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November 1978

Legitimate Indications for Intramuscular Injections

Author Affiliations

From the Department of Medicine, University of California, San Francisco.

Arch Intern Med. 1978;138(11):1705-1710. doi:10.1001/archinte.1978.03630360081031

Give me a shot, Doc" may not be elegant English, but in one variation or another patient requests for injections are a commonplace feature of medical practice. Often the medication requested is of dubious value—cyanocobalamin for fatigue, antibiotics for viral respiratory infections, or chorionic gonadotrophin for obesity. Even when the drug is appropriate, it may be far from clear that the intramuscular (IM) route is preferable to oral administration.

The questionable use of injections may also be promoted by physicians. "This shot will fix you up" is a phrase not entirely foreign to the ears of patients. So-called shot doctors use such phraseology frequently. At the extreme, the injudicious administration of injections is the hallmark of the nonscientific physician.1

Medical charlatans sometimes combine a predilection for the parenteral route with the selection of unapproved, inappropriate, or ineffective medication. It is a fact of life that such practitioners may be