Leishmania spp.
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
Simple cutaneous leishmaniasis may be left to self-heal in geographical areas with L. major. Some cutaneous lesions, mucocutaneous disease, and visceral leishmaniasis require treatment. Until recently the mainstay of treatment has been pentavalent antimony compounds. These include sodium stibogluconate and meglumine antimonate. They are administered by intramuscular injection on a daily basis for up to 28 days. The intramuscular injections can be painful and there can be systemic toxicity. Amphotericin B and more recently liposomal amphotericin B represent advances in treatment. However, they require intravenous administration, are also toxic, and are much more expensive, especially liposomal amphotericin B. An oral, tolerable agent is now available for visceral leishmaniasis. Oral miltefosine for 28 days was shown to be equally effective with amphotericin B for visceral leishmaniasis in India. Alternative treatments are very welcome, as about 60% of visceral leishmaniasis infections in Bihar, India are resistant to treatment with pentavalent antimonials.
Trigeminal autonomic cephalgias I – cluster headache: diagnosis and treatment
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby in Headache in Clinical Practice, 2018
Dihydroergotamine (DHE), available in injectable and intranasal forms, is effective in relieving acute attacks of cluster headache. Parenteral DHE (1mg intramuscularly)87 and intranasal DHE88 are effective for some, but not all, patients. Intravenous injection gives more rapid relief than intramuscular injection, with benefit in less than 10 minutes. Andersson and Jespersen88 conducted a double-blind comparative trial of DHE nasal spray (lmg). DHE did not change the duration or frequency of the attacks, but it did decrease pain intensity. Since DHE as a nasal spray has a 40% bioavailability, administration of a higher dose may be more effective for the treatment of cluster headache.
Improving knowledge and safety: pharmacological principles
Sherri Ogston-Tuck in Introducing Medicines Management, 2013
Common sites for intramuscular injections include: The deltoid muscle (Figure 5.5c) up to 1 ml (Workman, 1999; Greenway, 2004; Endacott et al., 2009). The rectus formalis and vastus lateralis muscles of the thigh (Figure 5.5b) up to 5 ml (in adults) and 4 ml in children (Greenway, 2004; Endacott et al., 2009).The dorsogluteal and ventrogluteal muscles of the buttock (Figure 5.5a) up to 4 ml (Greenway, 2004).
An evaluation of long-acting cabotegravir + rilpivirine for the treatment of virologically suppressed adults living with HIV
Published in Expert Opinion on Pharmacotherapy, 2022
Hamdi Qazzaz, Christopher Parganas, Theodore James Cory
Long-acting injectable products may have advantages as compared to traditional antiretroviral therapy strategies. The non-inferiority clinical trials including LATTE, LATTE-2 and ATLAS, coupled with high patient satisfaction scores, suggests that these approaches are safe, efficacious, and well tolerated. A potential niche of therapy for CAB+RPV is in patients that may benefit from an extended dosing interval product. Patients with adherence concerns, such as those who work long hours or who struggle with remembering to take daily medications would be significantly impacted by long-acting formulations. In addition, patients who experienced side effects from oral medications would also benefit from therapy that bypasses first pass metabolism or presystemic circulation. The intramuscular injection has a significant advantage in this subpopulation due to controlled administration at the clinician level. The benefits allow for increased dosing schedules for patients and allow for structured and atypical dosing schedules to fit the needs of patients who cannot be maintained on a fixed oral dosing regimen.
Fatal and life-threatening ADRs associated with paliperidone palmitate: an observational study in the French pharmacovigilance database
Published in Clinical Toxicology, 2021
D. Boels, J. Mahé, A. Olry, A. Citterio-Quentin, J. Moragny, P. Jolliet
On the basis of PK modeling data, because of their extremely low water solubility (log p≈8), PP particles in the suspension slowly dissolve into the local fluids at the injection site, and they gradually enter systemic circulation after hydrolysis. Several PK studies suggest that the rate-limiting factor is PP dissolution at the injection site. The median peak concentration and AUC can vary noticeably between injection site: in one study, after second administration, PP exposure was approximately 45% higher for deltoid injection than for gluteal injection, and approximately 25% higher after fourth administration [6,28]. In our series, injection site was not reported. This observed variation between injection sites can be explained by the distribution of muscle and adipose tissue, which condition plasma paliperidone uptake. True intramuscular injection is more likely for deltoid injection sites. The hypovascularity of subcutaneous adipose tissue relative to muscle tissue may result in a slower plasma uptake of paliperidone. Furthermore, the hydrolyzing capacities of each tissue probably differ, and this may affect paliperidone pharmacokinetics (i.e., Cmax, tmax, and AUC). There is still a lack of consensus on the bioequivalence of the two administration sites: doubt remains as to the risk (especially of supratherapeutic concentrations) posed by site switching [29]. Further investigation of this question may be warranted.
Sublingual methylcobalamin treatment is as effective as intramuscular and peroral cyanocobalamin in children age 0–3 years
Published in Hematology, 2021
Betül Orhan Kiliç, Serhat Kiliç, Elif Şahin Eroğlu, Eylem Gül, Fatma Burcu Belen Apak
The standard vitamin B12 treatment that has been known and applied for years is the parenteral vitamin B12 treatment. As a result of the studies in the world and our country over the years, it has been shown that oral vitamin B12 treatment is as effective as intramuscular therapy in adults[4–7]. Intramuscular injections are painful and prone to complications, and at the same time, they need to be applied at the hospital, so recently oral administration is preferred more frequently[4]. Therefore, oral vitamin B12 treatment, which is painless and easily applied is recently been used in children. In some studies, it was shown that oral cyanocobalamin therapy in children as was as effective as intramuscular treatment[8,9]. Although the effectiveness of sublingual therapy in adults has been demonstrated, limited studies are showing the efficacy of sublingual methylcobalamin therapy in children, which is easier to apply than oral cyanocobalamin therapy [10,11].
Related Knowledge Centers
- Deltoid Muscle
- First Pass Effect
- Muscle
- Vastus Lateralis Muscle
- Blood Vessel
- Injection
- Route of Administration
- Subcutaneous Administration
- Intradermal Injection
- Gluteal Muscles