Intramuscular stimulation

Historically the only melanocortin peptide to be used clinically is the parent hormone from which all these peptides are derived from namely ACTH (see above). It has also been used in the treatment infantile spasms for epilepsy, where it is administered as an intramuscular injection only over a 2-12 weeks period. Obvious side effects include weight gain, puffy face, high blood pressure and an increased risk of infection and should never be administered to patients with diabetics, renal or heart failure. ACTH is also used as a stimulation test to measure adrenal cortex activity, i.e. production of cortisol and is used to ascertain whether someone has Addison s disease. 

Three basic approaches are used to control viral diseases vaccination, antiviral chemotherapy, and stimulation of host resistance mechanisms. Vaccination has been used successfully to prevent measles, rubella, mumps, poliomyelitis, yellow fever, smallpox, chickenpox, and hepatitis B. Unfortunately, the usefulness of vaccines appears to be limited when many stereotypes are involved (e.g., rhinoviruses, HIV). Furthermore, vaccines have little or no use once the infection has been established because they cannot prevent the spread of active infections within the host. Passive immunization with human immune globulin, equine antiserum, or antiserum from vaccinated humans can be used to assist the body s own defense mechanisms. Intramuscular preparations of immune globulin may be used to prevent infection following viral exposure and as replacement therapy in individuals with antibody deficiencies. Peak plasma concentrations of intramuscular immune globulins occur in about 2 days. In contrast, intravenously administered immune globulin provides immediate passive immunity. 

Pharmacokinetics. Seed oil, administered intramuscularly to dogs at a dose of 1 mL/kg labeled glyceryl trioleate injected with the oil, was distributed primarily to iliac nodes, heart, liver, and lungs 5 Phytotoxic effect. Ethanol (95%) extract of the dried seed oil, at a concentration of 500 ppm, was inactive. The biological activity reported has been patented " k Prostaglandin induction. Seed oil, administered subcutaneously to rats at a dose of 1 g/day for 14 days, stimulated PGl-2 synthesis in the thoracic aorta . ... 

Conscious sedation implies that patients have a depressed level of consciousness but nevertheless have intact protective reflexes, the ability to maintain their airway, and the ability to respond appropriately to requests and physical stimulation (Kennedy and Luh-mann, 1999). Sedative agents familiar to psychiatrists that are used in this manner for procedures include chloral hydrate, given orally or rectally in a dose of 25 to 100 mg/kg midazolam, given intramuscularly or intravenously in a dose of 0.05 to 0.15 mg/kg, rectally in a dose of 0.3 to 0.5 mg/kg, or orally in a dose of 0.2 to 0.75 mg/kg and midazolam, which is felt to be preferable to diazepam for this purpose (Kennedy and Luhmann, 1999). Midazolam is also available in a nasal spray (Ljungman et ah, 2000). 

Topiramate, another antiepileptic drug, may also be helpful in a dose of 400 mg daily, built up gradually. Small quantities of alcohol may suppress essential tremor but only for a short time. Alprazolam (in doses up to 3 mg daily) or gabapentin (100-2400 mg/d) is helpful in some patients. Others are helped by intramuscular injections of botulinum toxin. Thalamic stimulation by an implanted electrode and stimulator is often worthwhile in advanced cases refractory to pharmacotherapy. Diazepam, chlordiazepoxide, mephenesin, and antiparkinsonism agents have been advocated in the past but are generally worthless. Anecdotal reports of benefit from mirtazapine were not confirmed in a double-blind study, which found no effect on the tremor in most patients. 

For all these hormonal substances to exert their desired effect, the method of administration to the animal is most important. They can be administered to animals by intramuscular injections but some compounds can be also administered incorporated into the feeds. However, the best method is one in which they are administered in form of a subcutaneous implant in the ear. This allows for a controlled slow release of the active ingredients, exposing the animal to a constant stimulating effect of the anabolic agent. 

A study in 10 women has been conducted to determine whether betamethasone administered at risk of preterm delivery causes adrenal suppression (375). After adrenal stimulation with corticotropin 1 microgram at 24-25 weeks, each woman received two intramuscular doses of betamethasone 12 mg 24 hours apart 1 week later, another... 

On occasion, there have even been such reactions to highly purified human products, notably FSH they can be managed by changing the treatment to intramuscular recombinant follicle stimulating hormone (41). 

Thyrotropin stimulates iodine uptake, and this facilitates the diagnosis and treatment of recurrent disease or metastases in the follow-up of differentiated thyroid cancer. It is used as an alternative to thyroid hormone withdrawal, to avoid symptomatic hypothyroidism (1). Headache and nausea occur in 6-40% of patients after intramuscular administration, but are usually mild and transient (2,3). 

Mephenteramine [Wyamine). This alpha-1 stimulant is used primarily to maintain or restore blood pressure during hypotensive episodes that may occur during spinal anesthesia. It is typically administered by intravenous or intramuscular injection. 

Metaraminol (Aramine). Metaraminol appears to act like ephedrine that is, metaraminol directly stimulates alpha-1, alpha-2, and beta-1 receptors, and indirectly stimulates them by increasing the release of presynaptic norepinephrine. This drug is usually administered by injection (intramuscularly, intravenously, or subcutaneously) to treat hypotension occurring in shock or general anesthesia. 

ACTH stimulation of the adrenals will fail to elicit an appropriate response in states of adrenal insufficiency. A rapid test for ruling out adrenal insufficiency employs cosyntropin (see below). Plasma cortisol levels are measured before and either 30 minutes or 60 minutes following an intramuscular or intravenous injection of 0.25 mg of cosyntropin. A normal plasma cortisol response is a stimulated peak level exceeding 20 g/dL. A subnormal response indicates primary or secondary adrenocortical insufficiency that can be differentiated using endogenous plasma ACTH levels (which are increased in primary adrenal insufficiency and decreased in the secondary form). 

It has been used as a mild expectorant and relieves gripping. Applied externally, camphor acts as a rubefacient and mild analgesic and is employed in liniments as a counter-irritant in fibrositis, neuralgia and similar conditions. Camphor has been administered as a solution in oil by subcutaneous or intramuscular injection as a circulatory and respiratory stimulant, but there is little evidence of its value for this purpose (121-125). 

Thus either intravenous or intramuscular doses of atropine are indicated to antagonize the muscarinic symptoms. Physostigmine and edrophonium are cholinesterase inhibitors and would exacerbate the problem. Norepinephrine would not be effective in combatting the cholinergic stimulation. Trimethaphan being a ganglionic blocker would also worsen the condition. 

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