INJECTION
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WHERE TO INJECT
All oil based and water based anabolic
steroids should be taken intramuscularly. This means the shot must penetrate the
skin and subcutaneous tissue to enter the muscle itself. Intramuscular
injections are used when prompt absorption is desired, when larger doses are
needed than can be given cutaneously or when a drug is too irritating to be
given subcutaneously. The common sites for in tramuscular injectons include the
buttock, lateral side of the thigh, and the deltoid region of the arm. Muscles
in these areas, especially the gluteal muscles in the buttock, are fairly thick.
Because of the large number of muscle fibers and extensive fascia, (fascia is a
type of connective tissue that surrounds and separates muscles) the drug has a
large surface area for absorption. Absorption is further promoted by the
extensive blood supply to muscles. Ideally, intramuscular injections should be
given deep within the muscle and away from major nerves and blood vessels. The
best site for steroid injections is in the gluteus medius muscle which is
located in the upper outer quadrant of the buttock. The iliac crest serves as a
landmark for this quadrant. The spot for an injection in an adult is usually to
7 1/2 centimeters (2 to 3 inches) below the iliac crest. The iliac crest is the
top of the pelvic girdle on the posterior (back) side. You can find the iliac
crest by feeling the uppermost bony area above each gluteal muscle. The upper
outer quadrant is chosen because the muscle in this area is quite thick and has
few nerves. The probability of injecting the drug into a blood vessel is remote
in this area. Injecting here reduces the chance of injury to the sciatic nerve
which runs through the lower and middle area of the buttock. It controls the
posterior of each thigh and the entire leg from the knee down. If an injection
is too close to this nerve or actually hits it, extreme pain and temporary
paralysis can be felt in these areas. This is especially undesirable and
warrants staying as far away from this area as possible.
If the gluteal region cannot be
injected for some reason, the second choice would be the lateral portion of the
thigh. Usually, intramuscular injections in the thigh are only indicated for
infants and children. The vastus lateralis muscle is the only area of the thigh
that should be injected intramuscularly. This site is determined by using the
knee and the greater trochanter of the femur as landmarks. The greater
trochanter is the bony area that you can feel where the femur joins the pelvic
girdle. The mid portion of the muscle is located by measuring the handbreadth
above the knee and the handbreadth below the greater trochanter. Injecting into
the front of the thigh or inside of the thigh is extremely unwise. These areas
contain nerves as well as a number of blood vessels.
WHAT TO USE FOR INJECTIONS
It is important to choose the proper
syringe for the administration of injectable anabolic steroids. The principle
components of a syringe include a cylindrical barrel to one end of which a
hollow needle is attached, and a close fitting plunger. The most acceptable
syringe for injecting anabolic steroids is a 22 gauge 1 1/2” or 23 gauge 1”
apparatus with a 3 cc case. This length allows for penetration to reach deep
inside the muscle tissue. Shorter needles, 5/8” or 1/2” are usually not
sufficient for intramuscular injections and occasionally leave a portion of the
Injection in a subcutaneous area which will cause a swell between the skin and
muscle as well as impaired absorption. The gauge size of a syringe represents
the needle\rquote s diameter. The lower the gauge number, the wider it is. A 27
gauge needle is very thin. An 18 gauge is quite wide; it is often referred to as
a cannon. The 22 and 23 gauge needles are not so large that they are difficult
to insert, yet are large enough for solutions to easily be propelled through
them. The use of insulin needles is not acceptable; they are simply too small.
Usually, insulin pins are 25 to 27 gauge and only a 1/2” long with a 1 cc
case.
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