The potential of the nasal mucosa route for emergency drug administration via a high-pressure needleless injection system

Abstract

It is often difficult to expeditiously establish an intravenous (IV) route in a medical emergency, and alternatives to an IV route may also be difficult for many dentists to accomplish. The purpose of this article is to demonstrate that without the necessity of advanced training, the nasal mucosa route of administration is a promising alternative to the IV route in an emergency without complications, and will also show that epinephrine can be quickly absorbed into systemic circulation from the nasal mucosa. Ten beagle dogs were administered 400 microg of epinephrine in the nasal septal mucosa. The mean peak value of the plasma epinephrine (20.1 +/- 12.4 ng/mL) was obtained after 15 seconds, and the peak systolic pressure was 200% of the control value after 60 seconds. Although the dose of epinephrine must be considered because blood flow decreases during cardiopulmonary resuscitation, this method presents a promising alternative to the IV route.