Prevention and Treatment of Motion Sickness by Intranasal Medication

Chinn, Herman I.; Hyde, Reed W.; Milch, Lawrence J.

doi:10.3181/00379727-90-22131

Cited by 8 publications

(11 citation statements)

References 2 publications

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“…The study conducted by Tonndorf, et al, (1953) compared subcutaneous, oral, and intranasal scopolamine and found the absorption of intranasal scopolamine to be comparable to subcutaneous in rate and "completeness." 1955) and Hyde et al, (1953), found analogous absorption results for intranasal scopolamine, however, they also reported a decrease in dose required to reach therapeutic levels, leading to a significant reduction in side effects. For example, marked vomiting in these studies was decreased by almost 40% with administration of only 0.2 mg of scopolamine.…”

mentioning

confidence: 93%

“…Understanding the limitations of oral and injected medications in an operational environment, early military research involving scopolamine explored intranasal instillation in the form of drops and spray (Chinn, et al, 1955;Chinn, Milch & Dugi, 1953;Tonndorf, Hyde, Chinn & Lett, 1953). The study conducted by Tonndorf, et al, (1953) compared subcutaneous, oral, and intranasal scopolamine and found the absorption of intranasal scopolamine to be comparable to subcutaneous in rate and "completeness."…”

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

“…The U.S. Navy is currently using a variety of antimotion sickness pharmaceuticals to preserve optimal manning and individual performance for personnel in challenging motion environments, such as: ScopDex, an oral combination of scopolamine and dextroamphetamine, the transdermal scopolamine patch, meclizine, and promethazine (Ambrose et al, 1991). These medications have proven effective for some, but most have negative performance impacts and none have shown efficacy after symptom onset (Ambrose et al;Bagian & Ward, 1994;Chinn, Hyde & Milch, 1955;Estrada, LeDuc, Curry, Phelps & Fuller, 2007; Homick, Kohl, Reschke, Degionanni & Cintron-Trevino, 1983;Putcha, Cintron, Tsui, Vanderploeg & Kramer, 1989). …”

Section: Scopolamine For Motion Sicknessmentioning

confidence: 99%

“…The rapid medication absorption and protection afforded in the swing test suggested exploring the therapeutic properties of intranasally delivered scopolamine. In the second experiment, Chinn et al, (1955) used military aircraft to provide a standardized, provocative stimulus with subjects being treated 15 minutes after take-off, a time based on previous flights where no vomiting would have occurred, however, vasomotor disturbances and nausea would be present. The data clearly showed that intranasal administration given after symptom onset significantly reduced the incidence of vomiting, while oral administration was shown to be "completely ineffective."…”

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

“…For example, marked vomiting in these studies was decreased by almost 40% with administration of only 0.2 mg of scopolamine. 1955) also tested intranasal scopolamine's anti-motion sickness properties using a swing test in one experiment and standardized in flight turbulence in a second. Intranasal scopolamine (0.3 mg) was given prophylactically in the swing test experiment and results showed that intranasal administration conferred approximately 40% greater emesis protection when compared to placebo.…”

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

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A Comparison of Intranasal and Oral Scopolamine for Motion Sickness Prevention in Military Personnel

Simmons¹,

Phillips²,

Lojewski³

et al. 2008

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Executive SummaryMotion sickness in astronauts, aviators, and military personnel often leads to decrements in operational performance. The anti-motion sickness medication, scopolamine, is effective; however, oral and transdermal administrations have proven problematic due to slow absorption, low bioavailability, unpredictable therapeutic effect, potential medication loss due to emesis, and side effects. Although efficacy and side-effect characteristics of intranasally administered scopolamine have not been established, results from preliminary studies indicate intranasal scopolamine has faster absorption, higher bioavailability, and a more reliable therapeutic index than equivalent oral or transdermal forms. The purpose of this study was to compare the efficacy, side-effect profile, and pharmacotherapeutics of a 0.4 mg dose of intranasal scopolamine gel and a 0.8 mg dose of oral scopolamine. It was hypothesized that intranasal delivery of scopolamine would rapidly achieve therapeutic concentrations at lower doses compared to oral scopolamine while minimizing medication-induced performance impairment. To test these hypotheses, 54 aviation candidates, 50 male and 4 female, were recruited and randomized to one of three treatment groups [intranasal scopolamine gel (IN SCOP); oral scopolamine (PO SCOP); or placebo] and then exposed to passive Coriolis cross-coupling for 40 minutes or until moderate nausea was reported. Medication efficacy was determined by number of head movements tolerated among groups and pharmacotherapeutics for IN SCOP and PO SCOP were determined by salivary assay. Side-effect profiles for all groups were derived from performance on a cognitive battery, measurements of near-focus visual accommodation (VA), scores on the Karolinska Sleepiness Scale (KSS) and motion sickness questionnaires. Analysis detected no significant differences in the number of head movements tolerated among groups, p > 0.05. Pharmacotherapeutic data show increased scopolamine absorption and decreased time to reach maximum salivary concentration with intranasal administration (T max = 1.463 ± 0.98 hr, C max = 54.857± 103.739 ng/mL, AUC = 51.732 ± 93.802 ng*h/mL). No treatment effects were detected over time on the cognitive battery, VA, or KSS, p > 0.05. An ANOVA revealed a significant decrease in heart rate over time for IN SCOP and PO SCOP versus placebo at several time points post-dose, while no clinically significant differences were found for systolic or diastolic blood pressures. A negative linear relationship was found between Motion Sickness Susceptibility Questionnaire (MSSQ) scores and number of head movements (r = -.24, p < .05). The present study lacked sufficient power to draw definitive conclusions regarding efficacy or to make adequate comparisons between the two medications, F (2, 50) = 0.743, p > .05, observed power = 17 %, however; medication absorption was significantly greater for IN SCOP at onehalf the dose (0.4 mg v. 0.8 mg) with no side effects or detrimental impact to performance. 3 Introduction Impac...

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mentioning

confidence: 93%

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

Section: Scopolamine For Motion Sicknessmentioning

confidence: 99%

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

Section: Early Intranasal Scopolamine Researchmentioning

confidence: 99%

See 3 more Smart Citations

A Comparison of Intranasal and Oral Scopolamine for Motion Sickness Prevention in Military Personnel

Simmons¹,

Phillips²,

Lojewski³

et al. 2008

View full text Add to dashboard Cite

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Dose escalation pharmacokinetics of intranasal scopolamine gel formulation

Boyd

Daniels

et al. 2014

The Journal of Clinical Pharmacology

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Astronauts experience Space Motion Sickness requiring treatment with an anti‐motion sickness medication, scopolamine during space missions. Bioavailability after oral administration of scopolamine is low and variable, and absorption form transdermal patch is slow and prolonged. Intranasal administration achieves faster absorption and higher bioavailability of drugs that are subject to extrahepatic, first pass metabolism after oral dosing. We examined pharmacokinetics of 0.1, 0.2, and 0.4 mg doses of the Investigational New Drug formulation of intranasal scopolamine gel (INSCOP) in 12 healthy subjects using a randomized, double‐blind cross‐over study design. Subjects received one squirt of 0.1 g of gel containing either 0.1 mg or 0.2 mg/0.1 mL scopolamine or placebo in each nostril. Serial blood samples and total urine voids were collected after dosing and drug concentrations were determined using a modified LC‐MS‐MS method. Results indicate dose‐linear pharmacokinetics of scopolamine with linear increases in Cmax and AUC within the dose range tested. Plasma drug concentrations were significantly lower in females than in males after administration of 0.4 dose. All three doses were well tolerated with no unexpected or serious adverse side effects reported. These results suggest that intranasal scopolamine gel formulation (INSCOP) offers a fast, reliable, and safe alternative for the treatment of motion sickness.

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