Intramuscular injection sites

Fig. 10. Clearance of lanthanides and actinides from intramuscular injection sites.

Glucagon is rapidly absorbed from subcutaneous and intramuscular injection sites. It is extensively degraded in the liver and kidneys and also in plasma and at its receptor sites. Its plasma half-life is a few minutes. 

The persistence of residues at intramuscular injection sites may be due in part to the irritant response produced in the muscle (52). Chloramphenicol, tylosin, penicillins, dihydrostreptomycin, and oxytetracycline have been shown to produce local irritation at the site of injection, leading to residue persistence this may be exacerbated by the solvent used. However, residues do not persist with proper injection of drugs and use of formulations that do not cause severe irritation (52), as has been demonstrated with one oxytetracycline product that produced little irritation (53-55). 

Neurotoxicity from artemether is related to drug accumulation due to slow and prolonged absorption from intramuscular injection sites. In mice, high doses of intramuscular artemether (50-100 mg/kg/day for 28 days) resulted in an unusual pattern of selective damage to certain brain-stem nuclei, especially those implicated in hearing and balance (30). 

Greenblatt DJ, Allen MD. Intramuscular injection-site complications. JAMA 1978 240(6) 542. ... 

Absorption of thiotepa from the gastrointestinal tract is incomplete while absorption through serous membranes (e.g., pleura and bladder) and from intramuscular injection sites is variable. Distribution of thiotepa occurs rapidly and extensively to tissues. Thiotepa is rapidly converted to its primary metabolite, triethylenephosphoramide (TEPA) by hepatic mixed function oxygenases. TEPA becomes the predominant form of thiotepa within 5 min of... 

Drug absorption from an intramuscular injection site is mainly determined by the formulation of the parenteral preparation and is influenced by the... 

Variations in absorption of medications from the gastrointestinal tract, intramuscular injection sites, and skin are important in pediatric patients, especially in premature and other newborn infants. 

Pharmacokinetics of ampicillin trihydrate and sodium ampicillin following intramuscular injection were studied 228 Serum levels of ampicillin activity were determined. The rates of absorption of the drug from the intramuscular injection sites were calculated. The ampicillin suspension data showed that absorption process is slower than the elimination process. Ampicillin sodium solutions are absorbed more efficiently than ampicillin trihydrate. Klein et al.229 gave three intramuscular injections of ampicillin to eight apparently healthy young men. Doses of 1.0... 

Moderate variability in absorption of oxytetracycline from different intramuscular injection sites in calves was reported by Nouws and Vree. Bioavailability values of 79%, 86%, and 89% were obtained for injection into the buttock, neck, and shoulder, respectively. The same group reported variable bioavailability and residue profiles with 10 formulations of oxytetracycline in pigs and 5 formulations in calves, sheep, and pigs. ... 

B. Local pain, induration, and sterile abscess formation may occur at intramuscular injection sites. Large intramuscular injections may also cause hypotension. 

C. Local pain may occur at intramuscular injection sites. Lidooaine (1 mL of 1% lidocaine per mL of EDTA concentrate) may be added to intramuscular injections to decrease discomfort. 

The absorption rate after intramuscular administration differs depending on type of muscle chosen. Studies have shown that intramuscular injections result in different plasma concentrations of narcotics and perceived pain relief depending oti the type of muscle used for administration. This was also found for the response to vaccination and use of antibiotics and insulin [7]. Absorption of active substances from the intramuscular site depends mi the quantity and composition of the connective tissue and the rate of vascular perfusion of the area. Blood flow in the muscles varies (it is increased in deltoid muscle) and is influenced by the exercise of the muscle and morbidity. The muscles are covered with the subcutaneous connective tissue, a hpid layer (adipose layer) and the skin. The thickness and the Upid content of these tissues are different in different body areas. The subcutaneous fat layer at the gluteal intramuscular injection site is thicker in females (mostly > 3 cm) than in males. The medication should be administered with a needle long enough to reach the muscle without penetrating underlying structures. 

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