Intramuscular administration

FIGURE 2-7. Stes for intramuscular administration. (A) Vastus lateralis site the patient is supine or sitting. 

INTRAMUSCULAR ADMINISTRATION. To promote an optimal response to therapy when giving these drug intramuscularly (IM), the nurse inspects previous injection sites for signs of pain or tenderness, redness, and swelling. In addition, the nurse reports any persistent local reaction to the primary health care provider. It also is important to develop a plan for rotation of injection sites and to record the site used after each injection. 

Heparin may be given by intermittent IV administration, continuous IV infusion, and the SC route. Intramuscular administration is avoided because of die possibility of the development of local irritation, pain, or hematoma (a collection of blood in die tissue). A solution of dilute heparin may be used to maintain patency of an IV site used for intermittent administration of any drug given by die IV route ... 

Castro A, Suarez D, Inglada L, CarbaUo E, Dominguez A, Diago M, Such J, Del Olmo JA, Perez-Mota A, Pedreira J, Quiroga JA, Carreno V (1997) Multicenter randomized, controlled study of intramuscular administration of interferon-beta for the treatment of chronic hepatitis C. J Interferon Cytokine Res 17 27-30... 

Ohsawa, T., Matsukawa, Y., Takakura, Y., Hashida, M., and Sezaki, H. (1985). Fate of lipid and encapsulated drug after intramuscular administration of liposomes prepared by the freezethawing method in rats, Chem. Pharm. Bull., 5013-5022. 

If treatment with an SSRI or another antidepressant such as clomipramine is not successful, hormonal treatment with a GnRH agonist, such as leuprolide, maybe considered. The use of leuprolide improves premenstrual emotional symptoms as well as some physical symptoms such as bloating and breast tenderness. Cost, the need for intramuscular administration, and the side effects of hypoestrogenism (e.g., vaginal dryness and hot flashes) limit its use. 

Vitamin B12 (cyanocobalmin) administered both orally and parenterally is equally effective in treating anemia from vitamin B12 deficiency. However, use of parenteral cyanacobalamin is the most common method of vitamin B12 replacement because it may be more reliable and practical. Subcutaneous or intramuscular administration is appropriate. Vitamin B12 is absorbed completely following parenteral administration, whereas oral vitamin B12 is absorbed poorly via the GI tract. Furthermore, use of parenteral vitamin B12 to treat megaloblastic anemia may circumvent the need to perform a Schilling test to diagnose lack of intrinsic factor. 

A. J. Wilensky and J. A. Lowden, Inadequate serum levels after intramuscular administration of diphenyl-hydantoin, Neurology, 23, 318-324 (1973). 

UFH must be given parenterally, preferably by the IV or subcutaneous (SC) route. Intramuscular administration is discouraged because absorption is erratic and it may cause large hematomas. 

LAIV is made with live, attenuated viruses and is approved for intranasal administration in healthy people between 5 and 49 years of age (Table 41-2). Advantages of LAIV include its ease of administration, intranasal rather than intramuscular administration, and the potential induction of broad mucosal and systemic immune response. 

Streptomycin Amikacin- kanamycin Aqueous solution (1-g vials) for IV or intramuscular administration Aqueous solution (500-mg and l-g vials) for IV or intramuscular administration Adults (max) Children (max) Adults (max) Children (max)... 

Capreomyrin Aqueous solution (l-g vials) for IV or intramuscular administration Adults (max) Children (max)... 

Phenytoin is associated with pain and burning during infusion. Phlebitis may occur with chronic infusion, and tissue necrosis is likely on infiltration. Intramuscular administration is not recommended. 

Continuous ECG, blood pressure, and respiratory status monitoring is recommended for all loading doses of fosphenytoin. Serum phenytoin concentrations should not be obtained for at least 2 hours after IV and 4 hours after intramuscular administration of fosphenytoin. 

Madsen, S. M., Lindeburg, T., F01sgard, S., Jacobsen, E., and Sillesen, H. (1983) Pharmacokinetics of the gamma-aminobutyric acid agonist THIP (Gaboxadol) following intramuscular administration to man, with observations in dog. Acta Pharmacol. Toxicol. (Copenh.) 53, 353-357. 

Immune Globulin (IG) IG is a sterile solution containing antibodies from human blood. It is obtained by cold ethanol fractionation of large pools of blood plasma and contains 15-18 percent protein. Intended for intramuscular administration, IG is primarily indicated for routine maintenance of immunity of certain immunodeficient persons and for passive immunity against measles and hepatitis. IG does not transmit hepatitis B virus, human immunodeficiency virus (HIV), or other infectious diseases. 

Treatment—Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.2. British Anti-Lewisite (BAL) dimercaprol antidote will alleviate some effects. It is available as a solution in oil for intramuscular administration to counteract systemic effects. It is not manufactured currently in the forms of skin and eye ointments.2... 

The daily intramuscular administration of 0-5-2-3 mg. of D.F.P. caused a sustained fall in plasma cholinesterase to 5-20 per cent of original activity. A slower progressive decline of red blood cell cholinesterase took place. 

The symptoms that followed the daily intramuscular administration of D.F.P. for 5 days mimicked most of the muscarine-like and nicotine-like effects (see p. 37) of cholinergic drugs. There were also effects on the central nervous system. 

Subcutaneous and intramuscular Administration Subcutaneous and intramuscular administration can be used to deliver protein-based drugs. The absorption of drug is faster than with the oral route. The rate of absorption is... 

Oral administration of arecoline is ineffective for clinical purposes due to first-pass metabolism (Hussain and Mollica 1991). The nasal route is an alternate possibility, with 85% bioavailability compared to intramuscular administration. 

Compound 302,196 intramuscular administration to man Edgewood Arsenal Technical Report No. 4634,1972. 

Sidell FR, Ketchum JS, Markis JE, Kysor KP. Compound 302,196 intramuscular administration to man. Edgewood Arsenal Technical Report No. 4634, 1972. 

Pentazocine has been successfully used to relieve labour pain [201] and its obstetric use in place of pethidine is favoured by,its apparent inferior ability to pass the placental barrier [206]. A clinical trial of (+)- and (-)-pentazocine adds to the rare number of examples in which optical enantiomorphs have been evaluated [207]. In post-operative patients, response to 60 mg of the dextro isomer was less than that to 5 mg of morphine, while 25—29 mg of (-)-pentazocine was as effective as 10 mg of morphine. Hence most of the activity of the race-mate resides in the laevo isomer, as anticipated from results in animals [208]. Several studies of the distribution, excretion and metabolism of pentazocine have been made. Peak levels of the tritium-labelled drug (and its c/s-3-chloroallyl analogue) were present in the C.N.S. of a cat within 40 minutes of intramuscular administration [209], the comparable figure for morphine being 2 hours [210]. 

Intramuscular administration in depot form. In its anionic form (-COO ) penicillin G forms poorly water-soluble salts with substances containing a positively charged amino group (procaine, p. 208 clemizole, an antihistamine benzathine, dicationic). Depending on the substance, release of penicillin from the depot occurs over a variable interval. 

Some less soluble hexavalent chromium compounds (lead chromate and zinc chromate pigments calcium chromate) are carcinogenic in rats, producing tumors at the sites of administration by several routes. Lead chromate also produces renal carcinomas after intramuscular administration in rats. ... 

Toxicology. DBA produced carcinomas in animals after oral or dermal exposure and injection site tumors after subcutaneous or intramuscular administration. 

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