View source for Insufflation (medicine)

{{Otheruses|Insufflation (disambiguation)}}
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'''Insufflation''' (Latin ''insufflatio'' "blowing on" or "into") is the practice of [[Inhalation|inhaling]] a substance.<ref>http://www.merriam-webster.com/medical/insufflation</ref> Insufflation has limited medical use, but is a common [[route of administration]] with many [[respiration (physiology)|respiratory]] drugs used to treat conditions in the [[lung]]s ([[asthma]] or [[emphysema]]) and [[paranasal sinus]] ([[allergy]]).

The technique is common for many [[Recreational drug use|recreational drugs]] and is also used for some [[entheogen]]s. Nasal insufflation ('''snorting''') is commonly used for many [[psychoactive drug]]s because it causes a much faster onset than orally and [[bioavailability]] is usually, but not always, higher than orally. This bioavailability occurs due to the quick absorption of molecules into the [[Circulatory system|bloodstream]] through the soft tissue in the [[mucous membrane]] of the [[Paranasal sinus|sinus cavity]]. Some drugs have a higher rate of absorption, and are thus more effective in smaller doses, through this route.

The '''intranasal route''' (administration through the nose) may allow certain drugs and other molecules to bypass the [[blood-brain barrier]] via [[diffusion]] or [[axonal transport]] along [[olfactory nerve|olfactory]] and [[trigeminal nerve]]s.<ref>William H. Frey. [http://www.drugdeliverytech.com/cgi-bin/articles.cgi?idArticle=61 "Bypassing the Blood-Brain Barrier to Deliver Therapeutic Agents to the Brain and Spinal Cord."] Drug Delivery Technology.</ref>

==Medical uses==
===Medical procedure===

Inert, nontoxic gases, such as [[carbon dioxide]], are often insufflated into a body cavity, in order to expand workroom, or reduce obstruction during [[minimally invasive surgery|minimally invasive]] or [[laparoscopic surgery]].

In the 18th century, the [[tobacco smoke enema]], an insufflation of tobacco smoke into the rectum, was a common method of reviving drowning victims. <ref>Lawrence, Ghislaine (20 April 2002). "Tobacco smoke enemas". The Lancet 359 (9315): 1442. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)08339-3/fulltext. Retrieved 2008-11-27.</ref>

Intranasal (IN) administration of various lipid soluble medications is increasing in popularity. It is often used for treatment of [[paediatric]] patients or patients who are otherwise alarmed or frightened by needles, or where [[Intravenous]] (IV) access is unavailable. In addition to a variety of [[Nasal spray|Nasal sprays]] readily available from pharmacies, some common medications delivered via IN include [[Fentanyl]], [[Midazolam]] and [[Naloxone]]. The time of onset for drugs delivered intranasally is generally only marginally slower than if given via IV.

===Administering drugs===

[[Psychoactive]] substances are often insufflated nasally for the purpose of intranasal absorption through the [[mucous membrane]], which is often more rapid, or more complete, than [[gastrointestinal tract|gastrointestinal]] absorption. For a substance to be effective when insufflated, it must be water soluble so it can be absorbed into the mucous membranes.  This practice is commonly referred to as ''snorting'', ''bumping'', ''railing'', or ''doozing''<ref>Definition of dooze, definition #4 ["http://www.urbandictionary.com/define.php?term=dooze"]</ref>.
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Although the majority of a dose of insufflated drug is taken up through the mucous membranes, some enters other parts of the gastrointestinal tract where it may also be absorbed. This is because some of the dose drips down the throat and into the stomach. This effect is commonly referred to as the [[drip|'drip']] and is often unpleasant to taste.

Commonly insufflated psychoactive substances (for non-medical use) include:

*[[Cocaine]] (benzoylmethylecgonine) - a strong stimulant that is highly addictive; most commonly associated with drug insufflation
*[[Opioids]] - a class of analgesic drugs (including [[heroin]], [[morphine]], [[oxycodone]], [[hydrocodone]], [[hydromorphone]], [[oxymorphone]], and the synthetic [[meperidine]] and [[fentanyl]]).
*[[Amphetamines]] - another class of strong stimulants (including [[amphetamine]], [[dextroamphetamine]] and [[methamphetamine]]) that are also highly addictive.
*[[Ritalin]] (methylphenidate) - another stimulant closely related to amphetamine, but often reported to have effects similar to that of cocaine when insufflated
*[[Ketamine]] - a dissociative anesthetic, used recreationally for its euphoric, anesthetic, and hallucinatory effects
*[[Phencyclidine]] - a dissociative anesthetic, commonly known as PCP or angel dust; no longer in common use because of reports of intensely negative experiences
*[[Methylenedioxymethamphetamine|MDMA]]/Ecstasy - an [[Empathogen-entactogen|entactogen]] that also possesses stimulant effects
*[[Zolpidem]] (Ambien) - a sedative hypnotic that can have various hallucinogenic effects with certain people and/or at high doses
*[[Snuff|Tobacco snuff]] - contains nicotine, a mild stimulant that is highly addictive. 
Various other drugs can be taken in intranasally for research purposes such as the [[neuropeptide]]s [[Melanocyte-stimulating hormone|MSH]]/[[ACTH]], [[vasopressin]] and [[insulin]].<ref>Born J, Lange T, Kern W, McGregor GP, Bickel U, Fehm HL. (2002). Sniffing neuropeptides: a transnasal approach to the human brain. Nat Neurosci.5(6):514-6. {{DOI|10.1038/nn849}} PMID 11992114</ref>

Note: Some psychoactive substances such as [[benzodiazepine]]s (valium, oxazepam, clonazepam) are water soluble to a small degree (about 350ml/1000&nbsp;mg). Though this means they will be somewhat effective when insufflated, they will not be as readily absorbed into the mucous membrane as highly soluble substances such as amphetamines and opiates. Typically [[sublingual]] administration is preferred for this class of drugs.

==Dangers==

Many recreational drugs which are commonly insufflated such as cocaine, can cause damage to the nasal cavity and has even been known to destroy the [[nasal septum]]<ref>http://www.thesite.org/drinkanddrugs/drugsafety/drugsandyourbody/cokeandyournose</ref>. Any damage to the inside of the nose is either because some insufflation highly constricts blood vessels – and therefore blood and oxygen/nutrient flow – to that area, or because the substance is physically caustic. A famous case where the septum was completely destroyed by cocaine was of [[Eastenders]] star [[Danniella Westbrook]].

==References==

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[[Category:Medical terms]]
[[Category:Routes of administration]]

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