Editing Subcutaneous administration (section)

==Medical uses==
[[Image:Insulin pump with infusion set.jpg|thumb|An [[insulin pump]] with a subcutaneous infusion site]]
A subcutaneous injection is administered into the fatty tissue of the [[subcutaneous tissue]], located below the [[dermis]] and [[Epidermis (skin)|epidermis]].<ref>{{DorlandsDict|four/000053802|subcutaneous injection}}</ref> They are commonly used to administer medications, especially those which cannot be administered by mouth as they would not be absorbed from the [[gastrointestinal tract]]. A subcutaneous injection is absorbed slower than a substance injected [[intravenous therapy|intravenously]] or [[intramuscular injection|into a muscle]], but faster than a medication administered by mouth.<ref name=Taylor>{{cite book | vauthors = Taylor C |title=Fundamentals of nursing : the art and science of nursing care |date=2011 |publisher=Wolters Kluwer Health and Lippincott Williams & Wilkins |location=Philadelphia |isbn=978-0781793834 |edition=7th}}</ref>{{rp|721}}

===Medications===
Medications commonly administered via subcutaneous injection or infusion include [[insulin]], [[Attenuated vaccine|live vaccines]], [[monoclonal antibodies]], and [[heparin]]. These medications cannot be administered orally as the molecules are too large to be absorbed in the intestines.<ref name="Adv2019">{{cite journal | vauthors = Usach I, Martinez R, Festini T, Peris JE | title = Subcutaneous Injection of Drugs: Literature Review of Factors Influencing Pain Sensation at the Injection Site | journal = Advances in Therapy | volume = 36 | issue = 11 | pages = 2986–2996 | date = November 2019 | pmid = 31587143 | pmc = 6822791 | doi = 10.1007/s12325-019-01101-6 | name-list-style = vanc }}</ref> Subcutaneous injections can also be used when the increased bioavailability and more rapid effects over oral administration are preferred. They are also the easiest form of [[parenteral administration]] of medication to perform by lay people, and are associated with less adverse effects such as pain or infection than other forms of injection.<ref name="Adv2019" />

====Insulin====
Perhaps the most common medication administered subcutaneously is insulin. While attempts have been made since the 1920s to administer insulin orally, the large size of the molecule has made it difficult to create a formulation with absorption and predictability that comes close to subcutaneous injections of insulin.<ref name="insulin2018">{{cite journal | vauthors = Gedawy A, Martinez J, Al-Salami H, Dass CR | title = Oral insulin delivery: existing barriers and current counter-strategies | journal = The Journal of Pharmacy and Pharmacology | volume = 70 | issue = 2 | pages = 197–213 | date = February 2018 | pmid = 29193053 | doi = 10.1111/jphp.12852 | name-list-style = vanc | s2cid = 12848146 | doi-access = free }}</ref> People with [[type 1 diabetes]] almost all require insulin as part of their treatment regimens, and a smaller proportion of people with [[type 2 diabetes]] do as well — with tens of millions of prescriptions per year in the United States alone.<ref>{{cite web |title=Insulin Human - Drug Usage Statistics |  work = ClinCalc DrugStats Database |url=https://clincalc.com/DrugStats/Drugs/InsulinHuman }}</ref>

Insulin historically was injected from a vial using a syringe and needle, but may also be administered subcutaneously using devices such as [[injector pen]]s or [[insulin pump]]s. An insulin pump consists of a catheter which is inserted into the subcutaneous tissue, and then secured in place to allow insulin to be administered multiple times through the same injection site.<ref name=Taylor />{{rp|722}}

===Recreational drug use===
Subcutaneous injection may also be used by people to (self-) administer [[Recreational drug use|recreational drugs]]. This can be referred to as [[skin popping]].<ref name="neph2016">{{cite journal | vauthors = Lejmi H, Jen KY, Olson JL, James SH, Sam R | title = Characteristics of AA amyloidosis patients in San Francisco | journal = Nephrology | volume = 21 | issue = 4 | pages = 308–313 | date = April 2016 | pmid = 26370715 | doi = 10.1111/nep.12616 | name-list-style = vanc | s2cid = 31760853 | url = https://escholarship.org/uc/item/3h34t4b7 }}</ref> In some cases, the administration of illicit drugs in this way is associated with unsafe practices leading to infections and other adverse effects. In rare cases, this results in serious side effects such as [[AA amyloidosis]].<ref name="neph2016" /> Recreational drugs reported to be administered subcutaneously have included [[cocaine]],<ref>{{cite journal | vauthors = Khan F, Mukhtar S, Anjum F, Tripathi B, Sriprasad S, Dickinson IK, Madaan S | title = Fournier's gangrene associated with intradermal injection of cocaine | journal = The Journal of Sexual Medicine | volume = 10 | issue = 4 | pages = 1184–1186 | date = April 2013 | pmid = 23347293 | doi = 10.1111/jsm.12055 | name-list-style = vanc }}</ref> [[mephedrone]],<ref>{{cite journal | vauthors = Meng H, Cao J, Kang J, Ying X, Ji J, Reynolds W, Rampe D | title = Mephedrone, a new designer drug of abuse, produces acute hemodynamic effects in the rat | journal = Toxicology Letters | volume = 208 | issue = 1 | pages = 62–68 | date = January 2012 | pmid = 22037396 | doi = 10.1016/j.toxlet.2011.10.010 | name-list-style = vanc }}</ref> and [[amphetamine]] derivatives such as [[para-Methoxy-N-methylamphetamine|PMMA]].<ref>{{cite journal | vauthors = Steele TD, Katz JL, Ricaurte GA | title = Evaluation of the neurotoxicity of N-methyl-1-(4-methoxyphenyl)-2-aminopropane (para-methoxymethamphetamine, PMMA) | journal = Brain Research | volume = 589 | issue = 2 | pages = 349–352 | date = September 1992 | pmid = 1382813 | doi = 10.1016/0006-8993(92)91298-s | s2cid = 232653 | doi-access =  }}</ref>