Pierre Chue
University of Alberta, Canada
Title: Perspectives on the administration of intramuscular (IM) long acting antipsychotic injections (LAIs) in mental health clients
Biography
Biography: Pierre Chue
Abstract
Objectives
- Review the second generation atypical antipsychotics (SGA) LAIs.
- Understand the differential pharmacokinetics (pK) of deltoid vs. gluteal injections.
- Discuss Canadian nursing best practice and patient acceptance.
Introduction
The (SGAs) risperidone, paliperidone, aripiprazole are available in Canada as long acting injections (LAIs) given at intervals of two weeks to three months. Although initially developed as formulations for gluteal intramuscular (IM) injection, all are now approved for deltoid injection in volumes of up to 2.7 mL (for paliperidone 3-monthly).
Methodology
The international literature was reviewed in the context and discussed in the context of Canadian nursing best practice.
Results
Recent data suggest deltoid vs. gluteal IM injections are associated with shorter TMAX and greater CMAX, thus potentially offering a different exposure and clinical response and tolerability. For mental health clients deltoid injections are associated with less stigma, greater convenience and greater practicality in multiple clinical scenarios. Current Canadian nursing practice recommends gluteal as the preferred route for irritating, viscous and larger volumes, with a maximum of 2 mL in a well-developed deltoid muscle.
Conclusion
Advantages and disadvantages of deltoid vs. gluteal IM injections of LAIs should be considered in the context of Canadian nursing best practice, pK and real world practicality.