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The choice of SC or IM injection depends on the specific medication, with SC administration preferred for products such as insulin where a slower and more sustained response is desirable, while IM administration is usually preferred for products such as vaccines where more rapid absorption leads to a more rapid antibody response. Obesity has the potential to influence the rate and extent of absorption, as well as adverse effects, of medications administered by the SC or IM route through changes in SC tissue composition and depth or by inadvertent administration of IM medications into SC tissue because of improper needle length. Potential adverse effects associated with IM or SC injections in addition to pain, bruising, and hematoma formation include sciatic nerve injury, particularly with IM injection in the upper outer quadrant of the buttock; bone contusion or rarely osteonecrosis if the IM injection is excessively deep; and granulomas, fat necrosis, and calcification with SC injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Issues related to medication absorption in obese patients are likely to become more prominent in the future with increasing approvals of a wide range of biotherapeutic agents administered by SC injection. Studies should be directed toward these and other agents to assist with dosing decisions in this challenging population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxac058","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T17:30:13Z","timestamp":1645119013000},"page":"1236-1244","source":"Crossref","is-referenced-by-count":26,"title":["Implications of obesity for drug administration and absorption from subcutaneous and intramuscular injections: A primer"],"prefix":"10.1093","volume":"79","author":[{"given":"Brian L","family":"Erstad","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona , Tucson, AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey F","family":"Barletta","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Midwestern University , Glendale, AZ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"issue":"6","key":"2022072208585239000_CIT0001","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1001\/jamainternmed.2018.1044","article-title":"Association of an opioid standard of practice intervention with intravenous opioid exposure in hospitalized patients","volume":"178","author":"Ackerman","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"1","key":"2022072208585239000_CIT0002","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/s13054-020-03040-z","article-title":"Drug dosing in the critically ill obese patient\u2014a focus on sedation, analgesia, and delirium","volume":"24","author":"Erstad","year":"2020","journal-title":"Crit Care"},{"issue":"1","key":"2022072208585239000_CIT0003","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s13054-021-03495-8","article-title":"Drug dosing in the critically ill obese patient: a focus on medications for hemodynamic support and prophylaxis","volume":"25","author":"Erstad","year":"2021","journal-title":"Crit Care"},{"issue":"10","key":"2022072208585239000_CIT0004","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1007\/s11095-017-2229-9","article-title":"Optimizing the bioavailability of subcutaneously administered biotherapeutics through mechanochemical drivers","volume":"34","author":"Collins","year":"2017","journal-title":"Pharm Res"},{"issue":"10","key":"2022072208585239000_CIT0005","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1056\/NEJM197609022951006","article-title":"Intramuscular injection of drugs","volume":"295","author":"Greenblatt","year":"1976","journal-title":"N Engl J Med"},{"issue":"34","key":"2022072208585239000_CIT0006","doi-asserted-by":"crossref","first-page":"6423","DOI":"10.1016\/j.vaccine.2007.05.046","article-title":"Echographic measurement of skin thickness in adults by high frequency ultrasound to assess the appropriate microneedle length for intradermal delivery of vaccines","volume":"25","author":"Laurent","year":"2007","journal-title":"Vaccine"},{"issue":"6","key":"2022072208585239000_CIT0007","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1185\/03007995.2010.481203","article-title":"Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations","volume":"26","author":"Gibney","year":"2010","journal-title":"Curr Med Res Opin"},{"issue":"2","key":"2022072208585239000_CIT0008","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/archfami.3.2.146","article-title":"Injection granulomas. 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