Spray nasal de adrenalina no tratamento de reações alérgicas de tipo I graves
Epinephrine nasal spray in the treatment of severe type I hypersensitivity reactions
Fabiana Andrade Nunes Oliveira; Fausto Yoshio Matsumoto; Marilyn Urrutia-Pereira; Dirceu Solé
Resumo
Anafilaxia é a manifestação clínica mais grave das reações alérgicas sistêmicas e apresenta um risco potencial de morte. A maioria dos episódios de anafilaxia ocorre fora de ambiente hospitalar, e para que haja tratamento imediato, dispositivos alternativos de administração de adrenalina, como os autoinjetores de adrenalina, foram desenvolvidos. Todavia, estes não são disponíveis em boa parte do mundo e há relutância com o seu uso, sobretudo por crianças, geralmente fóbicas por agulha. Assim o desenvolvimento de um spray nasal de adrenalina (SNA) representa alternativa interessante no tratamento das anafilaxias, com bons resultados. O presente estudo tem por objetivo realizar revisão narrativa sobre o SNA no tratamento da anafilaxia com relação à sua farmacocinética e farmacodinâmica, assim como os eventos adversos nas diferentes faixas etárias. Estudos comparativos entre a administração de adrenalina intramuscular e por SNA demonstram resultados comparáveis e reforçam a sua utilização como mais uma alternativa para o tratamento de reações alérgicas graves de tipo I, especialmente a anafilaxia.
Palavras-chave
Abstract
Anaphylaxis is the most severe clinical manifestation of systemic allergic reactions and carries a potential risk of death. Most episodes of anaphylaxis occur outside the hospital setting and, to ensure immediate treatment, alternative epinephrine devices, such as epinephrine autoinjectors, have been developed. However, these devices are not widely available across the world, and there is reluctance to use them, especially among children, who are often needle-phobic. In this context, the development of an epinephrine nasal spray (ENS) represents an interesting alternative for the treatment of anaphylaxis, with favorable results. This study provides a narrative review of ENS in the management of anaphylaxis, addressing its pharmacokinetics, pharmacodynamics, and adverse events across different age groups. Comparative studies between intramuscular and intranasal administration have demonstrated comparable results, supporting the use of ENS as an alternative for the treatment of severe type I hypersensitivity reactions, especially anaphylaxis.
Keywords
Referências
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Submetido em:
30/06/2025
Aceito em:
04/07/2025
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