Insulin pen

Rapid-acting insulins Humalog (insulin lispro) Yes Insulin pen 3-mL, vial, and 3-mL pen cartridge... 

Class 11b, for example, urethral stents, insulin pens, devices supplying ionising radiation, prosthetic joint replacements, intraocular lenses, maxillofacial implants... 

Geriatric Considerations - Summary Ensure that the older adult can demonstrate the appropriate use of insulin by assessing his or her ability to draw up the correct dose from a multidose bottle, read syringe markings, and administer the dose subcutaneously. Comorbidities such as poor vision, arthritis, tremor, or cognitive impairment may impair this process. Insulin pens maybe advantageous for some patients. Administration of insulin in the arm results in slower absorption than seen with abdominal administration. 

Disposable insulin pens are also available for selected formulations. These are regular insulin, insulin lispro, insulin aspart, insulin glulisine, insulin glargine, insulin detemir, and several mixtures of NPH with regular, lispro, or aspart insulin (Table 41-4). They have been well accepted by patients because they eliminate the need to carry syringes and bottles of insulin to the workplace and while traveling. 

Insulin pens are being increasingly used for intensive insulin therapy. For low doses, pens are more accurate than syringes (204). In 48 children and adolescents pen devices were more accurate than syringes when under 5 U of insulin had to be injected for higher doses pens and syringes were comparable (205). 

Annersten M, Frid A. Insulin pens dribble from the tip of the needle after injection. Pract Diabetes Int 2000 17 109-11. 

Novolin R (regular) Intermediate-acting Insulins (NPH) No Insulin pen, vial, or 3-mL pen cartridge, and InnoLet... 

In addition to needles and syo inges, alternative techniques for insulin administration have been developed, some availing themselves of the kinetics of insulin insulin pens (supplied preloaded or with replaceable cartridges), external infusions and implantable pumps. These latter are convenient for cm accurately controlled continuously functioning biofeedback system, but pose difficulties for routine replacement in insulin deficiency. Therefore sustained-release (depot) formulations are used to provide an approach reasonably near to natural function and compatible with the convenience of daily living. An even closer approach is provided by the development of (at present inevitably expensive) miniaturised infusion pumps which can be used by reliable patients. 

Vision Many people experience visual decline as they age (Fig. 5) (137,146). Moreover, there are typical diseases in the geriatric populations that affect the application of medicines. Macula degeneration and glaucoma diseases reduce the visual capabilities and may lead to blindness. A number of diabetic patients also show reduced visual potency. A special insulin pen has been developed, which is easy to handle and where the graduations are enlarged to facilitate the adjustment of the correct dose (Fig. 6). Impaired vision hinders one s ability to self-administer medication and to read instructions for the... 

Figure 6 Insulin pen (Innolet , Novo Nordisk, Denmark) with large graduations and numbers for diabetic patients with minor visual capabilities. Moreover, it requires only 6 N for activation, which is far below the average.

Clarke A, Spollett G. Dose accuracy and injection force dynamics of a novel disposable insulin pen. Expert Opin Drug Deliv 2007 4 165-174. 

Graff MR, McClunahan MA Assessment by patients with diabetes mellitus of two insulin pen delivery systems versus a vial and syringe, Clin Ther 1998, 20, 486-496. 

The above examples have only scratch the surface of the expanding role of the pack. What about dermal patches, implants, insulin pens, pump systems, suppository and pessary delivery systems, nebulisation, puffer packs, Ocuserts , a review of unit dose applications, etc. Systems are now so numerous that doing a paper search and review would take several weeks. However, they do indicate the new roles which are being undertaken by the pack. Each new system challenges new sets of tests in order to evaluate performance and efficiency. 

The nurse is teaching the client with Type 1 diabetes how to use an insulin pen injector. Which information should the nurse discuss with the client ... 

Discuss that the insulin pen injector must be used in the abdominal area only. 

The insulin pen injector does not require drawing up insulin in a syringe. 

The insulin pen injector can be used in any subcutaneous site that traditional insulin can be injected. 

Most clients state that there is less injection pain associated with the insulin pen than with the traditional insulin syringe. 

According to the EMA templates the name of a licensed medicine should be on the package in Braille, for blind or short-sighted patients. If this is not possible, the manufacturer has to provide justification for such exclusirai and the relevant national authorities must agree with it [1]. The Braille is only readable if the label of the pharmacy is not put on top of it. Patients with impaired hearing may have problems in hearing the cUck of an insulin pen or an auto-inhaler. 

Rosak, C., Burkard, G., Hoffrnan, J. A., Humburg, E., Look, D., and Landgraf, R., 1993, Metabolic effect and acceptance of an insulin pen treatment in 20,262 diabetic patients, DiabetesNutr. Metab. 6 139-145. 

The most important applications for POM in other markets are medical devices and plumbing. POM is used for medical devices such as parts for inhaler systems and insulin pens. 

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