Parenteral route intramuscular injection

Intramuscular. The large quantity of skeletal muscle in the body allows this route to be an easily accessible site for parenteral administration. Intramuscular injections can be used to treat a problem located directly in the injected muscle. For example, botu-linum toxin and other substances can be injected directly into hyperexcitable muscles to control certain types of muscle spasms or spasticity (see Chapter 13).7,78 Alternatively, intramuscular injection can be used as a method for a relatively steady, prolonged release of the drug into the systemic circulation to control conditions such as psychosis,2 or to administer certain vaccines. 

Iron salts occasionally cause gastrointestinal irritation, nausea, vomiting, constipation, diarrhea, headache, backache, and allergic reactions. The stools usually appear darker (black). Iron dextran is given by the parenteral route Hypersensitivity reactions, including fatal anaphylactic reactions, have been reported with the use of this form of iron. Additional adverse reactions include soreness, inflammation, and sterile abscesses at the intramuscular (IM) injection site Intravenous (IV) administration may result in phlebitis at the injection site When iron is administered via the IM route, a brownish discoloration of tlie skin may occur. Fhtients with rheumatoid arthritis may experience an acute exacerbation of joint pain, and swelling may occur when iron dextran is administered. 

There are a number of special concerns about the safety of materials that are routinely injected (parenterally administered) into the body. By definition, these concerns are all associated with materials that are the products of the pharmaceutical and (in some minor cases) medical device industries. Such parenteral routes include three major ones IV (intravenous), IM (intramuscular), and SC (subcutaneous) and a number of minor routes (such as intra-arterial) that are not considered here. 

Bolus intravenous, intramuscular, or subcutaneous injections can be administered by a single person by securing the animal s arm through the cage bars (Mazue and Richez, 1982). For safety considerations, many investigators prefer to have the animal physically restrained by a second person before the injection is given. Arterial injections (via the femoral artery) as well as limited or continuous intravenous infusion (via catheterization of the femoral or jugular vein) are other less commonly used parenteral routes in the monkey. 

Glucocorticoids are available in a wide range of preparations, so that they can be administered parenterally, orally, topically, or by inhalation. Obviously the oral route is preferred for prolonged therapy. However, parenteral administration is required in certain circumstances. Intramuscular injection of a water-soluble ester (phosphate or succinate) formed by esterification of the C21 steroid alcohol produces peak plasma steroid levels within 1 hour. Such preparations are useful in emergencies. By contrast, acetate and tertiary butylacetate esters must be injected locally as suspensions and are slowly absorbed from the injection site, which prolongs their effectiveness to approximately 8 hours. 

Calcitonin (Miacalcin, Miacalcin Nasal Spray) is a synthetic 32-amino acid polypeptide that is identical to salmon calcitonin. Salmon calcitonin is more potent than human calcitonin because of its higher affinity for the human calcitonin receptor and its slower metabolic clearance. Administration is by subcutaneous or intramuscular injection or by nasal spray. The absorption of the nasal form is slower than that of the parenteral routes. 

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. 

Some of the dosage formulations available for protein pharmaceuticals are listed in Table 5.7. An examination of Table 5.7 reveals that no protein drug up until this time has been formulated for oral administration. Most protein drugs are administered by means of injection (parenteral administration). Parenteral administration includes intravenous, intra-arterial, intracardiac, intraspinal or intrathecal, intramuscular, intrasynovial, intracuta-neous or intradermal, subcutaneous injections, and injection directly into a dermal lesion (e.g., a wart). The parenteral route of administration requires a much higher standard of purity and sterility than oral administration. It also may require trained... 

Protein-based drugs have been formulated mainly as stable liquids or in cases where liquid stability is limiting as lyophilized dosage forms to be reconstituted with a suitable diluent prior to injection. This is because their delivery has been limited primarily to the parenteral routes of intravenous (IV), subcutaneous (SC), or intramuscular (IM) administration. There are a few drugs that have been developed for pulmonary delivery, such as rhDNase (Pulmozyme ) and an inhalable formulation of insulin (e.g., Exubra ). However, even such drugs have been formulated as either liquid or lyophilized or spray-dried powders. This chapter will focus only on excipients that are applicable to liquid and lyophilized protein formulations. 

Results of pharmacokinetic studies of streptomycin are in most cases also applicable to dihydrostreptomycin and vice versa. In animals, the absorption of both streptomycin and dihydrostreptomycin is poor via the oral route but rapid after intramuscular administration. In cattle, peak serum levels were obtained 1 h after intramuscular injection of either streptomycin or dihydrostreptomycin (18), whereas serum concentrations produced in sheep and horses paralleled those obtained in cattle (19). As a result, most of an oral dose is recovered in the feces whereas most of a parenteral dose is recovered in the urine. However, if kidney function is severely impaired, little of an intramuscularly administered dose is excreted in the urine. 

Several types of CDD systems have been designed based on various mechanisms of drug release (Table I). These mechanisms are dependent on the required site of drug delivery, the physicochemical properties of the drug and also of the delivery vehicle (13), Modes of administration can be oral, sublingual, transdermal, rectal, intrauterine, ocular, or parenteral (intramuscular, peritoneal, and subcutaneous routes of injection). 

Injections are unpleasant and patient acceptance and compliance via this route are low. Intravenous injections may only be given by qualified medical professionals, making this route expensive and inconvenient. Intramuscular and subcutaneous preparations are self-injectable however, patients dislike them. In addition, elderly, infirm and pediatric patients cannot administer their own injections and require assistance, thereby increasing inconvenience to these patients and the cost of their therapy. Increased medical complications can result from the poor compliance associated with the parenteral route. 

Routine parenteral administration by injection serves to deliver drugs to specific body tissues. The most important routes of injection of these sterile products are intramuscular (im), intravenous (iv) and subcutaneous (sc). Basic parenteral formulation involves the selection of appropriate bases (e.g. aqueous, oily and emulsions) to achieve the desired bioavailability following injection. The detailed description of... 

Heroin is usually self-administered parenterally, either by intravenous or intramuscular injection, but may also be snorted or smoked. Other less common routes... 

The U.S. Pharmacopoeia (USP) classifies injections into five different types. The dosage form selected for a particular drug product is dependent upon the characteristics of the drug molecule (e.g., stability in solution, solubility, and injectability), the desired therapeutic effect of the product (e.g., immediate vs. sustained release), and the desired route of administration. Solutions and some emulsions (e.g., miscible with blood) can be injected via most parenteral routes of administration. Suspensions and solutions that are not miscible with blood (e.g., injections employing oleaginous vehicles) can be administered via intramuscular or subcutaneous injection but should not be given intravenously. 

A parenteral route is used to inject medication into the patient. There are four parenteral routes intradermal (ID), subcutaneous (SC), intramuscular (IM), and intravenous (IV). The healthcare provider determines the choice of route based on the medication, desired onset, and the patient s needs. 

The subcutaneous parenteral route is an injection into the skin (subcutaneous) where the medication is slowly absorbed into the capillaries, resulting in a slower onset than intramuscular and intravenous parenteral routes. The subcutaneous parenteral injection site should have an adequate fat pad and injections must be rotated to prevent lipodystrophy. Lipodystrophy is the loss of fat under the skin, resulting in effective absorption of the medication. Subcutaneous parenteral injection sites are ... 

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