A Medication That Is Administered Subcutaneously Is Quizlet

Subcutaneous injections, a common method of drug delivery, involve administering medication into the tissue layer between the skin and muscle. This technique offers several advantages, including ease of administration and slower absorption rates compared to intravenous injections. Understanding the nuances of subcutaneous injections is crucial for healthcare professionals and individuals who self-administer medications.

What is a Subcutaneous Injection?

A subcutaneous injection delivers medication into the subcutaneous tissue, the layer of fat and connective tissue beneath the dermis and epidermis. This method allows drugs to be absorbed gradually into the bloodstream, making it suitable for medications requiring sustained release. Common examples include insulin, heparin, and certain vaccines.

Advantages of Subcutaneous Injections

• Ease of Administration: Subcutaneous injections are relatively simple to administer, making them suitable for self-administration by patients at home.
• Slower Absorption: The subcutaneous tissue has fewer blood vessels compared to muscle tissue, resulting in slower absorption rates and prolonged drug effects.
• Reduced Risk of Complications: Compared to intravenous injections, subcutaneous injections carry a lower risk of infection and vessel damage.
• Suitable for Certain Medications: Subcutaneous injections are ideal for drugs that require slow, consistent absorption, such as insulin and some hormones.

Medications Commonly Administered Subcutaneously

Numerous medications are administered via subcutaneous injection due to the advantages it offers. Here are some of the most common:

Insulin

Insulin is a hormone crucial for regulating blood sugar levels in individuals with diabetes. Subcutaneous injection is the primary method of insulin delivery. Different types of insulin, such as rapid-acting, short-acting, intermediate-acting, and long-acting, are administered subcutaneously to mimic the body's natural insulin release patterns.

Heparin and Enoxaparin

These are anticoagulant medications used to prevent and treat blood clots. Heparin and enoxaparin (Lovenox) are frequently administered subcutaneously, particularly in hospital settings, to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE).

Epinephrine

Epinephrine, commonly known as adrenaline, is used to treat severe allergic reactions (anaphylaxis). Devices like EpiPens deliver a pre-measured dose of epinephrine via subcutaneous or intramuscular injection to quickly counteract the symptoms of anaphylaxis.

Human Growth Hormone (HGH)

HGH is prescribed for various conditions, including growth hormone deficiency. Subcutaneous injections of HGH stimulate growth and regulate body composition.

Interferons

Interferons are a class of proteins used to treat multiple sclerosis, hepatitis, and certain cancers. Subcutaneous administration of interferons helps modulate the immune system.

Fertility Medications

Several fertility drugs, such as gonadotropins, are administered subcutaneously to stimulate ovulation and support reproductive technologies like in vitro fertilization (IVF).

Certain Vaccines

Some vaccines, like the measles, mumps, and rubella (MMR) vaccine, are administered subcutaneously to stimulate an immune response.

Step-by-Step Guide to Administering a Subcutaneous Injection

Administering a subcutaneous injection correctly is essential to ensure the medication is delivered effectively and safely. Follow these steps:

1. Gather Supplies

• Prescribed medication
• Appropriate-sized syringe and needle (usually 25-30 gauge and 1/2 to 5/8 inches long)
• Alcohol swabs
• Sharps container for safe disposal of used needles and syringes
• Gloves (optional but recommended)

2. Wash Your Hands

Thoroughly wash your hands with soap and water for at least 20 seconds to prevent infection. If soap and water are unavailable, use an alcohol-based hand sanitizer.

3. Prepare the Medication

• If the medication is in a vial, remove the protective cap and clean the rubber stopper with an alcohol swab.
• Draw air into the syringe equal to the dose of medication needed.
• Insert the needle into the vial, inject the air, and invert the vial.
• Withdraw the correct dose of medication into the syringe, ensuring no air bubbles are present. If bubbles are present, gently tap the syringe to make them rise to the top, then expel them.

4. Choose an Injection Site

Select an appropriate injection site with adequate subcutaneous tissue. Common sites include:

• Abdomen (at least two inches away from the navel)
• Outer thigh
• Upper arm (back or side)

Rotate injection sites to prevent lipohypertrophy, a condition where fat accumulates under the skin due to repeated injections at the same site.

5. Clean the Injection Site

Clean the chosen injection site with an alcohol swab in a circular motion, moving outward from the center. Allow the alcohol to dry completely.

6. Pinch the Skin

Gently pinch the skin at the injection site to create a raised fold of subcutaneous tissue. This ensures the medication is delivered into the subcutaneous layer rather than the muscle.

7. Insert the Needle

Hold the syringe at a 45 to 90-degree angle to the skin, depending on the amount of subcutaneous tissue available. Insert the needle quickly and smoothly into the pinched skin.

8. Inject the Medication

Once the needle is in place, release the pinched skin and slowly inject the medication. Injecting slowly helps reduce discomfort and allows the medication to be absorbed properly.

9. Withdraw the Needle

After injecting the medication, wait a few seconds before withdrawing the needle. This ensures the entire dose is delivered. Remove the needle at the same angle it was inserted.

10. Apply Gentle Pressure

Apply gentle pressure to the injection site with a clean gauze pad or cotton ball. Do not rub the area, as this can cause irritation or bruising.

11. Dispose of the Syringe and Needle

Immediately dispose of the used syringe and needle in a sharps container. Never recap the needle to prevent accidental needlestick injuries.

12. Monitor the Injection Site

Check the injection site for any signs of redness, swelling, pain, or bleeding. If any of these occur, consult with a healthcare professional.

Factors Affecting Absorption Rate

Several factors can influence the absorption rate of medications administered subcutaneously:

• Blood Flow: Increased blood flow to the injection site can enhance absorption. Factors like exercise or applying heat can increase blood flow.
• Injection Site: Different injection sites have varying amounts of subcutaneous tissue and blood flow, affecting absorption rates. The abdomen generally has more consistent absorption compared to the thigh or arm.
• Medication Formulation: The formulation of the medication can impact absorption. For example, medications in solution form are typically absorbed faster than those in suspension.
• Individual Factors: Age, gender, body mass index, and underlying medical conditions can influence absorption rates.

Potential Complications and How to Avoid Them

While subcutaneous injections are generally safe, potential complications can occur. Here are some common issues and how to prevent them:

• Infection: Proper hand hygiene and cleaning the injection site with an alcohol swab can minimize the risk of infection.
• Bleeding and Bruising: Applying gentle pressure to the injection site after the injection can help prevent bleeding and bruising. Avoid rubbing the area.
• Pain and Discomfort: Injecting the medication slowly and allowing the alcohol to dry completely before injection can reduce pain and discomfort.
• Lipohypertrophy: Rotating injection sites regularly can prevent lipohypertrophy. Examine injection sites for changes in texture or thickness.
• Allergic Reactions: Although rare, allergic reactions can occur. Monitor for signs of an allergic reaction, such as rash, itching, swelling, or difficulty breathing. Seek immediate medical attention if any of these symptoms occur.

Subcutaneous Injection Techniques for Specific Medications

Insulin Injections

• Use a dedicated insulin syringe with fine gauge needles.
• Rotate injection sites within the same general area (e.g., abdomen) to maintain consistent absorption.
• Administer insulin 15-30 minutes before meals, as directed by your healthcare provider.

Heparin/Enoxaparin Injections

• Use pre-filled syringes with safety needles to prevent needlestick injuries.
• Inject into the abdomen at a 90-degree angle, without pinching the skin.
• Do not expel the air bubble in pre-filled syringes unless instructed by your healthcare provider.

Epinephrine Injections (EpiPen)

• Administer into the outer thigh, even through clothing if necessary.
• Hold the EpiPen in place for 3 seconds after injection.
• Seek immediate medical attention after using an EpiPen.

Innovations in Subcutaneous Drug Delivery

Advancements in drug delivery technology have led to innovations in subcutaneous injections:

• Autoinjectors: These devices simplify subcutaneous injections by automatically inserting the needle and delivering the medication with the push of a button.
• Prefilled Syringes: Prefilled syringes contain a pre-measured dose of medication, reducing the risk of dosing errors and contamination.
• Microneedle Patches: Microneedle patches deliver medication through tiny needles that penetrate the outer layer of the skin, offering a painless alternative to traditional injections.
• Implantable Devices: Implantable devices provide continuous subcutaneous drug delivery over an extended period, reducing the need for frequent injections.

The Role of Healthcare Professionals

Healthcare professionals play a crucial role in educating patients about subcutaneous injections. They provide instructions on proper injection techniques, medication storage, and potential side effects. Additionally, healthcare professionals assess patients' ability to self-administer injections and offer support and resources to ensure safe and effective treatment.

Subcutaneous Injections vs. Intramuscular Injections

While both subcutaneous and intramuscular injections involve injecting medication, they differ in terms of depth and absorption rates. Subcutaneous injections are administered into the subcutaneous tissue, while intramuscular injections are delivered into the muscle. Intramuscular injections have faster absorption rates due to the higher blood flow in muscle tissue. The choice between subcutaneous and intramuscular injection depends on the medication's properties and the desired rate of absorption.

Considerations for Pediatric and Geriatric Patients

Administering subcutaneous injections to pediatric and geriatric patients requires special considerations:

Pediatric Patients

• Use smaller gauge needles to minimize discomfort.
• Choose injection sites based on the child's age and body mass.
• Provide distraction techniques and emotional support to reduce anxiety.

Geriatric Patients

• Assess skin integrity and choose injection sites carefully.
• Consider using assistive devices, such as needle guides, to improve accuracy.
• Educate caregivers on proper injection techniques and potential complications.

Patient Education and Training

Effective patient education and training are essential for successful subcutaneous injections. Patients should receive comprehensive instructions on all aspects of the injection process, including:

• Medication information
• Proper injection technique
• Injection site selection and rotation
• Safe disposal of sharps
• Potential side effects and how to manage them
• When to seek medical attention

Overcoming Injection Anxiety

Many individuals experience anxiety or fear related to injections. Here are some strategies to help overcome injection anxiety:

• Education: Understanding the injection process and its benefits can reduce anxiety.
• Relaxation Techniques: Deep breathing exercises, meditation, and visualization can help calm nerves.
• Topical Anesthetics: Applying a topical anesthetic cream to the injection site can numb the area and reduce pain.
• Distraction: Listening to music, watching a video, or engaging in conversation during the injection can divert attention from the procedure.
• Support: Having a friend, family member, or healthcare professional present during the injection can provide emotional support.

The Future of Subcutaneous Drug Delivery

The field of subcutaneous drug delivery is constantly evolving, with ongoing research focused on developing new technologies and improving patient outcomes. Future directions include:

• Smart Injectable Devices: Smart devices that monitor medication levels and adjust dosing accordingly.
• Long-Acting Injectables: Medications that can be administered less frequently, improving patient adherence and convenience.
• Personalized Drug Delivery: Tailoring drug delivery methods to individual patient needs and characteristics.
• Painless Injections: Developing new needle-free injection technologies to eliminate pain and anxiety associated with injections.

Conclusion

Subcutaneous injections are a valuable method for delivering medications that require slow, consistent absorption. By understanding the principles of subcutaneous injection, healthcare professionals and patients can ensure safe and effective drug administration. Continuous advancements in drug delivery technology promise to further enhance the convenience and efficacy of subcutaneous injections in the future.