
Sedation articles
- Bkakta, IN midazolam for preoperative sedation, Ind J Anaesth 2007
- Hollenhorst, IN midazolam to prevent claustrophobia, AJR 2001
- Mathai, Preanesthetic sedation of preschool children: Comparison of intranasal midazolam versus oral promethazine. Anesth Essays Res 2011.
Seizure articles
- Lahat, IN midazolam vs IV diazepam for pediatric seizures, BMJ 2000
- Whitesell, IN midazolam vs rectal diazepam in status without an IV line - the evidence supports nasal midazolam, Abstract at NAPNP national conference 2009
- Ma, Clinical Guidelines on Management of Prolonged Seizures, HK J Paediatrics 2010
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- Klein-Kremer, IN midazolam for treating seizures in children in the emergency setting. Is J Med 2007
- Holsti, Prehospital IN midazolam for pediatric status epilepsy, Ped Emerg Care 2007
- French JA.. Benzo vs Benzo: And the winner is.. Epilepsy Curr 2011;11(5):143-144.
Intranasal Naloxone articles
- Kerr, IN verus IM naloxone for the treatment of heroin overdose, Addiction 2009
- Leavitt, Intranasal naloxone: Overcoming opiate overdose
- Wermeling, Opioid harm reduction strategies: focus on expanded access to intranasal naloxone. Pharmacotherapy 2010
- Leavitt, Intranasal naloxone for at home opioid rescue, Practical Pain Management October 2010
- Merlin, IN naloxone is an alternate to IV naloxone, Am J EM 2010
- Barton, IN naloxone as a needleless alternative to treatment of opioid overdose in the prehospital setting, J Emerg Med 2005
Topical anesthetic articles
- A guidance for the use of topical anesthetics for nasal/oropharyngeal and laryngotracheal procedures
- Chan, Lidocaine spray prior to NGT placement, Hong Kong Medical Journal 2010
- Whit Fisher, MD Procedurettes - how to create a NGT frozen curve to enhance passage through nose - link to video
Pediatric reviews
- Intranasal drug delivery in Children - by Ran Goldman, MD
- Intranasal drug delivery in the ER (2004 - relatively old article) - J Emerg Nursing
INTRANASAL DRUG DELIVERY REVIEWS AND MISC
- References for incident pain and incident dyspnea protocol
- Pires, Intranasal drug delivery - How, why, what for -extensive review, J Pharm Pharmaceut Sci 2009
- Naleen Bhandari, Intranasal medication delivery overview.ppt
- Alsarra, Vesicular systems for IN delivery 2009.pdf
- Putheti, Nasal drug delivery in biotech, e-Journal Science 2009.pdf
- Mercus, Influence of head position and anatomy on nasal drug deposition, Rhinology 2006.pdf
- "Nose Candy" - Emergency Physicians monthly article on IN drug delivery
INTERNET PROTOCOLS
- Intranasal diamorphine dosing table
- British association for emergency medicine pediatric pain protocol (click here).
- Palliative care incident pain and dyspnea protocol
- Sunshine Hospital emergency department pediatric IN fentanyl protocol
- Starship Children's hospital intranasal fentanyl protocol
- Princess Margaret Hospital educational information for parents after administration of IN fentanyl in the operating theatre
- Royal Children's Hospital Melbourne Australia intranasal pain treatment clinical practice guideline
Nasal Drug Compounding Pharmacies
Trusted Partner compounding pharmacy
Trusted partner compounding pharmacy PDF
Hospice links
Palliative care incident pain and dyspnea protocol
OTHER SITES OF INTEREST