Which of the following is NOT an indicated use for intranasal medications?

• A. Facial trauma
• B. Pain control
• C. Opioid overdose
• D. Seizure control

Answer: (A)

Intranasal delivery relies on the nasal mucosa for rapid absorption, so it works best when the nasal passages are open and intact. Facial trauma can disrupt those passages with fractures, bleeding, swelling, or obstruction, making absorption unpredictable and increasing risk for aspiration or further injury. Because of that, using the intranasal route in a patient with facial trauma is not indicated. In contrast, intranasal fentanyl is commonly used for quick pain relief when IV access is hard, intranasal naloxone is a standard treatment for opioid overdose, and intranasal midazolam is used to treat acute seizures in prehospital care. These uses assume a functional nasal route, which is not guaranteed in facial trauma.