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Delivery of topical nasal drugs

Clinical implications for rhinosinusitis therapy research

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American Journal of Drug Delivery

Abstract

This article reviews the importance of topical nasal drug delivery in the management of chronic rhinosinusitis, in particular the delivery of topical drugs to the key area of the middle meatus. Administration methods of topical nasal drugs include powered nasal sprays, pumped nasal sprays and nasal drops — each method has perceived advantages and disadvantages. The ideal nasal delivery system would allow a large proportion of the drug to penetrate the nasal valve; would have significant drug delivery to the middle meatus and minimal delivery to the pharynx and lower respiratory tract; be consistent; and be user friendly.

Methods of assessment of intranasal drug distribution can be classified as quantitative or qualitative. Quantitative techniques include: imaging of radiolabels with gamma cameras; endoscopic photography of the anterior end of the middle turbinate; absorption of a dyed/labeled drug on a patty inserted in the middle meatus; and positron emission tomography. Each technique has limitations that must be borne in mind. Qualitative techniques for gathering information can also be used; however, the information obtained tends to be difficult to utilize to draw firm conclusions from.

There are a number of factors that have been studied to determine their effect on nasal drug distribution: the nasal valve; inferior turbinate hypertrophy and rhinitis; sniffing; administration devices; head position; and, importantly, inter- and intra-individual variability.

Future research needs to be directed toward the deposition and distribution characteristics of nasal drugs to the middle meatus, the carrying forward of preclinical research and hypotheses to prospective clinical trials (including trials investigating patient compliance with different devices), and the interaction between drugs and the nasal mucosa and mucus.

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Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9DL, UK

    Jarrod J. Homer, Rohini Aggarwal & Arun Cordoza

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  1. Jarrod J. Homer
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  2. Rohini Aggarwal
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  3. Arun Cordoza
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Correspondence to Jarrod J. Homer.

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Homer, J.J., Aggarwal, R. & Cordoza, A. Delivery of topical nasal drugs. Am J Drug Deliv 1, 125–131 (2003). https://doi.org/10.2165/00137696-200301020-00004

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