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This might be the wrong place to ask, but I'm working on a story where the main character has a chronic condition that is usually managed by medication. However, on the off chance they run out of pills, I was looking at a quick-release injection to counter the symptoms until they can get more pills.

I've looked into processes like insulin or epipens, which have to be injected into fatty tissue or muscle, however it seems like these are a delayed release. I was wondering if injecting into one of the neck veins would lead to faster circulation to the affected areas, with a limited amount of effective time, or if this would lead to a dangerous outcome, or even prolonged presence within the body.

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  • Injecting into the external jugular is sometimes done (usually an IV, not a single injection), but if the patient was taking pills, why would fast onset be needed? Most pills take 20 minutes or more to dissolve and begin being absorbed. Commented Aug 15, 2023 at 23:13
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    It would entirely depend on the drug and its pharmacokinetics I would have thought. Commented Aug 16, 2023 at 0:49
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    From just a pure story criticism angle, ignoring any of the medical sciences: why would it ever be more convenient to have an injectable as a backup for a pill? The pill is going to be much smaller/portable, it would make far more sense to just have a separate pill container if one was worried about misplacing the first one. Commented Aug 16, 2023 at 14:35

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This might be the wrong place to post an answer (hypotheticals when writing are best posted on Worldbuilding.SE) but you don't seem to have a strong understanding of how "pills" (specifically pills given for a medical condition) work.

Most medications for long-term medical problems take a few days to reach steady state, that is, a concentration in the blood where the amount of drug in circulation reaches the therapeutic range and stays there as long as the drug is taken. That essentially means that the amount taken in/absorbed is equal to the amount lost through metabolism and excretion. It usually takes about 5 doses of the drug to reach steady state; if the drug needs to reach steady state more quickly, a "loading dose" of the drug is given.

The same is true of how quickly the drug falls out of the therapeutic range once it stops being taken. The drug isn't instantly out of your body when you miss a dose; it takes a while before it's subtherapeutic, and longer before it's eliminated completely.

So it's unlikely that missing a dose would result in the illness suddenly manifesting itself after one missed dose. The "patient" should have enough time to get a prescription refill before something bad happens; no need for an IV injection of the drug.

Most drugs, even in hospitalized patients, are given p.o. Where an immediate effect in needed (e.g. for pain control, to treat a serious infection, etc.) the drug is given IV initially. Besides drugs for pain, infection, serious allergic reactions, dangerously high blood pressure, fluid buildup in the lungs, cardiac dysrythmias, anesthesiology and a few other conditions/circumstances, I can't think of many drugs that would need to be given intravenously to be life-saving.

What is “Steady State” and why is it important?

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