Intranasal transmucosal drug delivery: An alternative approach to the parenteral route for medical emergencies

Abstract

Medical emergencies such as insulin-induced hypoglycaemia, anaphylactic reactions, seizures and opioid induced respiratory depression, need to be treated as quickly as possible in order to prevent untoward life-threatening circumstances. The currently available therapeutic interventions mainly involve administration of drugs through the parenteral route. However, the sophisticated administration related requirements of parenteral dosage forms, acts as a major concern for successful treatment of a medical emergency in non-clinical settings. The intranasal (IN) route, owing to its ease of administration, non-invasiveness, and quick onset of action, can be a potential alternative to the parenteral route in fulfilling the unmet needs of patients. Numerous attributes limit the nasal delivery of a drug, such as the nasal anatomy and physiology, physicochemical characteristics of the drug, and formulation related parameters. Despite the challenges involved in IN delivery, many breakthrough formulations introduced in to the market, have demonstrated equivalent biopharmaceutical performance to the parenteral route. This review critically discusses various IN marketed products which are currently in practice for treating medical emergencies in non-medical settings. In particular, the review discusses dosage form design and excipient roles in developing drug products to be used to attain rapid rise in plasma concentration for producing a fast onset of action similar to that of the parenteral intramuscular mode of drug administration.