Intramuscular toxicity

Marzulll, F.N., Wiles, J.S., Welmer, J.T., Van de Wal, A., Thomas, W.V., and Atkinson, J.C., 1959 Intramuscular toxicity and signs of poisoning with VX with recommended estimates for humans based on animal data. CWL Special Pub. 2-23, Edgewood,... 

Intramuscular Toxicity. On a molar basis, HCN and NaCN are both equitoxic, and more toxic than KCN. Signs appear within minutes, and include rapid breathing weak and uncoordinated movements, ataxia, tremors, convulsions, and respiratory arrest. Postmortem features are few, and include alveolar and subpleural hemorrhages, and congestion of tracheal mucosa (Ballantyne et ah, 1972). 

The relative toxicities of thallium compounds depend on their solubHities and valence states. Soluble univalent thallium compounds, eg, thaHous sulfate, acetate, and carbonate, are especiaHy toxic. They are rapidly and completely absorbed from the gastrointestinal tract, skin peritoneal cavity, and sites of subcutaneous and intramuscular injection. Tb allium is also rapidly absorbed from the mucous membranes of the respiratory tract, mouth, and lungs foHowing inhalation of soluble thallium salts. Insoluble compounds, eg, thaHous sulfide and iodide, are poorly absorbed by any route and are less toxic. 

In order to induce a toxic effect, local or systemic, the causative material must first come into contact with an exposed body surface these are the routes of exposure. In normal circumstances, and depending on the nature of the material, the practical routes of exposure are by swallowing, inhalation, and skin and eye contact. In addition, and for therapeutic purposes, it may be necessary to consider intramuscular, intravenous, and subcutaneous injections as routes of adininistration. 

Newer bleomycins such as peplomycin and especially liblomycin, are more resistant to bleomycin hydrolase. This results in less lung toxicity but more bone marrow toxicity, and allows for a different spectmm of antitumor action. Bleomycin is inactive orally it is given intravenously, intramuscularly, subcutaneously, or directiy into a cavity such as the pleural cavity. The majority of dmg is excreted unchanged in the urine. 

Melarsonyl potassium (Mel W, Trimelarsen) [13355-00-5] is a thioarsenite closely related to melarsoprol, and it also has been used for the treatment of trypanosomiasis (172). However, it appears to be more toxic and less effective than melarsoprol. The only advantage of melarsonyl potassium is that it is water-soluble and can be adrninistered intramuscularly or subcutaneously. This property is useful when the intravenous route caimot be employed. 

It is used by direct instillation into the bladder for multifocal local bladder carcinoma. Nausea and myelosuppression are the major toxicities of thiotepa. It is not a local vesicant and has been safely injected intramuscularly and even intra-thecally. 

Other adverse reactions that may be seen with administration of the cephalosporins are headache, dizziness, nephrotoxicity (damage to the kidneys by a toxic substance), malaise, heartburn, and fever. Intramuscular (IM) administration often results in pain, tenderness, and inflammation at the injection site Intravenous (IV) administration has resulted in thrombophlebitis and phlebitis. 

HYDANTOINS Fhenytoin is the most commonly prescribed anticonvulsant because of its effectiveness and relatively low toxicity. However, a genetically linked inability to metabolize phenytoin has been identified. For this reason, it is important to monitor serum concentrations of the drug on a regular basis to detect signs of toxicity Fhenytoin is administered orally and parenterally. If the drug is administered parenterally, the IV route is preferred over the intramuscular route because erratic absorption of phenytoin causes pain and muscle damage at the injection site... 

The well-known adverse reaction formerly often observed after intramuscular injection of clemizol penicilUn in the treatment of syphilis with anaphylaxis-like symptoms plus CNS involvement in the absence of immimological sensitization to penicillin was called the Hoigne syndrome or embolic-toxic reaction, and might be explained by intravasal appUcation of LA with subsequent toxic effects [8]. 

Earlier studies by Wiles et al. (5) in which palytoxin was administered by various routes showed that this material was extremely toxic to rabbits, dogs, and monkeys. The effect of route of administration on toxicity varies in that intravenous (iv), intramuscular (im), and subcutaneous (sc) toxicity is high, yet intrarectal (ir) or oral (po) palytoxin is relatively ineffective. It was also observed that palytoxin... 

Diazepam Being extremely lipophilic, diazepam penetrates quickly into the CNS, but can rapidly redistribute into body fat and muscle. This results in a faster decline in CNS levels and early recurrence of seizures. It is dosed at 5 to 10 mg (or 0.15 mg/kg) and infused no faster than 5 mg/minute. Repeated doses can be given every 5 minutes until seizure activity stops or toxicities are seen (e.g., respiratory depression). Diazepam can also be administered as a rectal suppository, making it possible for non-medical personnel to provide rapid therapy for seizures that develop at home or in public areas.11 The adult dose is 10 mg given rectally and this dose may be repeated once if necessary. Diazepam is erratically absorbed via the intramuscular route therefore, IM administration is not recommended. 

Laurencin et al. (1990) conducted extensive local and systemic toxicity studies with P(CPP-SA), which also showed excellent biocompatibility and toxicology. Domb (1992) studied the biocompatibility of P(CPP-IPA), P(CPP IPA-SA), and P(CPP-SA) by subcutaneous and intramuscular implants in rabbits. Inflammation occurred at week one and was more pronounced for the intramuscular implants, but subsided in all cases by week 4 (Domb, 1992). Domb and Nudelman (1995) conducted... 

Methotrexate, an antimetabolite, is indicated for moderate to severe psoriasis. It is particularly beneficial for psoriatic arthritis. It is also indicated for patients refractory to topical or UV therapy. Methotrexate can be administered orally, subcutaneously, or intramuscularly. The starting dose is 7.5 to 15 mg per week, increased incrementally by 2.5 mg every 2 to 4 weeks until response maximal doses are approximately 25 mg/wk. Adverse effects include nausea, vomiting, mucosal ulceration, stomatitis, malaise, headache, macrocytic anemia, and hepatic and pulmonary toxicity. Nausea and macrocytic anemia can be ameliorated by giving oral folic acid 1 to 5 mg/day. Methotrexate should be avoided in patients with active infections and in those with liver disease. It is contraindicated in pregnancy because it is teratogenic. 

Ballantyne G, Bright J, Swanston DW, et al. 1972. Toxicity and distribution of free cyanides given intramuscularly. Med Sci Law 12 209-219. 

Ethyl -fluorovalerate (IV) was found to be completely nontoxic, a subcutaneous injection of 160 mg./kg. failed to kill mice, and there was complete absence of any symptoms of poisoning. Intramuscular injection of 40 mg./kg. into rats similarly produced no toxic symptoms.1... 

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