Question about insulins

[mondkmondk]

Way back when I was in nursing school, Lantus insulin hadn't been invented. I was taught to draw up regular insulin (clear) first, then draw up NPH. My question is this: I have a patient who receives Novalog insulin (clear) and Lantus. I drew up the Novalog first, then the Lantus. My patient told me I did it wrong and that Lantus shouldn't be mixed with other insulins. I didn't mix them, just simply drew one up right after the other. Now, this may be wrong and if it WAS wrong, please please someone tell me. All the other nurses I asked that night didn't know. Please help; if I have to make a med error form out, I will....but please educate me about Lantus...thanks!

Blessings, Michelle

[achot chavi]

Nothing was meant personally. The fact that you asked means you care and you are a good nurse for caring.

Keep up the good work.

[signet123]

Don't feel like a fool. This is a very common mistake. When Lantus first came out, I remember Doing this once or twice. Someone asked me what this new type of insulin was. I looked it up online and found out you can't mix it. The drug books on the unit were all two or three years old. Didn't have it in there. I had a patient last week. They said in report she bottoms out every morning at 6am. She hasn't been eating well for dinner. They said she was 25 that am. Please don't give her Lantus @ hs. Her 9pm accucheck was 72. I didn't give the lantus. Wrote down that she refused it. The next am her accucheck was 58. If I'd given the lantus, I wonder what it would be? I got yelled at by sup. She said I should've called doc and got order to hold.

[achot chavi]

I had a patient last week. They said in report she bottoms out every morning at 6am. She hasn't been eating well for dinner. They said she was 25 that am. Please don't give her Lantus @ hs. Her 9pm accucheck was 72. I didn't give the lantus. Wrote down that she refused it. The next am her accucheck was 58. If I'd given the lantus, I wonder what it would be? I got yelled at by sup. She said I should've called doc and got order to hold.

Sorry - you did the right thing by holding the Lantus, but your sup was right, next time bother the doc- its your job. ANy time you decide to hold a med you must inform the MD.

BTW Lantus is usually once a day- rarely twice a day.

[lil' girl, LPN]

Your patient was right. NEVER mix lantus with other insulins! Glad we have so many that know the right way!

[ChristineN, BSN, RN]

Sorry - you did the right thing by holding the Lantus, but your sup was right, next time bother the doc- its your job. ANy time you decide to hold a med you must inform the MD.

BTW Lantus is usually once a day- rarely twice a day.

Or you could get the doctor to write paramiters for holding Lantus. BTW: With pediatrics I occasionally see pt's that get Lantus with breakfast as well as at bedtime. It seems strange, but it really works for keeping their blood sugar's stabilized.

[nckdl]

I'm with all other posters that to not mix Lantus with any other insulin. Also as an FYI the new insulin that is out Symlin, also cannot be mixed with any other insulin. I had a pt that had Symlin, Lantus and Humalog. Poor thing had to have 3 shots. I learned not to mix Lantus when I was orienting and the nurse I was with mixed them and taught me to mix them until another nurse told us it was wrong.