Editing Intramuscular injection (section)

==Contraindications==
Because an intramuscular injection can be used to administer many types of medications, specific [[contraindication]]s depend in large part on the medication being administered.<ref name=Nursing2002>{{cite journal |last1=Nicoll |first1=Leslie H. |last2=Hesby |first2=Amy |title=Intramuscular injection: An integrative research review and guideline for evidence-based practice |journal=Applied Nursing Research |date=August 2002 |volume=15 |issue=3 |pages=149–162 |doi=10.1053/apnr.2002.34142|pmid=12173166 }}</ref> Injections of medications are necessarily more invasive than other forms of administration such as by mouth or topical and require training to perform appropriately, without which complications can arise regardless of the medication being administered. For this reason, unless there are desired differences in rate of absorption, time to onset, or other pharmacokinetic parameters in the specific situation, a less invasive form of drug administration (usually by mouth) is preferred.<ref name=Nursing2002 />

Intramuscular injections are generally avoided in people with [[thrombocytopenia|low platelet count]] or clotting problems, to prevent harm due to potential damage to blood vessels during the injection. They are also not recommended in people who are in [[hypovolemic shock]], or have myopathy or [[muscle atrophy]], as these conditions may alter the absorption of the medication.<ref name="Polania" /> The damage to the muscle caused by an intramuscular injections may interfere with the accuracy of certain cardiac tests for people with suspected [[myocardial infarction]] and for this reason other methods of administration are preferred in such instances.<ref name="Polania" /> In people with an active myocardial infarction, the decrease in circulation may result in slower absorption from an IM injection.<ref name=LippNurs7 />{{rp|368–369}} Specific sites of administration may also be contraindicated if the desired injection site has an infection, swelling, or inflammation.<ref name="LippNurs7">{{cite book |editor1-last=Eckman |editor1-first=Margaret |title=Lippincott Nursing Procedures |date=October 9, 2015 |publisher=Lippincott Williams & Wilkins |location=Philadelphia |isbn=978-1-4698-5303-1 |edition=Seventh}}</ref>{{rp|368–369}} Within a specific site of administration, the injection should not be given directly over irritation or redness, birthmarks or moles, or areas with scar tissue.<ref name=LippNurs7 />{{rp|368–369}}