Muscles administration routes

The deltoid muscle can be used for i.m. injections in older children, but it is not an option for young infants and children because of their limited muscle mass. Although there are few complications associated with this administration route, nerve injury can occur. The technique is shown in Fig. The area for deltoid administration should be fully visible so that the anatomical landmarks can be visualized. Then the needle for deltoid injection should enter the muscle halfway between the acromium process and the deltoid tuberosity to avoid hitting the underlying nerves. The drug volume that can be administered by this route to older children and adults is 0.1-2ml.The recommended needle length for older children is 1 in. (2.5 cm). 

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. 

Androgens are important for general sexual function and libido, but testosterone supplementation is only effective in patients with documented low serum testosterone levels. In patients with hypogonadism, testosterone replacement is the initial treatment of choice, as it corrects decreased libido, fatigue, muscle loss, sleep disturbances, and depressed mood. Improvements in ED may occur, but they should not be expected to occur in all patients.23 The initial trial should be for 3 months. At that time, re-evaluation and the addition of another ED therapy is warranted. Routes of administration include oral, intramuscular, topical patches or gel, and a buccal tablet. 

Past chlordane use, coupled with atmospheric transport as the major route of dissemination, produced global contamination of fish and wildlife resources and human populations. The chemical and its metabolites were frequently detected in all species examined, but usually at low concentrations. Residues in fish muscle sometimes exceeded the U.S. Food and Drug Administration action level of 0.3 mg/kg fresh weight recommended for human health protection. In general, chlordane in animals is highest near areas where the chemical has been applied to control termites concentrations are highest in fat and liver, especially in predatory species. 

Signs of disulfoton toxicity, such as muscle tremors, fasciculations, lacrimation, and salivation, in animals are generally observed after a few daily doses, but begin to diminish in severity as exposure to dislllfoton continues (Bombinski and DuBois 1958). This phenomenon is known as tolerance. Tolerance appears to be a reproducible phenomenon that does not depend on the organophosphate insecticide used, the route of administration, or the animal species (Costa et al. 1982b). Several possible mechanisms have been proposed /explain this phenomenon. 

The minimal lethal oral dose in humans was estimated to be 140 mg/kg (Bruce et al. 1987), which is similar to the lethal oral dose for a variety of animal species (see Table 2-2). Regardless of the route of administration, the sequence of events leading to death appears to be similar in a variety of animal species muscle weakness and tremors, loss of coordination, paralysis, convulsions, coma, and... 

Incidents of vincristine overdosage have been reported relatively frequently in the medical literature. Some of these have involved inadvertent administration of the intravenous formulation into the central nervous system by the intrathecal route this produces devastating results by a combination of chemical damage to sensitive neuronal tissue as well as biochemical perturbations. Two representative cases of vincristine overdose were described (46) involving administration of vincristine to patients scheduled to receive vinblastine. In one patient toxicity initially involved vomiting and diarrhea with subsequent constipation and paralytic ileus (inhibition of motor activity in the small intestine). Muscle pain... 

Parenteral administration of digoxin should be used only when the need for rapid digitalization is urgent or when the drug cannot be taken orally. IM injection can lead to severe pain at the injection site, thus IV administration is preferred. If the drug must be administered by the IM route, inject it deep into the muscle followed by massage. Do not inject more than 500 meg (2 ml) into a single site. 

Administration - The IV route is preferred in the convulsing patient. However, if IV administration is impossible, the IM route may be used. Inject deeply into the muscle. Inject IV slowly (at least 1 minute for each 5 mg). Do not use small veins (eg, dorsum of hand or wrist) avoid intra-arterial use and extravasation. 

Parenteral administration This route is applicable for drugs which are inactivated by gastrointestinal tract or absorption is poor when given orally or there is a urgency for fast response in small dose. Intramuscular, intravenous, or subcutaneous routes are commonly used. The intravenous injection (in aqueous solution) is introduced directly into the vein by which a rapid response is produced. The subcutaneous injection are given through the layer of skin, while intramuscular injection, introduced through the skin layer deep into the muscle. The nature of intramuscular injection may be in aqueous or oily solution/suspension form. The aqueous solution will be rapidly absorbed as compared to oily solution or suspension. So, the rate of absorption is dependent on the nature of the preparation. 

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