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Title: A preliminary study of intranasal epinephrine administration as a potential route for anaphylaxis treatment
Authors: Chatchawan Srisawat
Kanittha Nakponetong
Patchanee Benjasupattananun
Chanthana Suratannon
Leatchai Wachirutmanggur
Siribangon Boonchoo
Duangjai Pankaew
Apirom Laocharoenkiat
Punchama Pacharn
Orathai Jirapongsananuruk
Nualanong Visitsunthorn
Pakit Vichyanond
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Keywords: Immunology and Microbiology
Issue Date: 1-Mar-2016
Citation: Asian Pacific Journal of Allergy and Immunology. Vol.34, No.1 (2016), 38-43
Abstract: © 2016, Allergy and Immunology Society of Thailand. All rights reserved. Background: The intranasal (IN) administration of epinephrine could be an alternative route for anaphylaxis treatment. Although IN epinephrine absorption has been demonstrated in animals, such data in humans are still lacking. Objective: To study the pharmacokinetics of IN epinephrine absorption in humans. Methods: Each healthy adult (n=5) was administered IN saline, IN epinephrine at various doses (i.e., 0.3, 0.6, 1.25, 2.5 and 5 mg), and intramuscular (IM) epinephrine at 0.3 mg. Plasma epinephrine levels at baseline and various time points up to 120 minutes after administration were determined using highperformance liquid chromatography with electrochemical detection. Results: Significant systemic absorption of epinephrine via IN route was observed only at the dose of 5 mg, and the absorption thereof was comparable to that of IM epinephrine; the average area-under-curve (AUC) values at 0-120 minutes for IN saline, IM epinephrine, and 5 mg IN epinephrine were 0.3, 18.3, and 19.4 ng.min/mL, respectively. In addition, the peak epinephrine concentrations and the time to reach them were also not significantly different between IM and 5-mg IN epinephrine; the corresponding values (mean ± SD) were 309 ± 88 pg/mL and 67 ± 43 min for IM epinephrine, and 386 ± 152 pg/mL and 70 ±17 min for 5 mg IN epinephrine. Conclusion: This preliminary study showed that epinephrine can be significantly absorbed via the IN route in humans. However, it requires a higher IN dose (5 mg) than the usual IM dose (0.3 mg) to achieve comparable systemic epinephrine absorption.
ISSN: 22288694
Appears in Collections:Scopus 2016-2017

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