title: A review of intranasal formulations for the treatment of seizure emergencies.
abstract: Epileptic seizure emergencies are life-threatening conditions, which in their most severe form, status epilepticus, have a high mortality rate if not quickly terminated. Treatment requires rapid delivery of anti-epileptics such as benzodiazepines to the brain. The nasal route is attractive due to its non-invasiveness, potential for direct nose to brain delivery, high vascularity, relatively large absorptive surface area, and avoidance of intestinal/liver metabolism. However, the limited volume of the nasal cavity and poor water solubility of anti-epileptics restrict absorption, leading to insufficient therapeutic brain levels. This review covers various formulation approaches adopted to improve nasal delivery of drugs, especially benzodiazepines, used to treat seizure emergencies. Other general topics such as nasal anatomy, challenges to nasal delivery, and drug/formulation considerations for nose to brain delivery are also discussed.
authors.affiliation: Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Mamta
authors.initials: M
authors.lastname: Kapoor
authors.affiliation: Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Cloyd
authors.affiliation: Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA; Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA. Electronic address: siege017@umn.edu.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Siegel
mesh_terms: D000281:Administration, Intranasal; D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000379:methods*; D004655:Emulsions / Q000737:chemistry; D006801:Humans; D053758:Nanoparticles / Q000737:chemistry; D014677:Pharmaceutical Vehicles / Q000737:chemistry*; D012640:Seizures / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D004655:Emulsions; D014677:Pharmaceutical Vehicles; D001569:Benzodiazepines
keywords: Benzodiazepines; Diazepam; Epilepsy; Intranasal; Nasal delivery device; Nose-to-brain; Seizure emergencies