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PubMed1979

Steroid levels after intramuscular injection of radioactive estradiol-17beta, estrone, progesterone and testosterone in the bovine.

Eight 2 year old Hereford cows from days 8 to 12 of the estrous cycle were injected intramuscularly with 5 ml of corn oil containing 5 mg of estradiol-17beta (two cows), estrone (two cows), progesterone (two cows) or testosterone (two cows). Each cow treated with estradiol received 494 microc of estradiol-17beta-6, 7 H3 and each cow treated with estrone received 492 microc of estrone-6, 7 H3. Each cow treated with progesterone or testosterone received 400 muc of H3 compound labeled in the 7 position. Total urine was collected by urethral catheterization of the cows treated with estrogens. Blood samples for plasma and serum were collected via jugular cannulae. Blood and urine samples from estrogen-treated cows were collected hourly for the first 24 hr, at 2 hr intervals for the next 26 hr, at 4 hr intervals for the next 12 hr and at 12 hr intervals until background was reached. Blood samples were collected hourly from 1 to 8 hr after injection from progesterone or testosterone-treated cows. Plasma and serum levels of radioactive estradiol-17beta, estrone, progesterone and testosterone were similar. Blood levels of radioactivity peaked at 2 hr post-injection in cows receiving estradiol-17beta and at 3 hr in cows receiving estrone. Blood levels of labeled estradiol-17beta and estrone were nondetectable by 54 hr and 83 hr, respectively. Peak urinary excretion of radioactivity was reached at 7 hr for estradiol-17beta and at 14 hr for estrone and nondetectable levels were reached by 95 hr for estradiol-17beta and 14 hr for estrone. At these times, 15.5% of the total dose of radioactive estradiol-17beta and 17.5% of the injected estrone had been excreted in the urine. Peak blood and urinary excretion levels were reached earlier for radioactive estradiol-17beta than for estrone, and excretion of estradiol-17beta was completed more rapidly. No difference was found in plasma and serum levels for any steroid studies; thus, endogenous steroid titers in blood plasma and serum are not different in the cow.

Journal Article↗
PubMed1991

Human dystrophin expression in mdx mice after intramuscular injection of DNA constructs.

Duchenne's muscular dystrophy (DMD), which affects one in 3,500 males, causes progressive myopathy of skeletal and cardiac muscles and premature death. One approach to treatment would be to introduce the normal dystrophin gene into diseased muscle cells. When pure plasmid DNA is injected into rodent skeletal or cardiac muscle, the cells express reporter genes. We now show that a 12-kilobase full-length human dystrophin complementary DNA gene and a 6.3-kilobase Becker-like gene can be expressed in cultured cells and in vivo. When the human dystrophin expression plasmids are injected intramuscularly into dystrophin-deficient mdx mice, the human dystrophin proteins are present in the cytoplasm and sarcolemma of approximately 1% of the myofibres. Myofibres expressing human dystrophin contain an increased proportion of peripheral nuclei. The results indicate that transfer of the dystrophin gene into the myofibres of DMD patients could be beneficial, but a larger number of genetically modified myofibres will be necessary for clinical efficacy.

Animals↗
PubMed1977

Radioactive conversion products of intramuscularly injected [4-14C]formononetin including sulfates in the urine of hens.

The phytoestrogen formononetin was injected intramuscularly as [4-14C]formononetin into two adult hens. Radioactive materials in the urine for the succeeding 14 days (hen 1) or 16 days (hen 2) were fractionated on DEAE-Sephadex-25 columns by elution with a gradient of NaCl; the four major fractions thus separated were examined by solvent partition, thin-layer chromatography, and enzymic cleavage. The following seven radioactive components were identified in the urine, the average proportions of each being given in terms of percentage of total 14C recovered from the urine: [14C]formononetin (4.3%); [14C]diaidzein (11.4%); [14C]equol (6.8%); [14C]daidzein monosulfate (30.4%); [14C]equol monosulfate (5.8%); [14C]diadzein disulfate (19.8%); and [14C]equol disulfate (6.5%). Small proportions of sulfates of unidentified radioactive phenols were present. Tests for presence of glucosiduronates of 14C-labelled material gave negative results. Radioactive formononetin sulfate was not detected in the urine of either hen.

Animals↗
PubMed2005

[Intramuscular injections in children].

Intramuscular injections are still part of routine care in the treatment of children. Vaccines, premedications and analgesics are administered by this route. The pain associated with an intramuscular injection is severe, the risk of complications is increased, and pharmacodynamics and pharmacokinetics are unpredictable. In many cases, equivalent alternatives of rectal, oral or intranasal routes of administering pharmacologic agents exist. Intramuscular injection of analgesics and premedications to children are-except in case of emergencies-obsolete. This demand corresponds to the guidelines of the World Health Organization (WHO) and the International Association for the Study of Pain (IASP).

Analgesics↗
PubMed1983

Pharmacokinetic behaviour and anthelmintic efficacy of 1-n-butyl carbamoyl oxfendazole given by intramuscular injection.

Oxfendazole (OFZ) was chemically modified to 1-n-butyl carbamoyl OFZ (C4-OFZ) in an attempt to improve the solubility of OFZ and enable it to be administered by injection. After intramuscular injection to sheep and cattle, C4-OFZ was metabolised to OFZ which resulted in higher plasma OFZ concentrations that persisted for a considerably longer period than those observed following administration of OFZ orally. The anthelmintic efficacy of injected C4-OFZ was tested, in sheep, against strains of Trichostrongylus colubriformis, Haemonchus contortus and Ostertagia circumcincta, which were highly resistant to benzimidazoles. In all cases, the C4-OFZ treatment showed a significant improvement in efficacy over the conventional oral OFZ drench.

Animals↗
PubMed1996

Healing of muscle trauma after intramuscular injection of antibiotics in sheep: correlations between clinical, macroscopic and microscopic scores.

The present study aimed to predict the resultant healing from early lesions (found days 3 and 10 post injection) caused by the intramuscular injection of veterinary antibiotic formulations. Nineteen marketed drugs were selected in order to screen a wide range of irritation conditions at the injection site. Nineteen ewes were each injected intramuscularly with one of the formulations. Each injection was at a different site, 3 and 10 days prior to slaughter. Fourteen of these ewes also received intramuscular injections at two other sites 21 and 32 days prior to slaughter. The tolerance was monitored by clinical examination of the injection site and by gross and microscopic pathology. Myodegeneration and fibre necrosis were determined histologically. The clinical scores did not correlate with the other findings. Myodegeneration correlated with the size of the lesion on day 3 post-injection and was not found thereafter. Although occasionally found alone, it was generally associated with and surrounded by fibre necrosis. When myodegeneration was the only lesion, regeneration was complete by day 21 and the fibrosis was minimal or absent. Necrosis at day 10 post-injection correlated with necrosis at days 3, 21 and 32 post-injection. Fibrosis became prominent around the necrotic muscles from day 10 post-injection. Healing from necrosis was slow with, in some instances, encapsulated debris still persisting at day 32 post-injection. The tissue irritation index correlated well with myodegeneration and necrose (acute lesions) and fibrose and necrose (older lesions). Thus, after considering a large sample of antibiotic formulations, this study indicated that healing could be predicted from the muscle fibre histopathology at days 3 and 10 post-injection. If myodegeneration was found alone, full recovery within 21 days could be predicted. If fibre necrosis was extensive, the healing involved encapsulating the necrotic tissues and thus resulted in extensive scar formation. The tissue changes explained why the irritation index of the lesions at days 21 and 32 post-injection could be predicted from their irritation index at days 3 and 10 post-injection. Likewise, the size of the lesion at days 21 and 32 post-injection could not be predicted from its size at day 3 post injection.

Animals↗
PubMed2000

Distribution of DNA vaccines determines their immunogenicity after intramuscular injection in mice.

Intramuscular injection of DNA vaccines elicits potent humoral and cellular immune responses in mice. However, DNA vaccines are less efficient in larger animal models and humans. To gain a better understanding of the factors limiting the efficacy of DNA vaccines, we used fluorescence-labeled plasmid DNA in mice to 1) define the macroscopic and microscopic distribution of DNA after injection into the tibialis anterior muscle, 2) characterize cellular uptake and expression of DNA in muscle and draining lymph nodes, and 3) determine the effect of modifying DNA distribution and cellular uptake by volume changes or electroporation on the magnitude of the immune response. Injection of a standard 50-microl dose resulted in the rapid dispersion of labeled DNA throughout the muscle. DNA was internalized within 5 min by muscle cells near the injection site and over several hours by cells that were located along muscle fibers and in the draining lymph nodes. Histochemical staining and analysis of mRNA expression in isolated cells by RT-PCR showed that the transgene was detectably expressed only by muscle cells, despite substantial DNA uptake by non-muscle cells. Reduction of the injection volume to 5 microl resulted in substantially less uptake and expression of DNA by muscle cells, and correspondingly lower immune responses against the transgene product. However, expression and immunogenicity were restored when the 5-microl injection was followed by electroporation in vivo. These findings indicate that distribution and cellular uptake significantly affect the immunogenicity of DNA vaccines.

AIDS Vaccines↗
PubMed2002

An experimental study on the use of manual pressure to reduce pain in intramuscular injections.

To investigate whether the application of manual pressure to the injection site before intramuscular injection reduces pain. An experimental study with intrasubject comparison was conducted using manual pressure to reduce pain associated with intramuscular injection. Seventy-four subjects, participating in an immunization vaccination campaign, were recruited by convenience sampling from a university. They were required to receive two doses of vaccines via intramuscular injections. One was given in a conventional way, i.e. without manual pressure being applied prior to the injection (control condition). The other was given with manual pressure being applied prior to the injection (experimental condition) for 10 seconds. The two conditions were randomly allocated for each subject. The instrument for measuring the perceived pain intensity was the Pain Intensity Verbal Rating Scale (Cantonese). To ensure the consistency of manual pressure being applied to the injection site, a mechanical pressure sensor device was used to record the manual pressure being applied. The mean manual pressure applied was 190.82 mmHg (SD=5.25). Results demonstrated a significant difference in the perceived pain intensity for experimental and control conditions. Subjects with manual pressure applied before injections reported lower pain intensity scores, whilst those without the application of manual pressure before injections reported higher pain intensity scores. Applying manual pressure to an injection site before performing an injection could be an effective means of decreasing pain intensity.

Adult↗
PubMed2001

Effects on the fusimotor-muscle spindle system induced by intramuscular injections of hypertonic saline.

Intramuscular injection of hypertonic saline (HS) is a procedure widely adopted to experimentally induce deep muscle pain in humans. This study was undertaken to test whether intramuscular injections of HS (5%) influence the activity of primary and secondary muscle spindle afferents (MSAs) from homonymous as well as heteronymous muscles. The experiments were performed on six cats anaesthetised with alpha-chloralose. Usually responses of two to nine MSAs from gastrocnemius medialis (GM) and/or gastrocnemius lateralis (GL) muscles were recorded simultaneously, while HS was injected either into the receptor-bearing muscle (homonymous responses) or into a close (GM/GL) or remote synergistic muscle (posterior biceps, PB, heteronymous responses). The mean rate of discharge and the depth of modulation of the MSA responses to sinusoidal stretching of the receptor-bearing muscle were calculated. Out of the 42 afferents tested (7 from GM and 35 from GL), 38 (90%) exhibited statistically significant responses to injections of HS into homonymous and/or heteronymous muscles. With injections into the homonymous muscle, the average maximal increase in mean rate of discharge was 74% and the average decrease in depth of modulation was --18%. The mean duration of the effects was 2.1 min. The corresponding values for heteronymous injections into a close synergist were 87%, -17% and 2.1 min (GM or GL), and for injections into PB 52%, -11%, and 1.8 min. The majority of the responses (72%) were compatible with reflex action on static fusimotor neurones, whereas 20% of the responses could be attributed to mixed static and dynamic fusimotor action. The remaining 8% of the responses were attributed to inhibition of fusimotor activity. There were no statistically significant differences between the responses following injections into homonymous or heteronymous muscles. Injections of Tyrode's solution did not induce any significant alterations in MSA responses, implying that they were not induced by direct and/or injury effects of the injections. HS-related changes in MSA activity were completely abolished after the nerves to corresponding muscles were cut, confirming the reflex nature of the effects. Thus, intramuscular injections of HS induce reflex changes in MSA activity from both homonymous and heteronymous muscles, most likely via fusimotor reflexes. Predominantly static fusimotor neurones were activated. The possible role of the fusimotor-muscle spindle system in altered motor control during experimentally induced muscle pain is discussed.

Action Potentials↗
PubMedDate not supplied

Using the ventrologluteal site for intramuscular injection.

The administration of intramuscular injections is a common nursing intervention in clinical practice. This article aims to raise awareness of the use of the ventrogluteal site for administering intramuscular injections. It describes the main reasons for using this site and outlines the complications associated with the dorsogluteal site. It is hoped that this review of the literature will shift everyday practice in favour of the ventrogluteal site.

Buttocks↗
PubMed2003

[Methotrexate administration in the treatment of unruptured tubal pregnancy. Prospective non-randomized study: intramuscular injection versus transvaginal sonography-guided injection].

OBJECTIVES: The aim of this study was to compare in a prospective non-randomized study, the efficacy of two methods of administering methotrexate (MTX) in the treatment of ectopic pregnancy (EP): transvaginal injection under sonographic control or intramuscular injection (IM). METHODS: Patients with EP who met specific inclusion criteria for medical treatment were treated by MTX: 73 patients (group 1) were treated by IM and 47 patients (group 2) by transvaginal local injection. MATERIALS AND METHODS: In group 1,50 mg/m(2) of MTX was injected intramuscularly; in group 2,1 mg/kg of MTX was injected transvaginally into the ectopic sac under sonographic guidance. Choice of the route depended on the physician's experience. RESULTS: The overall success rate, defined by a normal post-treatment hCG level (<10 mUI/mL) was 71.4% in group 1 versus 91.5% in group 2 (p<0.01); for patients with hCG levels<2,000 mUI/mL, 83% and 96% respectively (not significant); for patients with hCG 2,000 mUI/mL, 37.5% and 86.4% respectively (p<0.01). CONCLUSION: For medical treatment of EP, the efficacy of MTX is greater when administered by local transvaginal injection than by IM injection. We propose local treatment whenever the EP can be punctured, especially when hCG levels are 2,000 mUI/mL.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

Best practice guidelines for the administration of intramuscular injections in the mental health setting.

Intramuscular injections are administered to mental health consumers in both the community and hospital settings. Medications delivered by the intramuscular route assist consumers to live in the community and enhance their ability to integrate and engage in community life. Although the practice of giving intramuscular injections is routine for mental health nurses, the process is invasive and best practice guidelines are not well developed. The aim of this study was to identify a best practice technique for the administration of intramuscular injections in the mental health setting based on: (i) the identification of 300 abstracts and a systematic review of 150 articles in the subject area; (ii) an evaluation of current practice of 93 nurses; and (iii) the use of the newly developed technique with 96 consumers. The findings add significantly to the knowledge base on administering intramuscular injections in the mental health setting. The identified best practice technique provides mental health nurses with evidence-based guidelines, thus ensuring that the medication administered by intramuscular injection provides the best possible outcomes for consumers.

Adult↗
PubMed2003

[Distribution of the lateral cutaneous nerve of the thigh in the area of intramuscular injection].

UNLABELLED: The technique of intramuscular injection (IM) into the antero-lateral region of the thigh is widely used. Nevertheless, despite this area being indicated as the second best location for this practice, the technique is still observed to be very painful for both adult and child patients. OBJECTIVE: To study the localization, distribution and course of the lateral cutaneous nerve of the thigh, and its topographic relationship with the area recommended for the practice of intramuscular injection, relating these characteristics to the pain resulting from such procedures. METHOD: By means of exposing the antero-lateral region by classical dissection, the lateral cutaneous nerve of the thigh was identified and isolated in 20 fixed adult male cadavers, giving emphasis to the viewing of its nerve rami across the iliotibial tract. RESULTS: In 100% of the cases, the lateral cutaneous nerve emerged medially in relation to the upper anterior iliac spine. After this, it issued three wide-caliber rami in 70% of the specimens and only two in the remaining 30%. In the upper third and in the upper portion of the middle third of the thigh, a network of numerous small nerve rami was observed, enveloped in a variable quantity of adipose tissue. However, in the lower portion of the middle third of the thigh and in the lower third, no significant nerve rami were seen. CONCLUSION: Based on our data, we recommend whenever possible that the distal half of the region displayed by the classical technique be utilized as the location of choice for the practice of intramuscular injection into the antero-lateral region of the thigh. This is because this region is less innervated by the lateral cutaneous nerve of the thigh, which will cause less pain in this area during such procedures, thereby affording greater comfort to the patient.

Adult↗
PubMed1999

[Intramuscular injections in Sub-saharan African children, apropos of a frequently misunderstood pathology: the complications related to intramuscular quinine injections].

In West Africa, the incidence of poliomyelitis has decreased in the past years thanks to intensive immunization campaigns. Nowadays intramuscular injection is the main reason for paralysis of the legs in African children as well as attendance at Rehabilitation Centres. Intramuscular injection of quinine is the most frequently reported. Faced with the lack of sterile material, health workers do not rationalize the use of intramuscular injections. Although the use of the same needle has decreased, using the same syringe for many patients, with only a rapid washing between, is still commonplace Poor septic conditions and abuse of prescriptions also contribute to the transmission of severe diseases (hepatitis, malaria, syphilis, filariasis, Ebola virus, tetanus and HIV). Paralysis due to injection is often confused with poliomyelitis and health workers are often not aware of the sequelae of injection. It seems important to prevent risk related to intramuscular injection in Africa through educating health workers and the local population. Rationalization of practises, promotion of oral therapy and alternatives to intramuscular administration should be carried out. In this respect, the intrarectal administration of an injectable solution of diluted quinine--its efficiency and pharmacokinetic having been studied over the last ten years--offers interesting opportunities.

Africa South of the Sahara↗