Growth hormone (GH) is a naturally occurring substance produced by the pituitary gland, a small gland located at the base of the brain. It plays a role in growth and metabolism. When the body does not produce enough, or when needed for specific medical conditions, it can be administered externally. Delivery often involves specialized devices for precise and consistent administration.
Understanding Growth Hormone and Its Delivery
Growth hormone (somatotropin) is a protein hormone that stimulates growth, cell reproduction, and regeneration. It is responsible for growth in childhood and adolescence, and influences metabolism, body composition, and bone density in adulthood. Because growth hormone is a protein, it would be broken down by digestive enzymes if taken orally, preventing it from reaching the bloodstream in an active form.
Therefore, therapeutic growth hormone must be administered parenterally, typically through subcutaneous injection. This method bypasses the digestive system, allowing direct absorption into the bloodstream from the fatty tissue beneath the skin. This ensures the hormone remains intact and can exert its intended effects. The specific formulation and delivery device facilitate this absorption.
When GH Injections Are Prescribed
GH injections are indicated for various conditions in children and adults. In children, Growth Hormone Deficiency (GHD), where the pituitary gland does not produce sufficient GH, is a common reason, leading to impaired growth. Other conditions include Turner Syndrome (a genetic disorder affecting females) and Prader-Willi Syndrome (a complex genetic condition). Children born Small for Gestational Age (SGA) who do not experience catch-up growth by age 2-4 years may also be candidates.
Noonan Syndrome (a genetic disorder impacting development) and chronic kidney disease, which can impair growth, are also pediatric indications. In adults, GH injections are primarily prescribed for Adult Growth Hormone Deficiency (AGHD), which can result from pituitary tumors, surgery, or radiation therapy. This deficiency can lead to changes in body composition, bone density, and lipid profiles.
Navigating GH Injector Devices and Use
GH injector devices make self-administration straightforward and accurate. Common types include pre-filled pens, containing a single dose, and multi-dose pens, allowing multiple doses from a cartridge. Traditional syringes and vials, requiring reconstitution of powdered GH with a diluent, are also available, though less common for daily use. The choice of device often depends on the specific medication, dosage, and patient preference.
Before injecting, wash hands thoroughly with soap and water. The injection site (abdomen, thigh, or buttocks) should be cleaned with an alcohol swab and allowed to air dry. To perform the injection, the skin is often pinched to create a fold. The needle is then inserted, typically at a 90-degree angle, though some devices may recommend 45 degrees depending on needle length and body fat. Pressing the injection button or plunger then delivers the medication.
Rotate injection sites to prevent lipoatrophy or lipohypertrophy, localized fat tissue changes affecting absorption. Rotating sites (e.g., alternating between left and right abdomen or thighs) helps maintain healthy tissue and consistent medication absorption. Following the specific instructions provided with each device is essential for effective and safe administration.
Essential Guidelines for GH Therapy
Proper storage of GH medication is important for efficacy. Unopened vials or pens are typically stored in a refrigerator (36-46°F / 2-8°C). Once opened or reconstituted, storage instructions vary by product; some require refrigeration, others allow room temperature storage for a limited period. Exposure to extreme temperatures or direct sunlight should be avoided.
Regular medical supervision and follow-up appointments are necessary. These appointments allow for monitoring of growth progression, assessment of treatment effectiveness, and adjustment of dosages as needed. Blood tests may be performed periodically to measure GH levels and other relevant biomarkers. Adhering to general safety practices is also important, including never sharing injector devices to prevent infection transmission.
Used needles and syringes should be disposed of in a puncture-resistant sharps container immediately after use. Common side effects include injection site reactions (redness or swelling) or temporary fluid retention (swelling in the hands or feet). Any concerns or unexpected symptoms should be promptly discussed with the prescribing healthcare provider.
References
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