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[NawlinsGirl]

A recent report from the Institute for Safe Medication Practices (ISMP) points out a potential problem in using the OptiClik injection pen for the administration of insulin glargine (Lantus) or insuline glulisine (Apidra). Left-handed practitioners or patients could administer the wrong dose when the pen is inadvertently used with the dosing window viewed upside down and the needle facing to the right. It’s estimated that 20% of people are left handed — meaning that as many as one in five individuals with diabetes may naturally be inclined to hold the device facing the right while using their left hand to dial in their dose.

While numbers may be clearly visible in the dosing window, if the needle is facing the right, the numbers will be reversed. For example, when the needle is facing the right, a dose of 52 units will look like 25 units, 12 units will look like 21 units, and a dose of 1 unit will appear to be 10 units.

Patient teaching: Left-handed patients and practitioners using the OptiClik device should be careful that they have the pen properly oriented when they dial the dose-needle pointing left, knob on the right. This can be confirmed by making sure that the “OptiClik” printing on the pen is right-side-up. It’s also a good idea to remind insulin-using individuals with diabetes to always carry their blood glucose monitor and a source of rapid-acting carbohydrate in case of hypoglycemia.

Review current drug information before administering and monitoring medications.

Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, CRRN, who maintains a private practice in Plantation, Fla., and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.
Reference

ISMP Medication Safety Alert! Pharmaceutical Industry, Medical Device Company — Part of the Solution. Institute for Safe Medication Practices website. Available at: www.ismp.org/Newsletters/acutecare/articles/20061116.asp. Accessed April 19, 2007.

OptiClik® injection cideo. Lantus Website. Available at: www.lantus.com/tools_resources/opticlik.aspx?player=wm&video=opticlik&highLow=high Accessed April 19, 2007.