curious about air in syringe contradiction?

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Bonnie & Kyndra

Bonnie & Kyndra

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Why does the mfg say to draw air into the syringe first but on the "how to" here it says not to?

Also, my vet tech showed me to squirt excess insulin back into the vial, but I read here not, too (with what seems like a good reason). I am about to give Kyndra her 2nd does and I will not do air first (I didn't this morning either ) and will do the ER drama thing rather than shoot back in.

thanks,
Bonnie
 
I assume you are starting Lantus? If so.. that is the reason why to your questions. Different insulins, medications etc. have different handling instructions.
 
Yes, I am using Lantus.

The instructions included with the Lantus say to pull air into the syringe that is equal to the does to be given before inserting into vial but here, on this page: viewtopic.php?f=9&t=151 it says:
PROPER HANDLING OF LANTUS and LEVEMIR

* Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.

* Never shake or roll your vial, cartridge, or pen.

* In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.

* Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.

* Do not inject air into vial and especially not cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.

thus I am confused as both of these are referring to Lantus :?
 
Lantus is fragile. Injecting air into the vial could potentially destabilize the insulin. The pen/cartridges are a negative pressure system and there is the potential for them to explode if you inject air.

Drawing air into the syringe isn't a problem. It's one way to help get rid of bubbles (draw in extra air, tap/flick the syringe, expell the air and excess insulin).
 
to keep it really simple - it's all tricks that were learned on this board and put into instructions for all to help us preserve the integrity of the lantus and ensure that it lasts as long as possible.

also when dosing lantus for a human vs a cat - a human can go through a vial or cartirdge a lot faster than a cat, hence the reason why they don't have to fridge it, if they don't want, but here we say you must fridge it.

Also lantus is very fragile, no shake rattle or roll or it could break down integrity of insulin.

squirting lantus back into vial the damage can be caused, because what's in the syringe can contain contaminates and then it goes back into vial and viola you just ruined it. I found if I took too much it was just as easy to squirt into sink until I got to desired amount

now I can't explain the air in syringe thing - i don't know that one, I justknow I never did it... ;-)

hope this helps
 
I had a class last night so only getting to these posts now...

Since the tech gave me wrong directions by telling me to roll and it specifically says in the directions of Lantus not to (shake, etc.) I'll listen to your guys for this sort of stuff. :mrgreen:

thanks!
Bonnie & Kyndra
 
I do technical and health writing and often work for drug companies, insurance companies and I've done health-related writing for some very large corporations. Let me tell you that it is like pulling teeth to get people to let you say "why" or to offer any additional information about anything. Here's my guess from my experience: The drug company is assuming that you will use the Lantus for 28 days and toss it. They know it is good for far longer than that under very good storage conditions, but they figure injecting a little air in will make it easier for most people and not shorten the life of their product to under 28 days. So they say why not? Let's tell them to do that. There's so much time cushion built in, there is room to do that.

If you want your cartridge/vial to last as long as possible, the less you can inject into it or manhandle it, the better!

After you have the lantus in the syringe, drawing in some air does make it easier to get small bubbles to coalesce and get pushed out. And doesn;t hurt the lantus in the syringe.

Sienne, where did you see that about possible explosion? I'm trying to figure out how that could really be possible. You would have to, it seems to me, be injecting air into that cartridge with a whole lot of elbow grease to get the pressure up there to explode the cartridge. It would get very very hard to push that plunger in long before it exploded, I would think.
 
I think "explode" is a little dramatic but injecting air into a pen or catridge can cause it to "blow out", if you look inside the pen through the "window" you will notice a rubber stopper (in Lantus it's black I think and in Levemir orange) that rubber moves down each time you withdraw insulin from the pen. It is designed to work like a syringe when using the pen as an injector. The stopper keeps the insulin pressed against the rubber membrane (where you stick your needle in) so there is no air inside the pen (if you were using the pen to inject like it is designed for you wouldn't want air in it you would be injecting air bubbles and not enough insulin) If you force air into the pen each time you draw insulin it could cause to much pressure inside the barrel and eventually pop the membrane out (it is like a little ball stuck in there) or it could continually leak. It is theorectically possible that the pen could "explode" or crack but I doubt it would be a dramatic event :o just a waste of insulin and money.
 
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