Methotrexate in ob office

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Specializes in peds, allergy-asthma, ob/gyn office.

New to OB office. Can't find much info on how to give methotrexate IM. Specifically, which injection sites are acceptable for this drug?

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Specializes in Nurse Leader specializing in Labor & Delivery.

What is the actual volume of the injection? I would treat it like any other IM injection (i.e. either deltoid or glute, depending on volume).

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Specializes in peds, allergy-asthma, ob/gyn office.

I have only seen it given one other time since I"ve been there. The volume ended up being two injections of 1.2cc each. Given in the dorsogluteal. My coworker did it. I have been reading and realizes the dorsogluteal is out and ventrogluteal is in. I want to start using the ventrogluteal very much but am not sure how to get experience with it. My coworker also has never done ventrogluteal. I guess my main question is ... is methotrexate one of those that is irritating/meant for a large muscle? Coworker did say one of the docs gave it deltoid once himself.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Ventrogluteal works better when the patient is lying down. When I worked inpatient OB, I became proficient at ventro. Now that I work in ambulatory care and all my patients are standing when I give them shots, I'm used to dorsal.

Ventro is easy. You take your hand (the hand on which the pinky finger is pointed toward the patient's lady parts), place your pointer finger on the iliac spine, your thumb on the hip bone. Spread your other fingers out so pointer and middle finger make a V, then give the injection within that V.

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Specializes in peds, allergy-asthma, ob/gyn office.

This pt just had surgery. Still determining if all the tissue was removed. Drew hcg level today. Metho was mentioned, depending on what level shows. Kinda concerned she would have difficult laying on table and rolling side to side for a ventro inj in each hip.

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Specializes in Nurse Leader specializing in Labor & Delivery.

I believe you can give up to 4ml in the dorso or ventro gluteal. No need for two separate injections.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Did she lose a fallopian tube?

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Specializes in peds, allergy-asthma, ob/gyn office.

I actually don't have that information. her visit in the office today was rather unexpected, quick. thanks for all of your help klone

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Specializes in Nurse Leader specializing in Labor & Delivery.

No problem. I find outpatient OB to be endlessly fascinating! Always an interesting story or case.

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Specializes in peds, allergy-asthma, ob/gyn office.

It is interesting for sure, tons more interesting than the allergy clinic... my previous job!

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Specializes in Pedi.
I have only seen it given one other time since I"ve been there. The volume ended up being two injections of 1.2cc each. Given in the dorsogluteal. My coworker did it. I have been reading and realizes the dorsogluteal is out and ventrogluteal is in. I want to start using the ventrogluteal very much but am not sure how to get experience with it. My coworker also has never done ventrogluteal. I guess my main question is ... is methotrexate one of those that is irritating/meant for a large muscle? Coworker did say one of the docs gave it deltoid once himself.

Methotrexate is routinely given subq in autoimmune/rheumatological diseases so I do not think it needs to be given in a larger muscle.

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