Faculty Sponsor

Jana Stedman

College

College of Nursing & Health Professions (CONHP)

Department/Program

Physician Assistant Program

Presentation Type

Poster Presentation

Symposium Date

Summer 7-22-2026

Abstract

The objective of this research is to determine whether intranasal epinephrine is as effective as intramuscular epinephrine for treating anaphylaxis by comparing pharmacokinetic, pharmacodynamic, and safety outcomes in adult and pediatric populations. A literature review was conducted using PubMed and Google Scholar, including randomized crossover trials, phase 1 clinical studies, and a narrative review comparing intranasal and intramuscular epinephrine. These studies evaluated pharmacokinetic outcomes, including maximum plasma concentration (Cmax), time to maximum concentration (Tmax), and area under the curve (AUC), as well as pharmacodynamic outcomes such as changes in systolic blood pressure, diastolic blood pressure, and heart rate. Most studies included healthy participants and excluded patients with significant cardiovascular or respiratory disease that could affect the response to epinephrine. Across the reviewed studies, intranasal epinephrine consistently achieved therapeutic systemic absorption and produced increases in blood pressure and heart rate comparable to intramuscular epinephrine. Although intramuscular epinephrine generally reached peak concentrations quicker, intranasal epinephrine demonstrated comparable efficacy and the potential to reduce treatment delays associated with needle phobia and hesitation. Based on the current evidence, intranasal epinephrine appears to be a promising alternative for select patients; however, intramuscular epinephrine should remain the gold standard because the current evidence is primarily limited to pharmacokinetic and pharmacodynamic studies in healthy volunteers rather than clinical outcomes during active anaphylaxis. Additional real-world studies are needed before intranasal epinephrine can be considered an equivalent first-line treatment. Keywords: anaphylaxis; intranasal epinephrine; intramuscular epinephrine; neffy; epinephrine autoinjector; pharmacokinetics; pharmacodynamics; needle phobia.

Biographical Information about Author(s)

Kylie has a special interest in orthopedics and plans on working in orthopedic surgery following graduation. She will be presenting on “Nasal Spray vs Needle: Rethinking Epinephrine Delivery in Anaphylaxis” because she has a special interest in emerging therapies that improve patient safety, expand access to lifesaving therapies, and enhance the overall patient experience. 

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