Adrenaline nasal spray in emergency management: An initial expert opinion.

Adrenaline is the drug of choice for the treatment of anaphylaxis. Up to now, intramuscular administration using an autoinjector has been recommended in national and international guidelines as the first-line treatment for anaphylaxis. Various adrenaline autoinjectors are available on the German market as emergency medication for immediate treatment by medical laypersons and specialists. Recently, a nasally administered adrenaline preparation was introduced for the first time and is available on the market. There are mainly data on healthy control subjects, which show a good adrenaline level and an expected effect on blood pressure and heart rate. To date, there is little clinical experience in the world literature for patients with anaphylaxis in children/adolescents and none in adults or from Germany. Therefore, we would like to discuss theoretically the use of adrenaline via the nasal route of administration in the care of anaphylaxis patients and compare it with the intramuscular administration of adrenaline autoinjectors.