Improving internasal medication efficacy by blowing out to close the soft palate

Improving internasal medication efficacy by blowing out to close the soft palate

Intranasal medication is sprayed into the nasal cavity via the nostril to be absorbed by the soft tissue of the nasal cavity. However, much of the spray or resulting liquid can be lost down the throat as the soft palate is normally open. By blowing out during and after administration of the medication, the medication is kept in the nose and not lost down the throat.

Figure 1 In normal breathing, the soft palate is open allowing some intranasal medication to be lost down the throat.

Figure 2 By blowing gently out the mouth during and after administration of intranasal medication, the soft palate is closed and the dose is kept in the nasal cavity for higher and more repeatable efficacy.

Devices for administering intranasal medication

The most effective way to administer a liquid intranasal drug is to use a Teleflex "MAD Nasal™" Intranasal Mucosal Atomization Device. The syringe administers a full dose with one application.

The Teleflex Nasal devise performs in a similar manner to the Spravato ketamine spray device. However, the Teleflex device can be used with generic ketamine at any appropriate dose.

Figure 3 Teleflex "MAD Nasal™" Intranasal Mucosal Atomization Device. Very effective for intranasal medication. https://www.teleflex.com/usa/en/product-areas/anesthesia/atomization/mad-nasal-device/index.html

Figure 4 Spravato (esketamine) two dose nasal spray.

Generic nasal pump-spray bottles have a number of problems. The pump-spray bottle must be pumped a number of times for any more than the minimum dose. During pumps, there needs to be time for the spay pump to reprime, otherwise, a full dose is not administered. Further, when reused for another dose, the drug can crystallise in the nozzle and partially block it, again compromising efficacy. 

Figure 4 Intranasal pump-spray bottles can have a number of problems compared to the Teleflex MAD Nasal device.

Diagrams from: https://www.claudiafriedlander.com/the-liberated-voice/2018/06/articulation-preview.html