Injection Protocol and Instructions
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Injection information and Procedures
and Testosterone Hormone Replacement Therapy can be provided via
injection. In fact, the only safe and effective way to administer
Therapeutic Human Growth Hormone is with a shot. Testosterone, on the
other hand, can be delivered via a number of different means,
including Testosterone Gels, Testosterone Creams, Testosterone
Sprays, and even via implanted Dermal Pellets.
both forms of medication can be delivered via injection, they are
delivered via different techniques. Human Growth Hormone is delivered
using a technique known as Subcutaneous Injection. Testosterone is
almost always delivered via Intramuscular Injection.
a Subcutaneous Injection?
Subcutaneous Injection is a form of injection which is delivered just
under the layers of the skin. Subcutaneous Injections are sometimes
referred to by the scientific shorthand, SubQ. This form of injection
utilizes a short, thin needle which is specially designed to puncture
just below the skin. The medication contained within the syringe is
delivered to the space between the deepest levels of the skin and the
top layers of the muscle tissue. The needle used for Subcutaneous
Injection is often referred to as an Insulin Needle, because it is
the type of needle used by diabetics in order to deliver daily
Kinds of Medicine Can Be Delivered Subcutaneously?
of medicine cannot be administered orally. Human Growth Hormone is
one example of this. Insulin is a second example. These medications
cannot survive the digestive process, because enzymes and acids in
the stomach are designed to tear apart complex proteins, hormones,
and enzymes, rendering them to their component parts.
this is a good thing. The stomach has to break apart the food that
you eat, down to its basic components, so that the organs of your
body can reassemble those nutrients in order to serve the purposes of
your body. Complex organic medications are different, however. These
delicate medications need to be delivered to target organs intact so
that they can be properly activated.
Subcutaneous Injections Superior to Intravenous Injections?
it is also possible to deliver medications intravenously, in many
cases it is preferable to deliver them in other ways. Intravenous
Injections take a certain level of skill and finesse to deliver
quickly and efficiently. In order to deliver a medication
intravenously, it is necessary to target and hit a vein perfectly in
order to direct the contents of the needle directly to the
injections, on the other hand, are much easier to deliver, as they
simply need to be delivered just under the surface of the skin. There
is a chance that you will nick a blood vessel when you deliver
medication subcutaneously, but if you do so, all you have to do is
pick another injection site. Subcutaneous Injection is ideal for
delivering very small doses of potent medications. Subcutaneous
Injection is convenient, safe, and highly effective.
Injections are ideal for drug doses up two two milliliters. Human
Growth Hormone Injections for Adult HGH Deficiency generally range
from 1-2 CCs. Subcutaneous Injections are relatively fast-acting, but
still take a little while to be fully metabolized by the body.
Generally, Subcutaneous Injections deliver medications over the
course of a twenty-four hour period.
Types of Medicine are Administered Subcutaneously?
the small maximum volume for Subcutaneous dosage, medications that
utilize this form of delivery tend to either be incredibly potent, or
only needed in small doses. Protein-derived medications are very
often delivered subcutaneously because they would not survive
ingestion due to the powerful acids contained within the stomach.
Hormones, which are derived from proteins, are a second example of
medication that is often delivered Subcutaneously.
mentioned earlier, Subcutaneous injections are delivered with the
same needle that diabetics use to deliver Insulin. Human Growth
Hormone is also administered in the same fashion. Subcutaneous
Injection is also useful for medications that need to be delivered
rapidly, but are effective in small doses.
is an example of a medication that is delivered subcutaneously
quickly in emergency situations. Epinephrine injections are generally
stored in "pens" that can be activated and used quickly, because
Epinephrine is used in order to treat dangerous allergic reactions,
such as those that individuals have for substances such as peanuts
and poison from bee stings. These Epinephrine Pens are referred to as
EpiPens, and you likely know multiple people that carry these with
them on a daily basis. A number of pain meds can also be delivered
Subcutaneously, especially powerful ones such as hydromorphone and
powerful anti-nausea medications can also be delivered through an
insulin needle, such as dexamethasone and metoclopramide. Allergy
shots and some vaccines are delivered utilizeing this method as well,
although others are delivered Intramuscularly. Subcutaneous
Injections also have applications for many drugs which can actually
be delivered orally, but the patient is unable to take drugs by
Are Subcutaneous Injections Administered?
administering a subcutaneous injection, it is incredibly important to
choose an injection site that is appropriate for maximum safety and
effectiveness. In order for the Subcutaneous Medications to work
appropriately, they must be delivered just underneath the skin.
Although all areas of the body contain this subcutaneous layer, some
parts of the body have more to work with than others.
Are the Best and Worst Locations To Administer a Subcutaneous
important to choose a location where this sub-dermal area is clear,
because it is important to avoid hitting blood vessels, bone, or
muscle with the needle. The most ideal areas of the body for
Subcutaneous Injection are the stomach, the front of the thigh, or
the sides or back of the upper arm
Type of Needles Are Used in Subcutaneous Injections?
injections are delivered using needles which are 5/8 inch long. The
needle-width is generally fairly small, most often either 25 or 27
gauge. Doses which are between one and two milliliters may require a
slightly wider needle.
Subcutaneous Medications Stored?
Subcutaneous Medications, the medication is stored as a liquid in
small vials. Certain drugs, such as Human Growth Hormone, are stored
differently, however. For particularly sensitive and delicate drugs
like HGH, pharmacies and medical manufacturers convert the drug to a
powder form, through a process known as Lyophilization.
simply means that the medication is freeze-dried until it is ready to
be used. The Lyophilization process is safe to use on delicate
medications like Human Growth Hormone and does nt alter or break down
the chemical structure of the medication. Liquid HGH is incredibly
sensitive to both temperature and tampering. It must be stored under
refrigeration, even when lyophilized, and even agitating the vial too
much can break down the dried HGH and render it inert.
medications like Human Growth Hormone are prepared for Subcutaneous
Injection through a process known as Reconstitution. This is
generally performed carefully, by combining the Lyophilized
medication with sterile solution in order to restore it to its normal
composition. For medications that will be used fairly quickly after
they have been reconstituted, simple, sterilized water will be
drugs, including Human Growth Hormone intended to be stored for up to
a month after reconstitution, the Lyophilized Medication is generally
combined with water that has been treated by a preservative such as
benzene. Some vials of medicine are only intended to be used once,
whereas others are intended for multiple uses.
Injection with Pens
much all Subcutaneous Injections can be delivered using a standard
insulin needle and syringe, but there are also other products which
are intended to make the injection process easier and simpler. The
most common of these is the "Pen." Pens are small machines
intended to store and deliver a medication easily, which is shaped
like a pen. The pen contains liquid medication, and each time the
medication is delivered, it uses a new needle.
are generally engineered so that they automatically deliver a range
of doses simply by adjusting a dial. Some medications can also be
delivered via computerized, hand-held devices.
preparing to administer a subcutaneous injection, it is important
that the first thing you do is to wash your hands thoroughly. If you
are delivering a subcutaneous injection for someone else, it is
vitally important to wear gloves.
addition to washing your hands, you should also appropriately
sterilize the area in which you plan to arrange your supplies. It is
incredibly important to maintain optimal cleanliness throughout the
injection process so that you minimize the potential for
following steps are necessary when performing Subcutaneous Injections
utilizing a syringe:
Sure the Right Person is Getting the Right Medication
drawing the medicine from its vial, always look at the bottle in
order to ensure that you are always injecting the appropriate
medication. Nurses and other medical professionals constantly stress
the importance of the 5 Rights of Medication Delivery: the Right
Medicine, the Right Dosage, the Right Patient, the Right Time, and
the Right Route. By following these five steps every time, you ensure
that the treatment you intend to deliver is delivered appropriately
have obtained the appropriate vial of medication, remove the cap and
place it to the side. If the pen or vial that you are using is
intended for multiple uses, write down the date at which you first
opened the vial. After being opened, Subcutaneous Medications often
have relatively short shelf-lives. For example, once reconstituted,
Human Growth Hormone Replacement Therapy generally keeps for a few
weeks. After that point, it is no longer medically potent.
the Medication from the Vial
removing the cap from the medication, sterilize the rubber stopper on
the vial with an alcohol swab. At this point, take your syringe and
pull the plunger back so that the amount of air inside represents the
dose that you intend to draw. At this point, carefully remove the cap
which has been covering the tip of the needle, making sure not to
make contact with the needle, itself. If you do accidentally touch
the needle, discard it and choose another needle.
bring the needle into contact with the stopper of the vial. After
piercing the vial with the needle, inject the air contained within
the needle into the vial. This will maintain air pressure in the vial
and make it easier to draw the medication. At this point, tilt both
syringe and vial topside down with the needle pointed straight
upward. If there are air bubbles in the solution, tap the side of the
vial lightly in order to jar any air bubbles to the bottom of the
the plunger until the dose you intend to inject is contained within
the vial. Carefully pull the needle from the vial and check the
syringe for any trapped bubbles of air. If there are any bubbles of
air, tap the syringe lightly so that they rise to the top. At this
point, slowly depress the plunger, ejecting any bubbles contained
within. Release the plunger when you see the medication itself breach
the tip of the needle.
Administering Subcutaneous Medication using a Pen:
mentioned earlier, Injection Pens are used because they simplify the
process significantly. When using a Pen, the medication is already
contained within the device and ready for use. The only thing you
need to do is replace the needle every dose until either the pen is
expended or the medication contained within is out of date.
that the needle is connected to the pen safely without making contact
with the tip of the needle. When using a Subcutaneous Pen, the dial
on the side of the pen represents the size of the dose that will be
delivered. Turn the dial so that when activated, the pen will deliver
the appropriate dose.
choosing a location on your body to deliver the medication, we
recommend one of the sites mentioned above: the midsection, the sides
or back of the upper arms, or the top of the thighs. When selecting a
location, pick a spot of clean and healthy skin. Avoid injecting into
an area with skin irritation, burns, bruising, hardness, or swelling.
is important to inject into a different location every time you
deliver a shot. Repeatedly injecting in the same general location can
structurally weaken the skin or cause irritation and pain. Before
settling in for your injection, clean the injection site with an
alcohol swab. Set the syringe or pen to the side where it can be
picked up and utilized easily.
hand, take the patch of skin, and squeeze it between your index
finger and thumb so that it is raised. This allows the needle to
inject completely into the skin while also delivering the medication
to the appropriate layer underneath the skin. Pick up the needle and
hold it at a right-angle to the skin. If you have very low body-fat,
you may need to turn the needle to a forty-five degree angle in order
to inject the medication correctly.
the Subcutaneous Medication
ready, pierce the skin firmly and steadily with the needle. When the
needle is fully inserted into the skin, draw back just a tiny bit.
If you draw blood when you pull the plunger back, that means that you
have pricked a blood vessel and will need to pull out, replace the
needle, and choose a new injection site. If you do not see any blood,
deliver the medication by depressing the plunger slowly and
have delivered the medication, pull the needle out of the skin
quickly, yet carefully. After removing the needle, set the syringe or
pen aside and clean the injection site with clean gauze. If you do
experience any bleeding after the injection, there should be very
little blood. Do not be overly concerned if you occasionally
experience bruising as a result of injection.
of All Equipment Appropriately
have completed the injection process, recap your needle and throw it
away in an OSHA-Approved SHARPS container. If you do not have a
SHARPS container, or other container approved for medical waste, do
not inject until you have a way to safely dispose of the needles.
Used needles are bio-hazardous waste, and it is both dangerous and
illegal to dispose of them improperly.
Complications are Related to Subcutaneous Injection?
injection, there is a non-negligible chance that you will experience
an infection. Although there is always a risk of infection, this risk
can be reduced a significant amount by following procedures which
ensure that all aspects of injection are handled appropriately and
you follow all of the appropriate steps for safe injection, you may
still experience changes in skin, irritation, or bruising. Changing
injections sites with every administration will greatly reduce the
risk of experiencing these symptoms.
that have issues with cardiovascular circulation may have issues
experiencing the full effects of Subcutaneous Medication, because
poor circulation inhibits optimal absorption rates.
patients may also be allergic to preservatives contained within
medications which are intended to increase the shelf life of larger
prescriptions. For these patients, alternative preservatives may be
needed, or the patient may opt for smaller vials which do not require
preservatives at all.
Information listed in this document is provided for informational purposes and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treatment of a health problem or disease, or prescribing any medication. If you have or suspect that you have a medical problem, promptly contact your health care provider or your representative.
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