Storage & Handling

• Store unopened lyophilized vials at room temperature

• After reconstitution: refrigerate at 36–46°F

• Use within 24 hours

• Discard unused portion after expiration window

• Maintain strict aseptic technique during preparation and transfer
  
  

Patient Eligibility & Safety

• Review medical history, medications, and allergy profile

• Avoid or use with caution in patients with:

• Active sinus or upper respiratory infection

• Recent nasal surgery or trauma (<6–8 weeks)

• Chronic epistaxis or severe nasal septal deviation

• Active malignancy unless medically cleared

• Pregnancy or breastfeeding (unless explicitly approved)

• Obtain written informed consent, including off-label disclosure

• Baseline vitals optional; not routinely required for intranasal delivery

Preparation

1. Reconstitution:

• Reconstitute vial with 1 mL preservative-free sterile saline (Bacteriostatic saline may be used if allowed by clinic policy, but PF saline preferred for nasal mucosa)

• Inject saline slowly down vial wall

• Gently swirl - do not shake

• Confirm complete dissolution before use

2. Intranasal Device Preparation:

Transfer reconstituted solution into:

• Metered nasal spray device

• Prime device prior to first use to ensure accurate dosing

Administration - Intranasal Delivery

1. Patient gently blows nose prior to administration

2. Patient seated upright or slightly reclined

3. Insert applicator just inside nostril (do not advance deeply)

4. Aim slightly laterally toward nasal mucosa

5. Administer spray/drop during gentle inhalation

6. Alternate nostrils between sprays

7. Avoid blowing nose for 10 minutes post-dose

Post-Administration Monitoring

• Observe patient 10–15 minutes after first dose or initial titration

Educate patient on:

• Normal sensations: mild nasal warmth, transient taste, slight throat drip

• Symptoms requiring provider notification

Adverse Event Management

Mild

• Nasal irritation, sneezing, watery eyes

• Reduce volume per dose

• Increase spacing between administrations
  
  Moderate

• Headache, lightheadedness, sinus pressure

• Hold therapy temporarily

• Resume at lower frequency or dose
  
  Severe (Rare)

• Significant epistaxis, dyspnea, allergic reaction

• Discontinue immediately

• Activate emergency protocol and manage per ACLS if indicated

Regulatory Status

• Quantum intranasal administration is off-label

• Intended for use only by licensed healthcare providers

• Providers must be trained in intranasal drug delivery and adverse-event management

• Use within scope of state licensure and clinical practice guidelines