Parenteral route subcutaneous injection

Nickel salts administered by intravenous or subcutaneous injection are comparatively toxic. For all routes of parenteral administration, the LD50 (lethal dose to 50% of the sample) range for injected nickel salts is 6 mg Ni/kg BW for dogs given nickel oxide intravenously to 600 mg Ni/kg BW for mice given nickel disodium F.DTA intraperitoneally (Nielsen 1977). 

No antibody activity was found after oral immunization in any of the individual rabbits immunized with liposphere R32NS 1-vaccine formulation. However, rabbit immunization by all parenteral routes tested resulted in enhanced immunogenicity, with increased antibody IgG levels over the entire postimmunization period. The individual rabbit immune response shows that immunization by subcutaneous injection was the most effective vaccination route among all parenteral routes of administration tested. 

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. 

PROMETHAZINE HYDROCHLORIDE The preferred parenteral route of administration is deep IM injection properly administered IV doses are well tolerated, but this method is associated with increased hazard. IV administration should not exceed 25 mg/mL at a rate no more than 25 mg/min. Avoid subcutaneous and intra-arterial injection. Use contraindicated in patients younger than 2 years of age. 

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. 

The rates of absorption, clearance, and elimination of penicillin G are further influenced by the route of administration. Intramuscular and subcutaneous injections provide drug to the bloodstream more slowly, but maintain concentrations longer than the intravenous administration. Absorption of penicillin G from intramuscular or subcutaneous sites can be further slowed down by the use of the relatively insoluble procaine salt. When equivalent dosages of penicillin G and procaine penicillin G were injected parenterally, peak residues concentration in blood occurred after 2 h and the drug had cleared the blood by 8 following penicillin G administration. With the procaine penicillin G, peak residues concentration appeared 5 h after injection and the drug cleared the plasma 24 h after administration (57). 

Subcutaneous. Injecting medications directly beneath the skin is used when a local response is desired, such as in certain situations requiring local anesthesia. Also, a slower, more prolonged release of the medication into the systemic circulation can be achieved in situations where this is the desired effect. A primary example is insulin injection in a patient with diabetes mellitus. Subcutaneous administration provides a relatively easy route of parenteral injection that can be performed by patients themselves, providing they are properly trained. 

Vitamin B12 is available in pure form for oral administration or in combination with other vitamins and minerals for oral or parenteral administration. The choice of a preparation always must be made with recognition of the cause of the deficiency. Although oral preparations may be used to supplement deficient diets, they are of relatively little value in the treatment of patients with deficiency of intrinsic factor or ileal disease. Even though small amounts of vitamin B12 may be absorbed by simple diffusion, the oral route of administration cannot be relied upon for effective therapy in the patient with a marked deficiency of vitamin B12 and abnormal hematopoiesis or neurological deficits. Therefore, the preparation of choice for treatment of a vitamin B12-deficiency state is cyanocobal-amin, and it should be administered by intramuscular or deep subcutaneous injection. 

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... 

Several cases of ricin exposure via parenteral routes were documented. A 20-year-old man was admitted to the hospital 36 h after subcutaneously injecting castor bean extract. Symptoms were characteristic of nausea, weakness, dizziness, and myalgias. He developed anuria and hypotension, followed by hepatorenal and cardiorespiratory failure, and died 18 h following admission. In another report, a 36-year-old chemist extracted ricin from a castor... 

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 ... 

Injections are made using a 25- to 27-gauge needle that is 1/2 or 5/8 inches in length and with a 1- to 3-ml syringe calibrated 0.5 to 1.5 ml. (Syringes for insulin are measured in units, not ml.) When administering medication using the subcutaneous parenteral route ... 

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