Subcutaneous Injection

A subcutaneous injection is also called a subQ inject. The peptide is given into the layer between the skin and muscle. Your caregiver chose this kind of shot because of one or more of these reasons:

• The amount of medicine to be given. Small amounts of medicine are given subQ.
• The kind of medicine to be given. Certain peptides must be given into the subcutaneous space.
• The speed at which the hormone needs to act. Medicine that needs to work slowly is given subQ.

What should I know about the syringe?

• A syringe has 3 major parts: the needle, the barrel and the plunger. The needle goes under the skin to put in medicine. The barrel holds the medicine. The barrel has markings on it like a ruler. The markings are for mL's (milliliters). The plunger is used to get medicine into and out of the syringe.
• Subcutaneous shots must be given in small amounts. You will usually get an "insulin syringe" for a subQ shot. Insulin syringes will hold a maximum of 1 mL of medicine. The syringe shows divisions well marked with 10, 20, 30, 40, 50, 60, 70, 80, 90 and 100. 100 is the same as 1 mL. The marking at 50 is the same as half of a mL.

Where can I give a subcutaneous shot?

There are many sites on the body that are safe to give subcutaneous shots. Following is a list of the sites where subcutaneous shots may be given:

• Upper Arm: Uncover the arm to the shoulder to see the whole arm. Have the person getting the shot stand with hand on hip. Stand next to and a little behind the person. Find the area in the middle part of the arm, halfway between the elbow and shoulder. Gently grasp the skin at the back of the arm between your thumb and first 2 fingers. You should have 1-2 inches of skin.
• Abdomen: Uncover the abdomen to see the whole area. Find the waist area. You may give a shot bounded by these landmarks: below the waist, to just above the hip bone, and from where the body curves at the side to about 2 inches from the middle of the abdomen. Avoid the bellybutton. Use the natural line in the middle of the body as a marker. It may be hard to see, but it is there unless it was removed by surgery.
• Thigh: Uncover the entire leg. Find the area between the knee and hip. The middle of the thigh, from mid-front to mid-side, on the outside part of the thigh is a safe site. Gently grasp the area to make sure you can pinch one to two inches of skin.
• Lower back: Uncover the back from the waist to the top of the rear-end. A shot may be given just below the waist to a line that runs across the back above the crack between rear end cheeks. Give the shot between the area where the body curves at the hip and a few inches from the spine.

How do I choose a good place for the shot? Any of the following sites may be used: upper arm, abdomen, thigh, lower back. It is important to keep track of the sites you use and to use a different site each time you give a shot. Some sites are preferred for certain medicines. Ask your caregiver if the medicine you are taking has a preferred site. If you are giving shots to yourself you may not be able to use your back or your arm.

• To keep track of where you are giving shots, make a list of the sites you use. Write down the date, time, and the site each time you give a shot.
• The sites where shots are given should be at least 1 inch away from each other. Picture 1 inch squares, like a checkerboard. A shot may be given into each of those squares. You may choose to rotate your shots through one area, like the left thigh, then begin again in the same area. Or you may rotate through one area then go to another.
• It is very important to rotate sites. Giving a shot in the same site can make the site scarred and hard. Hard areas will keep you from using all the medicine.

What do I need to give a subcutaneous injection?

• One alcohol wipe wrapped in foil.
• One sterile 2 x 2 gauze pad.
• An ampule, vial, or pre-filled syringe containing the medicine.
• The correct size syringe and needle. Your caregiver should give you this information.

How do I inject medicine into subcutaneous tissue? Please read this section all the way through before giving the shot. It is important to get the general idea of what you are about to do before you begin. You may read this step-by-step procedure again as you do it.

• Subcutaneous shots can be given straight in at a 90 degree angle, or at a 45 degree angle. Give the shot straight in at a 90 degree angle if 2 inches of skin can be grasped between your thumb and first (index) finger. If only 1 inch of skin can be grasped, give the shot at a 45 degree angle.

How can I get rid of used syringes and needles? Your caregiver may have given you a hard plastic container made especially for used syringes and needles. If you were not given this kind of container, look around your home for a hard plastic container with a screw-on top such as:

• A clothes softener bottle or a hard plastic detergent bottle for washing clothes.
• Make sure you can put both the syringe and needle into the container easily. Whatever container you choose, make sure that the needles cannot break through the sides, bottom or top. Call your caregiver or a pharmacy to find out what your state or local requirements are for getting rid of used syringes and needles.

How do I get the Peptide from the vial? A vial is a small bottle with a plastic or metal top covering a rubber stopper. The vial may hold enough medicine for one or more doses. If the vial will be used for more than one dose (a multiple dose vial), make sure you write the date you open it on the vial. The medicine may be a powder or a liquid.

Never re-use needles, dispose properly after each use

Reconstitute Melanotan II:

• Remove a syringe from its wrapper. Two syringes are required when begining a new vial. The first syringe is needed to add the liquid, bacteriostatic water in most cases. The second syringe is needed to administer the shot.
• Take the metal or plastic top off the sterile saline or sterile distilled water vial. Do not take the rubber stopper off.
• Use an alcohol wipe to wipe the top of the vial with the sterile liquid used to add to the powder. Wipe the top of the vial with the powdered medicine in it. Do not touch the tops of the vials after wiping them.

A vial has a certain amount of pressure in it. When air or liquid is removed, it must be replaced.

• You need to add air to the vial in the same amount that you plan to take out in order to get the medicine out of the vial. To do this, you must know how much medicine to inject.
• Pull the plunger on the syringe back to the amount you plan to give.
• Insert the needle into the vial and push down on the plunger.
• Once the air has been pushed into the vial, turn the vial, attached to the syringe, upside down. Make sure the tip of the needle is in the medicine. The medicine will come back into the syringe and stop at or near the correct place.
• When you have the correct amount of medicine in the syringe, remove the needle and carefully put the cover back over the needle.

Things that may go wrong:

• If you put in too much air, the plunger will be difficult to push.
• If you do not put in enough air, the plunger will be difficult to pull.
• If you are using a multiple dose vial, too much or too little air may have been put in for a previous dose. If so, you will have to adjust your pull or push on the plunger.

Agreement:

You have the right to care for yourself or your loved one at home. To help with this plan, you must first learn how to give a subcutaneous injection. You always have the right to refuse the instructions on this sheet.
The above information is an educational aid only. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.