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.
Bibliographical noteFunding Information:
This work was supported by grants from the Academic Health Center, University of Minnesota (G. Georg, PI), the American Epilepsy Society , and the Epilepsy Foundation . Discussions with Profs. Gunda Georg and Edward Patterson, Dr. Leah Hanson, and Davin Rautiola are gratefully acknowledged.
© 2016 Elsevier B.V.
- Nasal delivery device
- Seizure emergencies