Home Drug Guide Insulin Glulisine

Drug Guide

Generic Name

Insulin Glulisine

Brand Names Apidra, Apidra Solostar

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Insulin analog

FDA Approved Indications

  • Improvement of glycemic control in adults and children with diabetes mellitus

Mechanism of Action

Insulin glulisine is a rapid-acting insulin analog that mimics endogenous insulin by facilitating cellular uptake of glucose, promoting storage of glucose as glycogen, and inhibiting lipolysis and gluconeogenesis.

Dosage and Administration

Adult: Injected subcutaneously 15 minutes before or within 20 minutes after initiation of a meal. Dose adjusted based on blood glucose monitoring.

Pediatric: Similar to adults; dose individualized based on age, weight, and response.

Geriatric: Use with caution; start at lower doses and titrate carefully.

Renal Impairment: Requires careful titration; monitor blood glucose closely.

Hepatic Impairment: Use with caution; adjust doses as needed.

Pharmacokinetics

Absorption: Rapid absorption following subcutaneous injection.

Distribution: Distributed throughout extracellular fluid.

Metabolism: Metabolized in the liver and kidneys.

Excretion: Excreted primarily in urine as metabolites.

Half Life: About 1 hour.

Contraindications

  • Hypoglycemia
  • Allergy to insulin glulisine or any component of the formulation

Precautions

  • Altered insulin requirements during illness or due to changes in activity or diet, hypoglycemia risk, lipodystrophy at injection sites, injection site reactions, potential for allergic reactions

Adverse Reactions - Common

  • Hypoglycemia (Common)
  • Injection site reactions (redness, swelling, itching) (Common)

Adverse Reactions - Serious

  • Severe hypoglycemia (Serious)
  • Anaphylaxis (Rare)

Drug-Drug Interactions

  • Corticosteroids, diazoxide, thyroid hormones, and some beta-blockers may alter insulin effectiveness.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly, observe for signs of hypoglycemia or hyperglycemia.

Diagnoses:

  • Risk for unstable blood glucose levels
  • Risk for hypoglycemia or hyperglycemia

Implementation: Administer subcutaneously as prescribed; rotate injection sites.

Evaluation: Assess blood glucose trends and patient’s response to insulin therapy.

Patient/Family Teaching

  • Inject insulin as directed; do not skip doses.
  • Recognize symptoms of hypoglycemia and hyperglycemia.
  • Carry quick source of glucose.
  • Maintain proper diet and exercise habits.

Special Considerations

Black Box Warnings:

  • Hypoglycemia is the most common adverse effect and can be life-threatening.
  • Ensure proper storage and handling to maintain insulin potency.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Severe hypoglycemia—confusion, seizures, unconsciousness.

Treatment: Administer intravenous glucose or glucagon; seek emergency medical assistance.

Storage and Handling

Storage: Unopened vials or pens: Store in refrigerator; open vials or pens: Keep at room temperature for up to 28 days.

Stability: Stable at room temperature for 28 days; avoid direct sunlight and extreme temperatures.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.