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Why Do You Draw Up Short Acting Insulin Before Long Acting?

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How To Draw Up Insulin

AMBULATORY CARE: Insulin should be drawn up correctly and safely. This will help prevent problems such as infection or low or high blood sugar levels. Use the correct size insulin syringe to make sure you get the right dose of insulin. For example, you must inject U100 insulin with U100 syringes. A different syringe is needed for U500 insulin. Your healthcare provider or pharmacist will help you find the right size syringe. The syringe will have measurements in mL and units. Contact your healthcare provider if: You have questions about how to draw up insulin. You cannot afford to buy your diabetes supplies. You have questions or concerns about your condition or care. How to draw up 1 type of insulin into a syringe: If you use only 1 type of insulin at a time, do the following: Remove insulin from the refrigerator 30 minutes before you will use it. Inject insulin that is room temperature. Wash your hands. This will help decrease your risk for an infection. Gather your insulin supplies. Get your insulin bottle, syringe, and alcohol pads. Check the insulin bottle to make sure it is the right type and strength of insulin. Also check the expiration date. Do not use expired insulin. Rapi Continue reading >>

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  1. TheCommuter

    We draw up the clear insulin first due to the following rationale:
    1. Clear insulin will not significantly impact the action of cloudy insulin if we draw it up before drawing the cloudy insulin.
    2. On the other hand, even minute amounts of cloudy insulin will slow down the action of clear insulin if we draw the cloudy insulin first.
    3. The overarching point of drawing up 'clear before cloudy' is to prevent altering of the action of both insulins so they act as intended in our patients' bodies.

  2. Cell-Nurse

    Sorry, can you clarify this?
    They are going to mix in the syringe. How does drawing one up before the other impact the other at all when they are simply going to mix anyways?

  3. RNcali22

    I would think it's so that if you get any in the vial that will be used again you have less concerns when going clear to cloudy

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What is INSULIN SHOCK THERAPY? What does INSULIN SHOCK THERAPY mean? INSULIN SHOCK THERAPY meaning - INSULIN SHOCK THERAPY definition - INSULIN SHOCK THERAPY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks. It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s. It was one of a number of physical treatments introduced into psychiatry in the first four decades of the twentieth century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. Insulin coma therapy was a labour-intensive treatment that required trained staff and a special unit. Patients, who were almost invariably diagnosed with schizophrenia, were selected on the basis of having a good prognosis and the physical strength to withstand an arduous treatment. There were no standard guidelines for treatment; different hospitals and psychiatrists developed their own protocols. Typically, injections were administered six days a week for about two months. The daily insulin dose was gradually increased to 100150 units until comas were produced, at which point the dose would be levelled out. Occasionally doses of up to 450 units were used. After about 50 or 60 comas, or earlier if the psychiatrist thought that maximum benefit had been achieved, the dose of insulin was rapidly reduced before treatment was stopped. Courses of up to 2 years have been documented. After the insulin injection patients would experience various symptoms of decreased blood glucose: flushing, pallor, perspiration, salivation, drowsiness or restlessness. Sopor and comaif the dose was high enoughwould follow. Each coma would last for up to an hour and be terminated by intravenous glucose. Seizures sometimes occurred before or during the coma. Many would be tossing, rolling, moaning, twitching, spasming or thrashing around. Some psychiatrists regarded seizures as therapeutic and patients were sometimes also given electroconvulsive therapy or cardiazol/metrazol convulsive therapy during the coma, or on the day of the week when they didnt have insulin treatment. When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc. Patients required continuous supervision as there was a danger of hypoglycemic aftershocks after the coma. In "modified insulin therapy", used in the treatment of neurosis, patients were given lower (sub-coma) doses of insulin. A few psychiatrists (including Sakel) claimed success rates for insulin coma therapy of over 80 percent in the treatment of schizophrenia; a few others argued that it merely sped up remission in those patients who would undergo remission anyway. The consensus at the time was somewhere in between - claiming a success rate of about 50 percent in patients who had been ill for less than a year (about double the spontaneous remission rate) with no influence on relapse. Sakel suggested the therapy worked by "causing an intensification of the tonus of the parasympathetic end of the autonomic nervous system, by blockading the nerve cell, and by strengthening the anabolic force which induces the restoration of the normal function of the nerve cell and the recovery of the patient." The shock therapies in general had developed on the erroneous premise that epilepsy and schizophrenia rarely occurred in the same patient. Another theory was that patients were somehow "jolted" out of their mental illness.

Insulin Therapy

Why do I need to take insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an insulin pen or an insulin pump. How often will I need to take insulin? You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 insulin shots a day for good blood sugar control. Some people need 3 or 4 shots a day. Do I need to monitor my blood sugar level? Yes. Monitoring and controlling your blood sugar Continue reading >>

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Popular Questions

  1. Pharmacy Kid

    Clear before Cloudy

    What's the reason for drawing regular before NPH?

  2. BeLikeBueller

    I don't know, but when I utilized the most reliable of all search methods (google ), I came across a diabetes help forum where someone had the username "Cinnabon."
    If I had to guess though (after a little bit of digging), I would say it is because if you introduce the protamine component from the NPH into the regular insulin vial, you have effectively transformed a small portion of your fast-acting insulin to intermediate acting insulin (since it's an association of insulin with the protamine that causes the increased duration - if I recall insulin pharmacology correctly)? Whereas if you introduce regular insulin into a solution of NPH, regular insulin associating w/ protamine would have really no effect (it's already an intermediate acting insulin after all).
    Hopefully someone w/ a greater knowledge base in pharmacology will respond. I just had to share about "Cinnabon" and felt like it was important to add something meaningful to the discussion as well.

  3. zelman

    Nph is also cloudy, and cloudiness in regular insulin would mean it should be discarded.

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Read the open access research: http://www.bmj.com/content/349/bmj.g5459 This systematic review by Andrea Tricco and colleagues sets out to answer the question, are newer, longer lasting insulin analogues better than isophane insulin and zinc insulin, which have been commonly used since the 1950s for treating type 1 diabetes? Tricco et al suggest that newer insulin analogues are probably superior to intermediate acting insulin analogues, although the difference is small for haemoglobin A1c. Patients and their physicians should tailor their choice of insulin according to preference, cost, and accessibility.

​insulin Syringe Preparation: How To Mix Short- And Intermediate-acting Insulin

​Nurses from the Department of Specialty Nursing, Singapore General Hospital, a member of the SingHealth group, share the right way of mixing short-acting (clear) and intermediate-acting (cloudy) insulin for injection. How to mix short-acting (clear) insulin and intermediate-acting (cloudy) insulin Step 1: Roll and clean ​ Wash and dry your hands. Roll the cloudy (intermediate-acting) bottle of insulin between your palms 10 times gently. Do not shake vigorously. Clean the top of vial with an alcohol swab. Step 2: Add air to cloudy (intermediate-acting) insulin ​ Draw the required amount of air (equal to the dosage of cloudy insulin) into the insulin syringe. Inject air into the cloudy insulin vial. Do not draw out any insulin, and remove the syringe and needle. Step 3: Add air to clear (short-acting) insulin ​ Using the same syringe and needle, draw the required amount of air (equal to the dosage for clear insulin) into the insulin syringe. Inject air into the clear insulin vial. Step 4: Withdraw clear (short-acting) insulin first, then cloudy (intermediate-acting) insulin ​ With the insulin syringe and needle attached, turn the clear insulin bottle upside down, with the Continue reading >>

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Popular Questions

  1. TheCommuter

    We draw up the clear insulin first due to the following rationale:
    1. Clear insulin will not significantly impact the action of cloudy insulin if we draw it up before drawing the cloudy insulin.
    2. On the other hand, even minute amounts of cloudy insulin will slow down the action of clear insulin if we draw the cloudy insulin first.
    3. The overarching point of drawing up 'clear before cloudy' is to prevent altering of the action of both insulins so they act as intended in our patients' bodies.

  2. Cell-Nurse

    Sorry, can you clarify this?
    They are going to mix in the syringe. How does drawing one up before the other impact the other at all when they are simply going to mix anyways?

  3. RNcali22

    I would think it's so that if you get any in the vial that will be used again you have less concerns when going clear to cloudy

  4. -> Continue reading
read more

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