Prospects for the use of intranasal nanoscale polymer delivery systems for drugs and antidotes in extreme medicine

Introduction . The development of improved formulations of antidotes and remedies, which can be used not only by qualified medical personnel, but also in self- and mutual assistance, is an urgent task for extreme medicine. Objective . Evaluation of the possibility of using nanoscale polymer delivery systems for medicines and antidotes intended for intranasal administration (into the nasal cavity) in extreme medicine. Discussion . The main submicron-sized polymer carriers which are promising as the basis for the creation of an intranasal form of antidotes are identified. The bioavailability of the substance delivered is dependent on the physico-chemical properties of the carrier, the conditions for its production, as well as physiological and anatomical factors. Data is presented regarding possible ways of correcting these factors in order to increase bioavailability. Examples of the use of polymer nanocarriers in the treatment of poisoning with heavy metals and rocket fuel components, as well as lesions caused by radioactive substances, are presented. It is shown that carriers (dendrimers, cyclodextrins) can act as antidotes in certain cases. The study presents a list of antidotes approved for use within the territory of the Russian Federation, for which the development of intranasal forms is possible, taking their physico-chemical and pharmacokinetic properties into account. Conclusions . Following a review of literature sources, the most promising submicron-sized polymer carriers for the intensification of intranasal delivery of drugs and antidotes are herein proposed: dendrimers, liposomes, nanocapsules, nanoparticles, and cyclodextrins. Using the list of antidotes approved for use in the Russian Federation as an example, promising drugs that can be potentially developed on the basis of these carriers are proposed.