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Proc Natl Acad Sci USA (2019) 116:133209

The availability of epinephrine nasal spray may reduce barriers to rapid treatment of anaphylaxis. Neffys approval is based on four studies in 175 healthy adults, without anaphylaxis, that measured epinephrine concentrations in the blood following administration of the nasal spray or approved epinephrine injection products

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Specifically, steric hindrance may be induced if arrestins bind to the activated receptor crevice, but may not be induced if arrestins bind to a receptor region other than the crevice

Chemically speaking, it is ethoxylated Cetearyl alcohol, meaning that some ethylene oxide is added to the fatty alcohol to increase the water-soluble part in the molecule