Abstract
Opioids are widely used in all fields of pain management and may be delivered by a number of routes of administration. The intranasal administration of opioid is a convenient route of transmucosal drug delivery that has received limited attention. Potential advantages compared with parenteral or oral administration include avoidance of painful injection, avoidance of risks associated with intravenous access, rapid onset and titration to effect, good bioavailability, and high levels of acceptability and familiarity to patients. These features also lend themselves to the benefits of patient-controlled delivery systems and commercially available devices are described. In this paper we briefly consider the relevant pharmacology of intranasal drug delivery; opioid drugs and formulations; and delivery devices used clinically for intranasal administration. We review the clinical applications of intranasal opioid analgesia. These have included use for in-hospital pain management in adult and paediatric populations, in the emergency department, perioperatively and in burns units. Out-of-hospital use has included palliative care and paramedic use during retrieval and transfer to hospital. Many small trials suggest that intranasal opioids play a useful role in pain management, but large clinical trials are needed to better define advantages, safety and acceptability.
Keywords: Opioid intranasal, drug administration intranasal, analgesia opioid, analgesia patient-controlled
Current Drug Delivery
Title: The Clinical Applications of Intranasal Opioids
Volume: 5 Issue: 1
Author(s): Michael James Paech and Katherine Shelley
Affiliation:
Keywords: Opioid intranasal, drug administration intranasal, analgesia opioid, analgesia patient-controlled
Abstract: Opioids are widely used in all fields of pain management and may be delivered by a number of routes of administration. The intranasal administration of opioid is a convenient route of transmucosal drug delivery that has received limited attention. Potential advantages compared with parenteral or oral administration include avoidance of painful injection, avoidance of risks associated with intravenous access, rapid onset and titration to effect, good bioavailability, and high levels of acceptability and familiarity to patients. These features also lend themselves to the benefits of patient-controlled delivery systems and commercially available devices are described. In this paper we briefly consider the relevant pharmacology of intranasal drug delivery; opioid drugs and formulations; and delivery devices used clinically for intranasal administration. We review the clinical applications of intranasal opioid analgesia. These have included use for in-hospital pain management in adult and paediatric populations, in the emergency department, perioperatively and in burns units. Out-of-hospital use has included palliative care and paramedic use during retrieval and transfer to hospital. Many small trials suggest that intranasal opioids play a useful role in pain management, but large clinical trials are needed to better define advantages, safety and acceptability.
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Cite this article as:
Paech James Michael and Shelley Katherine, The Clinical Applications of Intranasal Opioids, Current Drug Delivery 2008; 5 (1) . https://dx.doi.org/10.2174/156720108783330989
DOI https://dx.doi.org/10.2174/156720108783330989 |
Print ISSN 1567-2018 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5704 |
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