Journal articles: 'Subcutaneous delivery'

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Dychter, Samuel S., David A. Gold, and Michael F. Haller. "Subcutaneous Drug Delivery." Journal of Infusion Nursing 35, no. 3 (2012): 154–60. http://dx.doi.org/10.1097/nan.0b013e31824d2271.

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Benagiano, Giuseppe, Henry Gabelnick, and Manuela Farris. "Contraceptive devices: subcutaneous delivery systems." Expert Review of Medical Devices 5, no. 5 (September 2008): 623–37. http://dx.doi.org/10.1586/17434440.5.5.623.

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Houtzagers, C. M. G. J. "Subcutaneous Insulin Delivery: Present Status." Diabetic Medicine 6, no. 9 (December 1989): 754–61. http://dx.doi.org/10.1111/j.1464-5491.1989.tb01274.x.

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Selvaraj, Jothy, Graham Rhall, Mounir Ibrahim, Talat Mahmood, Nigel Freeman, Zennon Gromek, Grant Buchanan, Farhan Syed, Hany Elsaleh, and Ben J. C. Quah. "Custom-designed Small Animal focal iRradiation Jig (SARJ): design, manufacture and dosimetric evaluation." BJR|Open 2, no. 1 (November 2020): 20190045. http://dx.doi.org/10.1259/bjro.20190045.

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Objective: Preclinical animal models allow testing and refinement of novel therapeutic strategies. The most common preclinical animal irradiators are fixed source cabinet irradiators, which are vastly inferior to clinical linear accelerators capable of delivering highly conformal and precise treatments. The purpose of this study was to design, manufacture and test an irradiation jig (small animal focal irradiation jig, SARJ) that would enable focal irradiation of subcutaneous tumours in a standard fixed source cabinet irradiator. Methods and materials: A lead shielded SARJ was designed to rotate animal holders about the longitudinal axis and slide vertically from the base plate. Radiation dosimetry was undertaken using the built-in ion chamber and GAFChromic RTQA2 and EBT-XD films. Treatment effectiveness was determined by irradiating mice with subcutaneous melanoma lesions using a dose of 36 Gy in three fractions (12 Gy x 3) over three consecutive days. Results: The SARJ was tested for X-ray shielding effectiveness, verification of dose rate, total dose delivered to tumour and dose uniformity. Accurate and uniform delivery of X-ray dose was achieved. X-ray doses were limited to the tumour site when animal holders were rotated around their longitudinal axis to 15o and 195o, allowing sequential dose delivery using parallel-opposed tangential beams. Irradiation of subcutaneous melanoma tumour established on the flanks of mice showed regression. Conclusion: SARJ enabled delivery of tangential parallel-opposed radiation beams to subcutaneous tumours in up to five mice simultaneously. SARJ allowed high throughput testing of clinically relevant dose delivery using a standard cabinet-style fixed source irradiator. Advances in knowledge: A custom designed jig has been manufactured to fit into conventional cabinet irradiators and is dosimetrically validated to deliver clinically relevant dose distributions to subcutaneous tumours in mice for preclinical studies.

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Mapletoft, John W., Laura Latimer, Lorne A. Babiuk, and Sylvia van Drunen Littel-van den Hurk. "Intranasal Immunization of Mice with a Bovine Respiratory Syncytial Virus Vaccine Induces Superior Immunity and Protection Compared to Those by Subcutaneous Delivery or Combinations of Intranasal and Subcutaneous Prime-Boost Strategies." Clinical and Vaccine Immunology 17, no. 1 (October 28, 2009): 23–35. http://dx.doi.org/10.1128/cvi.00250-09.

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ABSTRACT Bovine respiratory syncytial virus (BRSV) infects cells of the respiratory mucosa, so it is desirable to develop a vaccination strategy that induces mucosal immunity. To achieve this, various delivery routes were compared for formalin-inactivated (FI) BRSV formulated with CpG oligodeoxynucleotide (ODN) and polyphosphazene (PP). Intranasal delivery of the FI-BRSV formulation was superior to subcutaneous delivery in terms of antibody, cell-mediated, and mucosal immune responses, as well as reduction in virus replication after BRSV challenge. Although intranasal delivery of FI-BRSV also induced higher serum and lung antibody titers and gamma interferon (IFN-γ) production in the lungs than intranasal-subcutaneous and/or subcutaneous-intranasal prime-boost strategies, no significant differences were observed in cell-mediated immune responses or virus replication in the lungs of challenged mice. Interleukin 5 (IL-5), eotaxin, and eosinophilia were enhanced after BRSV challenge in the lungs of subcutaneously immunized mice compared to unvaccinated mice, but not in the lungs of mice immunized intranasally or through combinations of the intranasal and subcutaneous routes. These results suggest that two intranasal immunizations with FI-BRSV formulated with CpG ODN and PP are effective and safe as an approach to induce systemic and mucosal responses, as well to reduce virus replication after BRSV challenge. Furthermore, intranasal-subcutaneous and subcutaneous-intranasal prime-boost strategies were also safe and almost as efficacious. In addition to the implications for the development of a protective BRSV vaccine for cattle, formulation with CpG ODN and PP could also prove important in the development of a mucosal vaccine that induces protective immunity against human RSV.

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Yamasaki, Yoshimitsu. "Subcutaneous and transmucosal delivery of insulin." Drug Delivery System 15, no. 6 (2000): 525–32. http://dx.doi.org/10.2745/dds.15.525.

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Jones, Graham B., David S. Collins, Michael W. Harrison, Nagarajan R. Thyagarajapuram, and Justin M. Wright. "Subcutaneous drug delivery: An evolving enterprise." Science Translational Medicine 9, no. 405 (August 30, 2017): eaaf9166. http://dx.doi.org/10.1126/scitranslmed.aaf9166.

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Yang, M. X., B. Shenoy, M. Disttler, R. Patel, M. McGrath, S. Pechenov, and A. L. Margolin. "Crystalline monoclonal antibodies for subcutaneous delivery." Proceedings of the National Academy of Sciences 100, no. 12 (June 2, 2003): 6934–39. http://dx.doi.org/10.1073/pnas.1131899100.

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Anderson, David R., Jeffrey S. Ginsberg, Robert Burrows, and Pat Brill-Edwards. "Subcutaneous Heparin Therapy during Pregnancy: a Need for Concern at the Time of Delivery." Thrombosis and Haemostasis 65, no. 03 (1991): 248–50. http://dx.doi.org/10.1055/s-0038-1647659.

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SummarySubcutaneous heparin is the treatment of choice for women requiring anticoagulant therapy during pregnancy. However, heparin therapy presents a management problem at delivery because of its potential to cause a persistent anticoagulant effect and thus increase the risk of bleeding. In order to avoid therapeutic complications it has been our practice to have women eithei discontinue their heparin injections with the onset of labour or to terminate heparin injections 12 h prior to elective induction. To determine the safety of our anticoagulant protocol at delivery we reviewed consecutive patients treated with subcutaneous heparin therapy during pregnarcl, at our centre. Over a 23 month period we found that six of 11 women receiving subcutaneous heparin during pregnancy delivered while their aPTT was prolonged. In addition, three women received intravenous protamine sulphate prior to delivery and in one patient major bleeding occurred during an emergency cesarean section. Those women who had elevated aPTTs at the time of delivery all gave birth within 28 h of their last injection of heparin. In order to avoid a prolonged aPTT at delivery, we have now adopted a more conservative approach to the management of subcutaneous heparin use at term. Subcutaneous heparin is discontinued 24 h prior to commencing an elective induction of labour.

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Dirnena-Fusini, Ilze, Marte Kierulf Åm, Anders Lyngvi Fougner, Sven Magnus Carlsen, and Sverre Christian Christiansen. "Intraperitoneal, subcutaneous and intravenous glucagon delivery and subsequent glucose response in rats: a randomized controlled crossover trial." BMJ Open Diabetes Research & Care 6, no. 1 (November 2018): e000560. http://dx.doi.org/10.1136/bmjdrc-2018-000560.

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ObjectiveHypoglycemia is a frequent and potentially dangerous event among patients with diabetes mellitus type 1. Subcutaneous glucagon is an emergency treatment to counteract severe hypoglycemia. The effect of intraperitoneal glucagon delivery is sparsely studied. We performed a direct comparison of the blood glucose response following intraperitoneally, subcutaneously and intravenously administered glucagon.Research design and methodsThis is a prospective, randomized, controlled, open-label, crossover trial in 20 octreotide-treated rats. Three interventions, 1 week apart, in a randomized order, were done in each rat. All 20 rats were given intraperitoneal and subcutaneous glucagon injections, from which 5 rats were given intravenous glucagon injections and 15 rats received placebo (intraperitoneal isotonic saline) injection. The dose of glucagon was 5 µg/kg body weight for all routes of administration. Blood glucose levels were measured before and until 60 min after the glucagon/placebo injections.ResultsCompared with placebo-treated rats, a significant increase in blood glucose was observed 4 min after intraperitoneal glucagon administration (p=0.009), whereas after subcutaneous and intravenous glucagon administration significant increases were seen after 8 min (p=0.002 and p<0.001, respectively). In intraperitoneally treated compared with subcutaneously treated rats, the increase in blood glucose was higher after 4 min (p=0.019) and lower after 40 min (p=0.005) and 50 min (p=0.011). The maximum glucose response occurred earlier after intraperitoneal compared with subcutaneous glucagon injection (25 min vs 35 min; p=0.003).ConclusionsGlucagon administered intraperitoneally gives a faster glucose response compared with subcutaneously administered glucagon in rats. If repeatable in humans, the more rapid glucose response may be of importance in a dual-hormone artificial pancreas using the intraperitoneal route for administration of insulin and glucagon.

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Quinn, C. P., M. V. Pishko, D. W. Schmidtke, M. Ishikawa, J. G. Wagner, P. Raskin, J. A. Hubbell, and A. Heller. "Kinetics of glucose delivery to subcutaneous tissue in rats measured with 0.3-mm amperometric microsensors." American Journal of Physiology-Endocrinology and Metabolism 269, no. 1 (July 1, 1995): E155—E161. http://dx.doi.org/10.1152/ajpendo.1995.269.1.e155.

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The time between intravenous injection of a glucose bolus and the time the glucose concentration peaked in the subcutaneous tissue was measured in pentobarbital-anesthetized rats with implanted 290-microns-diameter amperometric sensors. Boluses of 100, 200, and 400 mg/kg body wt were injected. The glucose concentration in the jugular vein was monitored by frequent withdrawal and analysis of samples. The glucose concentration in the subcutaneous tissue was continuously monitored with the sensors. The times required for the subcutaneously implanted sensor to reach its maximum current, corrected for sensor response times, were 7.5 +/- 3.9, 9.8 +/- 5.5, and 10.0 +/- 4.4 min for the smallest to the largest dose, respectively. The shorter delay in response to the smallest dose was statistically significant (P < 0.03). The results were consistent with dilution of the bolus in the cardiovascular system and transport of glucose by both diffusion and facilitated transport via a saturable mediator. An understanding of the differences in the dynamics of venous vs. subcutaneous response to a glucose dose is important in developing algorithms for the control of blood glucose based on a subcutaneous measurement.

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Vilchez, G., and EV Kontopoulos. "Subcutaneous closure after caesarean delivery: evidence update." BJOG: An International Journal of Obstetrics & Gynaecology 124, no. 7 (May 22, 2017): 1026. http://dx.doi.org/10.1111/1471-0528.14637.

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GANDHI, J. S. "Delivery of fluids by the subcutaneous route." Postgraduate Medical Journal 76, no. 897 (July 1, 2000): 453. http://dx.doi.org/10.1136/pmj.76.897.453.

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Usmani, Saad Z., Hareth Nahi, Maria-Victoria Mateos, Niels W. C. J. van de Donk, Ajai Chari, Jonathan L. Kaufman, Philippe Moreau, et al. "Subcutaneous delivery of daratumumab in relapsed or refractory multiple myeloma." Blood 134, no. 8 (August 22, 2019): 668–77. http://dx.doi.org/10.1182/blood.2019000667.

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Abstract Daratumumab, a human monoclonal antibody targeting CD38, is approved as monotherapy and in combination regimens for patients with multiple myeloma (MM). Currently, daratumumab is administered IV. The phase 1b PAVO (MMY1004) study evaluated subcutaneously administered daratumumab in combination with the recombinant human hyaluronidase PH20 enzyme (rHuPH20) in patients with relapsed or refractory MM. Part 1 of the study, reported here, evaluated a mix-and-deliver (MD) formulation of daratumumab and rHuPH20 (DARA-MD) administered by subcutaneous infusion. Patients received subcutaneous daratumumab according to the approved IV monotherapy dosing schedule at 1200 mg (n = 8) or 1800 mg (n = 45). Primary end points were safety and pharmacokinetic (PK) variables. The most common treatment-emergent adverse events with DARA-MD 1200 mg were thrombocytopenia, upper respiratory tract infection, insomnia, and decreased appetite (37.5% each). Anemia (33.3%), upper respiratory tract infection, pyrexia, and diarrhea (26.7% each) were the most common treatment-emergent adverse events with DARA-MD 1800 mg. One patient in the 1200-mg dose group (12.5%) and 11 patients in the 1800-mg dose group (24.4%) experienced infusion-related reactions, which were generally grade 1/2 and typically occurred at the first infusion. The 1800 mg dose achieved similar or greater serum concentrations compared with the 16 mg/kg IV dose. Overall response rates of 25.0% and 42.2% were achieved with 1200-mg and 1800-mg DARA-MD, respectively. Subcutaneous administration of DARA-MD was well tolerated in patients with relapsed or refractory MM, with the 1800-mg dose exhibiting PK concentrations and responses consistent with IV daratumumab in a similar patient population. This study was registered at www.clinicaltrials.gov as #NCT02519452.

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Waqar, Mueez, Jonathan R. Ellenbogen, Ram Kumar, Christine Sneade, Bassel Zebian, Dawn Williams, and Benedetta L. Pettorini. "Indwelling intrathecal catheter with subcutaneous abdominal reservoir: a viable baclofen delivery system in severely cachectic patients." Journal of Neurosurgery: Pediatrics 14, no. 4 (October 2014): 409–13. http://dx.doi.org/10.3171/2014.6.peds13686.

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Intrathecal baclofen (ITB) is a reversible treatment that reduces muscle tone to ameliorate spasticity and dystonia in patients with cerebral palsy (CP). The resulting decrease in energy expenditure allows patients to gain much-needed weight, albeit temporarily. Modern techniques require sufficient abdominal musculature and subcutaneous fat to permit the implantation of an indwelling pump. In patients with extremely low muscle bulk, visceral pumps may be impractical or impossible, with increased risks of dehiscence and infection. The authors describe a variation of the classical procedure in a young patient with severe cachexia. A 10-year-old boy with spastic-dystonic quadriplegic CP was admitted to the neuromedical unit. Numerous drug trials had failed, and surgical intervention was deemed necessary but was complicated by his cachectic body habitus. The authors inserted a lumbar intrathecal catheter and subcutaneously tunneled it to the anterolateral abdomen, where it was connected to a subcutaneous injection port. Baclofen was continuously infused into the subcutaneous port using a noncoring needle connected to an external pump. The needle and line were changed every 5 days to minimize the risk of sepsis. Although other techniques, such as intraventricular baclofen delivery, have been described, these are largely dependent upon sufficient musculature to support a visceral pump. A subcutaneous injection port system represents an alternative approach that reduces the risk of sepsis and may be better tolerated in cachectic patients.

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Stewart, Sarah, Juan Domínguez-Robles, Victoria McIlorum, Elena Mancuso, Dimitrios Lamprou, Ryan Donnelly, and Eneko Larrañeta. "Development of a Biodegradable Subcutaneous Implant for Prolonged Drug Delivery Using 3D Printing." Pharmaceutics 12, no. 2 (January 28, 2020): 105. http://dx.doi.org/10.3390/pharmaceutics12020105.

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Implantable drug delivery devices offer many advantages over other routes of drug delivery. Most significantly, the delivery of lower doses of drug, thus, potentially reducing side-effects and improving patient compliance. Three dimensional (3D) printing is a flexible technique, which has been subject to increasing interest in the past few years, especially in the area of medical devices. The present work focussed on the use of 3D printing as a tool to manufacture implantable drug delivery devices to deliver a range of model compounds (methylene blue, ibuprofen sodium and ibuprofen acid) in two in vitro models. Five implant designs were produced, and the release rate varied, depending on the implant design and the drug properties. Additionally, a rate controlling membrane was produced, which further prolonged the release from the produced implants, signalling the potential use of these devices for chronic conditions.

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Ochoa, Manuel, Charilaos Mousoulis, and Babak Ziaie. "Polymeric microdevices for transdermal and subcutaneous drug delivery." Advanced Drug Delivery Reviews 64, no. 14 (November 2012): 1603–16. http://dx.doi.org/10.1016/j.addr.2012.09.035.

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Kuzma, Petr, Alfred J. Moo-Young, Daniel Mora, Harryp Quandt, Clyde W. Bardin, and Peter H. Schlegel. "Subcutaneous hydrogel reservoir system for controlled drug delivery." Macromolecular Symposia 109, no. 1 (May 1996): 15–26. http://dx.doi.org/10.1002/masy.19961090103.

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Fenning, Stephen J., Steinunn R. Boyce, Paul Wilson, and Fran Stretton. "Subcutaneous magnesium in the advanced cancer setting." BMJ Supportive & Palliative Care 8, no. 2 (June 23, 2017): 191–93. http://dx.doi.org/10.1136/bmjspcare-2017-001360.

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Hypomagnesaemia can arise from a variety of causes but is particularly prevalent in cancer populations. This case report describes a patient with recurrent symptomatic hypomagnesaemia, on the background of advanced ovarian cancer and a high-output ileostomy, who was successfully managed on a daily continuous subcutaneous infusion of magnesium via a syringe pump. There is limited published information on the subcutaneous administration of magnesium and, to our knowledge, this is the first case to report its routine delivery over 24 hours in a syringe pump. This novel but effective approach for administering magnesium can be delivered in the community and can, therefore, prevent repeated hospital admissions for patients with recurrent symptomatic hypomagnesaemia who would otherwise need intravenous replacement.

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Grossman, Rachel, Betty Tyler, Lee Hwang, Patti Zadnik, Bachchu Lal, Kashi Javaherian, and Henry Brem. "Improvement in the standard treatment for experimental glioma by fusing antibody Fc domain to endostatin." Journal of Neurosurgery 115, no. 6 (December 2011): 1139–46. http://dx.doi.org/10.3171/2011.8.jns11125.

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Object Brain tumors pose many unique challenges to treatment. The authors hypothesized that Fc-endostatin may be beneficial. It is a newly synthesized recombinant human endostatin conjugated to the Fc domain of IgG with a long half-life (weeks) and unknown toxicity. The authors examined the efficacy of Fc-endostatin using various delivery methods. Methods Efficacy was assessed using the intracranial 9L gliosarcoma rat model treated with Fc-endostatin for use in rodents (mFc-endostatin), which was administered either systemically or locally via different delivery methods. Oral temozolomide (TMZ) was administered in combination with mFc-endostatin to determine if there was a beneficial synergistic effect. Results Intracranial delivery of mFc-endostatin via a polymer or convection-enhanced delivery 5 days after tumor implantation increased median survival, compared with the control group (p = 0.0048 and 0.003, respectively). Animals treated weekly with subcutaneous mFc-endostatin (started 5 days post–tumor implantation) also had statistically improved survival as compared with controls (p = 0.0008). However, there was no statistical difference in survival between the local and systemic delivery groups. Control animals had a median survival of 13 days. Animals treated either with subcutaneous mFc-endostatin weekly or with polymer had a median survival of 18 and 15 days, respectively, and those treated with oral TMZ for 5 days (Days 5–9) had a median survival of 21 days. Survival was further increased with a combination of oral TMZ and mFc-endostatin polymer, with a median survival of 28 days (p = 0.029, compared with TMZ alone). Subcutaneous mFc-endostatin administered every week starting 18 days before tumor implantation significantly increased median survival when compared with controls (p = 0.0007), with 12.5% of the animals ultimately becoming long-term survivors (that is, survival longer than 120 days). The addition of TMZ to either weekly or daily subcutaneous mFc-endostatin and its administration 18 days before tumor implantation significantly increased survival (p = 0.017 and 0.0001, respectively, compared with TMZ alone). Note that 12.5% of the animals treated with weekly subcutaneous mFc-endostatin and TMZ were long-term survivors. Conclusions Systemically or directly (local) delivered mFc-endostatin prolonged the survival of rats implanted with intracranial 9L gliosarcoma. This benefit was further enhanced when mFc-endostatin was combined with the oral chemotherapeutic agent TMZ.

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Jakes, AD, K. Kunde, and A. Banerjee. "Case report: Postpartum pneumomediastinum and subcutaneous emphysema." Obstetric Medicine 12, no. 3 (March 14, 2018): 143–45. http://dx.doi.org/10.1177/1753495x18757162.

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Postpartum pneumomediastinum is a rare complication of labour and delivery, where air leaks into the mediastinum following rupture of marginal alveoli. It follows prolonged and forceful Valsalva manoeuvres that increase intra-thoracic pressure. Subcutaneous emphysema may also develop. A chest radiograph can confirm the diagnosis, however a computed tomography thorax maybe required. Treatment is conservative as it is usually self-limiting. We present a case of postpartum pneumomediastinum following a delay in the second stage of labour and subsequent instrumental delivery. She developed chest pain and dyspnea 40 min post-delivery, and subcutaneous emphysema was palpable. Supplementary nasal flow oxygen was administered for 24 h prior to discharge. There is sparse evidence or guidance as to the management of postpartum pneumomediastinum, but consensus appears to be supplemental oxygen for 24 h. More data are needed on the type and duration of oxygen therapy, need for repeat imaging and management of subsequent pregnancies.

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Lahtela, Jorma T., Jukka Mustonen, and Amos Pasternack. "Comparison of Intraperitoneal and Subcutaneous Insulin Administration on Insulin Sensitivity and Serum Lipids in Type I Diabetic Patients on Continuous Ambulatory Peritoneal Dialysis Treatment." Clinical Science 88, no. 4 (April 1, 1995): 427–32. http://dx.doi.org/10.1042/cs0880427.

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1. The metabolic effects of intraperitoneal and subcutaneous insulin delivery were compared in a crossover manner in six C-peptide-negative diabetic patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Each treatment period lasted at least 3 months. Hyperinsulinaemic euglycaemic clamp was performed and glucose turnover assessed using [3-3H]glucose as a tracer. 2. During intraperitoneal delivery the daily insulin dose was 2.4 times higher than during subcutaneous administration and glycaemic control was significantly better (HbA1c 7.63% ± 0.46% and 9.52% ± 0.51% during intraperitoneal and subcutaneous insulin respectively, P < 0.01). The number of hypoglycaemic episodes was lower during intraperitoneal insulin than during subcutaneous therapy. 3. Intraperitoneal insulin resulted in an enhanced glucose disposal rate (P < 0.01) and reduced fasting hepatic glucose production (P < 0.01). High-density lipoprotein-cholesterol decreased and the ratio of low-density lipoprotein/high-density lipoprotein-cholesterol increased significantly (P < 0.05) during intraperitoneal insulin delivery. 4. The results suggest that intraperitoneal insulin, while resulting in better glycaemic control and improved insulin sensitivity than subcutaneous insulin, increases serum triacylglycerol and total cholesterol and reduces high-density lipoprotein-cholesterol, possibly via a direct effect on the liver.

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Macedo, Ana, Patrícia Filipe, Natália G. Thomé, João Vieira, Carolina Oliveira, Catarina Teodósio, Raquel Ferreira, Luís Roque, and Pedro Fonte. "A Brief Overview of the Oral Delivery of Insulin as an Alternative to the Parenteral Delivery." Current Molecular Medicine 20, no. 2 (January 14, 2020): 134–43. http://dx.doi.org/10.2174/1566524019666191010095522.

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: Diabetes mellitus greatly affects the quality of life of patients and has a worldwide prevalence. Insulin is the most commonly used drug to treat diabetic patients and is usually administered through the subcutaneous route. However, this route of administration is ineffective due to the low concentration of insulin at the site of action. This route of administration causes discomfort to the patient and increases the risk of infection due to skin barrier disturbance caused by the needle. The oral administration of insulin has been proposed to surpass the disadvantages of subcutaneous administration. In this review, we give an overview of the strategies to deliver insulin by the oral route, from insulin conjugation to encapsulation into nanoparticles. These strategies are still under development to attain efficacy and effectiveness that are expected to be achieved in the near future.

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Verma, Arun, Nitin Kumar, Rishabha Malviya, and Pramod Kumar Sharma. "Emerging Trends in Noninvasive Insulin Delivery." Journal of Pharmaceutics 2014 (May 14, 2014): 1–9. http://dx.doi.org/10.1155/2014/378048.

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This paper deals with various aspects of oral insulin delivery system. Insulin is used for the treatment of diabetes mellitus, which is characterized by the elevated glucose level (above the normal range) in the blood stream, that is, hyperglycemia. Oral route of administration of any drug is the most convenient route. Development of oral insulin is still under research. Oral insulin will cause the avoidance of pain during the injection (in subcutaneous administration), anxiety due to needle, and infections which can be developed. Different types of enzyme inhibitors, like sodium cholate, camostat, mesilate, bacitracin, leupeptin, and so forth, have been used to prevent insulin from enzymatic degradation. Subcutaneous route has been used for administration of insulin, but pain and itching at the site of administration can occur. That is why various alternative routes of insulin administration like oral route are under investigation. In this paper authors summarized advancement in insulin delivery with their formulation aspects.

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Jarvi, Nicole L., and Sathy V. Balu-Iyer. "Immunogenicity Challenges Associated with Subcutaneous Delivery of Therapeutic Proteins." BioDrugs 35, no. 2 (February 1, 2021): 125–46. http://dx.doi.org/10.1007/s40259-020-00465-4.

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Sequeira, Joana A. D., Ana C. Santos, João Serra, Catarina Estevens, Raquel Seiça, Francisco Veiga, and António J. Ribeiro. "Subcutaneous delivery of biotherapeutics: challenges at the injection site." Expert Opinion on Drug Delivery 16, no. 2 (January 24, 2019): 143–51. http://dx.doi.org/10.1080/17425247.2019.1568408.

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Duems-Noriega, Oscar, and Sergio Ariño-Blasco. "Subcutaneous fluid and drug delivery: safe, efficient and inexpensive." Reviews in Clinical Gerontology 25, no. 2 (May 2015): 117–46. http://dx.doi.org/10.1017/s095925981500012x.

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SummaryPatients with difficult venous access or oral intolerance and clinical situations with inadequate response to oral therapy have generated the need for alternative routes of delivery for drugs and fluids.The purpose of this study was to conduct a systematic review examining the evidence for subcutaneous (SC) administration of drugs and/or fluids.We used a broad search strategy using electronic databases CINAHL, EMBASE, PubMed and Cochrane library, key terms and ‘Medical Subject Headings’ (MeSH) such as ‘subcutaneous route’, ‘hypodermoclysis’ and the name/group of the most used drugs via this route (e.g. ‘ketorolac, morphine, ceftriaxone’, ‘analgesics, opioids, antibiotics’).We conclude that the SC route is an effective alternative for rehydration in patients with mild–moderate dehydration and offers a number of potential advantages in appropriately selected scenarios. Experience of administering drugs by this route suggests that it is well tolerated and is associated with minimal side-effects.

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Kovalainen, M., R. Kamakura, J. Riikonen, M. Finnilä, T. Nissinen, J. Rantanen, M. Niemelä, et al. "Biodegradation of inorganic drug delivery systems in subcutaneous conditions." European Journal of Pharmaceutics and Biopharmaceutics 122 (January 2018): 113–25. http://dx.doi.org/10.1016/j.ejpb.2017.10.014.

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Reeder, Steven R. "Subcutaneous emphysema, pneumomediastinum, and pneumothorax in labor and delivery." American Journal of Obstetrics and Gynecology 154, no. 3 (March 1986): 487–89. http://dx.doi.org/10.1016/0002-9378(86)90587-9.

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Reeder, S. R. "Subcutaneous Emphysema, Pneumomediastinum, and Pneumothorax in Labor and Delivery." Obstetric Anesthesia Digest 6, no. 3 (September 1986): 282. http://dx.doi.org/10.1097/00132582-198609000-00042.

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Gorshkova, V. M., and S. V. Savchenko. "Potential Use of Ultrasound for Subcutaneous Delivery of Anesthetics." Biomedical Engineering 47, no. 1 (May 2013): 36–38. http://dx.doi.org/10.1007/s10527-013-9329-6.

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McLennan, Danielle N., Christopher J. H. Porter, and Susan A. Charman. "Subcutaneous drug delivery and the role of the lymphatics." Drug Discovery Today: Technologies 2, no. 1 (March 2005): 89–96. http://dx.doi.org/10.1016/j.ddtec.2005.05.006.

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Abbasi, Mehrnaz, and Shu Wang. "Browning Subcutaneous White Adipose Tissue Using Transdermal Delivery of ASC-Targeting Peptide and Resveratrol Conjugate." Current Developments in Nutrition 6, Supplement_1 (June 2022): 1042. http://dx.doi.org/10.1093/cdn/nzac070.001.

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Abstract Objectives Trans-resveratrol (RES) can significantly enhance the browning of subcutaneous white adipose tissue (WAT) when delivered to adipose stromal stem cells (ASCs) in WAT, the precursors of beige adipocytes. ASC-targeting peptide (GSWKYWFGEGGC) and RES have been conjugated using succinyl as a linker. The objective of this study is to transdermally deliver ASC-targeting peptide-RES conjugate directly to subcutaneous WAT using microneedle (MN) and iontophoresis (INT) and validate their browning and anti-obesity efficacy in obese mice. Methods Dissolving MN patches were developed using carboxymethylcellulose (CMC). Delivery effectiveness of MN was determined by an in vivo fluorescence imaging after applying dye-loaded MN on the skin above inguinal WAT (iWAT) in mice. Peptide-RES conjugate was loaded into CMC MN that was applied on the skins above iWAT of mice. After MN were dissolved, INT patch was applied to enhance penetration. Male C57BL/6J mice (5/group) were fed ahigh fat diet for 9 weeks. After 4 weeks of the high fat diet, mice were randomly divided into 3 groups as 1. MN (Blank)+INT, 2. MN (free RES)+INT, and 3. MN (peptide-RES conjugate) +INT. Mice received treatments 2 times/week from week 5 to 9. Food intake, body weight, and body composition were measured weekly, and the glucose tolerance test was conducted at week 9. Results MN (dye)+INT-treated mice had 2-fold higher dye signals in iWAT as compared to mice treated with MN alone. Dye signals in other organs/tissues were too low to be detected indicating the success of local (MN + INT) delivery and less diffusion. After 5 weeks of treatment, mice treated with MN (peptide-RES conjugate)+INT as compared to other two groups of mice had more than 1.5-fold lower body weight and fat%, 1.4-fold lower blood glucose levels, and more than 3-fold iWAT mRNA levels of UCP1 indicating browning of iWAT. Conclusions Transdermal delivery of ASC-targeting peptide-RES conjugate to iWAT induces browning of subcutaneous WAT, resulting in body weight and fat loss in obese mice. Transdermal delivery might provide an innovative and efficient approach for combating obesity and its comorbidities. Funding Sources NIH 1R15AT010395-01 and American Heart Association 19AIREA34480011.

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WORLEY, DEANNA R., RYAN J. HANSEN, LUKE A. WITTENBURG, LAURA S. CHUBB, and DANIEL L. GUSTAFSON. "Docetaxel Accumulates in Lymphatic Circulation Following Subcutaneous Delivery Compared to Intravenous Delivery in Rats." Anticancer Research 36, no. 10 (October 12, 2016): 5071–78. http://dx.doi.org/10.21873/anticanres.11076.

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Sommer, Christine, Anne K. Jenum, Christin W. Waage, Kjersti Mørkrid, Line Sletner, and Kåre I. Birkeland. "Ethnic differences in BMI, subcutaneous fat, and serum leptin levels during and after pregnancy and risk of gestational diabetes." European Journal of Endocrinology 172, no. 6 (June 2015): 649–56. http://dx.doi.org/10.1530/eje-15-0060.

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ObjectiveTo explore the differences between Europeans and South Asians in BMI, subcutaneous fat, and serum leptin (s-leptin) levels during and after pregnancy and their relationship with gestational diabetes (GDM).DesignMulti-ethnic population-based cohort study, whereof 353 Europeans (93.1% of the included) and 190 South Asians (95.0% of the included).MethodsS-leptin, BMI, and subcutaneous fat (sum of triceps, subscapular, and suprailiac skinfolds) were measured at 14 and 28 weeks of gestation, and 14 weeks after delivery. GDM was diagnosed with the WHO criteria 2013.ResultsSouth Asians had similar thickness of the triceps and suprailiac skinfolds, thicker subscapular skinfold, and higher s-leptin than Europeans in early pregnancy, despite lower BMI. South Asians retained more subcutaneous fat (mean (95% CI) 10.0 (7.4–12.7) mm vs 3.8 (1.9–5.8) mm) and BMI (1.5 (1.2–1.8) kg/m2 vs 0.1 (−0.1 to 0.3) kg/m2) than Europeans 14 weeks after delivery and s-leptin decreased less in South Asians than Europeans (−0.13 (−0.27 to −0.00) μg/l vs −0.47 (−0.57 to −0.37) μg/l, P<0.001 for all). The prevalence of GDM was 23.8% (n=84) in Europeans and 42.6% (n=81) in South Asians. BMI, subcutaneous fat, and s-leptin were all positively associated with GDM, also after adjustment for covariates.ConclusionsThe relatively high amounts of subcutaneous fat and s-leptin in South Asians in early pregnancy contributed to their increased risk of GDM. South Asians retained more weight and subcutaneous fat after delivery, potentially increasing their risk of adiposity and GDM in future pregnancies.

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Kotaka, Shinji, Shigeyuki Wakitani, Akira Shimamoto, Naosuke Kamei, Mikiya Sawa, Nobuo Adachi, and Mituo Ochi. "Magnetic Targeted Delivery of Induced Pluripotent Stem Cells Promotes Articular Cartilage Repair." Stem Cells International 2017 (December 26, 2017): 1–7. http://dx.doi.org/10.1155/2017/9514719.

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Cartilage regeneration treatments using stem cells are associated with problems due to the cell source and the difficulty of delivering the cells to the cartilage defect. We consider labeled induced pluripotent stem (iPS) cells to be an ideal source of cells for tissue regeneration, and if iPS cells could be delivered only into cartilage defects, it would be possible to repair articular cartilage. Consequently, we investigated the effect of magnetically labeled iPS (m-iPS) cells delivered into an osteochondral defect by magnetic field on the repair of articular cartilage. iPS cells were labeled magnetically and assessed for maintenance of pluripotency by their ability to form embryoid bodies in vitro and to form teratomas when injected subcutaneously into nude rats. These cells were delivered specifically into cartilage defects in nude rats using a magnetic field. The samples were graded according to the histologic grading score for cartilage regeneration. m-iPS cells differentiated into three embryonic germ layers and formed teratomas in the subcutaneous tissue. The histologic grading score was significantly better in the treatment group compared to the control group. m-iPS cells maintained pluripotency, and the magnetic delivery system proved useful and safe for cartilage repair using iPS cells.

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Guillot, Antonio José, Ana Sara Cordeiro, Ryan F. Donnelly, M. Carmen Montesinos, Teresa M. Garrigues, and Ana Melero. "Microneedle-Based Delivery: An Overview of Current Applications and Trends." Pharmaceutics 12, no. 6 (June 19, 2020): 569. http://dx.doi.org/10.3390/pharmaceutics12060569.

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Microneedle arrays (MNA) are considered as one of the most promising resources to achieve systemic effects by transdermal delivery of drugs. They are designed as a minimally invasive, painless system which can bypass the stratum corneum, overcoming the potential drawbacks of subcutaneous injections and other transdermal delivery systems such as chemical enhancers, nano and microparticles, or physical treatments. As a trendy field in pharmaceutical and biomedical research, its applications are constantly evolving, even though they are based on very well-established techniques. The number of molecules administered by MNA are also increasing, with insulin and vaccines administration being the most investigated. Furthermore, MNA are being used to deliver cells and applied in other organs and tissues like the eyes and buccal mucosae. This review intends to offer a general overview of the current state of MNA research, focusing on the strategies, applications, and types of molecules delivered recently by these systems. In addition, some information about the materials and manufacturing processes is presented and safety data is discussed.

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Violaris, Ioannis G., Konstantinos Kalafatakis, Eder Zavala, Ioannis G. Tsoulos, Theodoros Lampros, Stafford L. Lightman, Markos G. Tsipouras, Nikolaos Giannakeas, Alexandros Tzallas, and Georgina M. Russell. "Modelling Hydrocortisone Pharmacokinetics on a Subcutaneous Pulsatile Infusion Replacement Strategy in Patients with Adrenocortical Insufficiency." Pharmaceutics 13, no. 6 (May 21, 2021): 769. http://dx.doi.org/10.3390/pharmaceutics13060769.

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In the context of glucocorticoid (GC) therapeutics, recent studies have utilised a subcutaneous hydrocortisone (HC) infusion pump programmed to deliver multiple HC pulses throughout the day, with the purpose of restoring normal circadian and ultradian GC rhythmicity. A key challenge for the advancement of novel HC replacement therapies is the calibration of infusion pumps against cortisol levels measured in blood. However, repeated blood sampling sessions are enormously labour-intensive for both examiners and examinees. These sessions also have a cost, are time consuming and are occasionally unfeasible. To address this, we developed a pharmacokinetic model approximating the values of plasma cortisol levels at any point of the day from a limited number of plasma cortisol measurements. The model was validated using the plasma cortisol profiles of 9 subjects with disrupted endogenous GC synthetic capacity. The model accurately predicted plasma cortisol levels (mean absolute percentage error of 14%) when only four plasma cortisol measurements were provided. Although our model did not predict GC dynamics when HC was administered in a way other than subcutaneously or in individuals whose endogenous capacity to produce GCs is intact, it was found to successfully be used to support clinical trials (or practice) involving subcutaneous HC delivery in patients with reduced endogenous capacity to synthesize GCs.

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Alejandro Juárez, Bethliza, Patrick Fleischmann-de la Parra, Karla Tania Esmeralda Rayo-Mercado, and Teresa Ponce-Lopez. "Comparison between insulin delivery methods: subcutaneous, inhaled, oral, and buccal." Proceedings of Scientific Research Universidad Anáhuac. Multidisciplinary Journal of Healthcare 1, no. 1 (July 22, 2021): 62–71. http://dx.doi.org/10.36105/psrua.2021v1n1.08.

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Diabetes mellitus is a complex and chronic metabolic disorder characterized by hyperglycemia. Part of the treatment for this condition is the administration of insulin, a protein that directly influences blood glucose levels. It is traditionally administered parenterally; however, new alternative ways for its application seek greater efficiency and less invasiveness. The objective of this article is to compare the different methods of insulin administration, taking into account new technologies. This review article provides an overview of diabetes and insulin, highlights the advantages and disadvantages of insulin delivery methods (subcutaneous, inhaled, oral, and buccal), and shows the new technologies that include biotechnological applications.

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Stewart, Sarah A., Juan Domínguez-Robles, Emilia Utomo, Camila J. Picco, Francesca Corduas, Elena Mancuso, Muh Nur Amir, et al. "Poly(caprolactone)-based subcutaneous implant for sustained delivery of levothyroxine." International Journal of Pharmaceutics 607 (September 2021): 121011. http://dx.doi.org/10.1016/j.ijpharm.2021.121011.

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Knowles, Stephen P., Marie A. Printz, David W. Kang, Michael J. LaBarre, and Renee P. Tannenbaum. "Safety of recombinant human hyaluronidase PH20 for subcutaneous drug delivery." Expert Opinion on Drug Delivery 18, no. 11 (September 29, 2021): 1673–85. http://dx.doi.org/10.1080/17425247.2021.1981286.

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Guo, Xiaohui, and Wei Wang. "Challenges and recent advances in the subcutaneous delivery of insulin." Expert Opinion on Drug Delivery 14, no. 6 (September 20, 2016): 727–34. http://dx.doi.org/10.1080/17425247.2016.1232247.

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Trajanoski, Z., and P. Wach. "Neural predictive controller for insulin delivery using the subcutaneous route." IEEE Transactions on Biomedical Engineering 45, no. 9 (1998): 1122–34. http://dx.doi.org/10.1109/10.709556.

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Zisser, Howard C., Wendy Bevier, Eyal Dassau, and Lois Jovanovič. "Siphon Effects on Continuous Subcutaneous Insulin Infusion Pump Delivery Performance." Journal of Diabetes Science and Technology 4, no. 1 (January 2010): 98–103. http://dx.doi.org/10.1177/193229681000400112.

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Oladosu, Folabomi A., Brittney P. Ciszek, Sandra C. O’Buckley, and Andrea G. Nackley. "Novel intrathecal and subcutaneous catheter delivery systems in the mouse." Journal of Neuroscience Methods 264 (May 2016): 119–28. http://dx.doi.org/10.1016/j.jneumeth.2016.03.006.

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Turner, Michael R., and Sathy V. Balu-Iyer. "Challenges and Opportunities for the Subcutaneous Delivery of Therapeutic Proteins." Journal of Pharmaceutical Sciences 107, no. 5 (May 2018): 1247–60. http://dx.doi.org/10.1016/j.xphs.2018.01.007.

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Lauterbach, Roy, Dana Vitner, Chen Ben David, Gal Bachar, Yuval Ginsberg, Nadir Ganem, Ron Beloosesky, Zeev Weiner, and Yaniv Zipori. "888: Continuous versus Interrupted subcutaneous tissue closure during cesarean delivery." American Journal of Obstetrics and Gynecology 222, no. 1 (January 2020): S554. http://dx.doi.org/10.1016/j.ajog.2019.11.901.

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Jegadeesan, Rangarajan, Kush Agarwal, Yong-Xin Guo, Shih-Cheng Yen, and Nitish V. Thakor. "Wireless Power Delivery to Flexible Subcutaneous Implants Using Capacitive Coupling." IEEE Transactions on Microwave Theory and Techniques 65, no. 1 (January 2017): 280–92. http://dx.doi.org/10.1109/tmtt.2016.2615623.

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Stuart, Peter, Jane Lee, Gill Arnold, and Melanie Davis. "A centralized storage system for the delivery of subcutaneous infusions." British Journal of Nursing 17, no. 8 (April 2008): 512–16. http://dx.doi.org/10.12968/bjon.2008.17.8.29415.

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Brisken, Axel F. "Methods and apparatus for the subcutaneous delivery of acoustic vibrations." Journal of the Acoustical Society of America 112, no. 4 (2002): 1246. http://dx.doi.org/10.1121/1.1520977.

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Journal articles on the topic 'Subcutaneous delivery'

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