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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Severe Hypoglycemia from Patient Misuse of Insulin Glargine Pen
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Severe Hypoglycemia from Patient Misuse of Insulin Glargine Pen

机译：患者因误用胰岛素甘精胰岛素而导致严重低血糖

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Objective: To report a case of severe hypoglycemia resulting from a patient's misuse of an insulin glargine pen. Case Summary: A 61-year-old male with a history of diabetes mellitus type 2 (T2DM), obesity, hypertension, end-stage renal disease, and systolic heart failure was admitted to the emergency department (ED) for severe hypoglycemia. The patient's treatment was recently switched from insulin glargine to an insulin glargine pen and had mistakenly injected the entire insulin pen. He was found lethargic and unresponsive at home and was brought into the ED with an initial blood glucose level of 11 mg/dL. He was given 6 ampules of dextrose 50% in the ED, started on a dextrose 10% infusion and was subsequently transferred to the medical intensive care unit (MICU). Throughout his stay in the MICU, the patient received a dextrose 20% infusion and a total of 11 ampules of dextrose 50% to keep his blood glucose level above 100 mg/dL. After a 6-day hospital course, the patient was stabilized and was discharged on sitagliptin.Discussion: The concern for hypoglycemia is present for any patient receiving insulin therapy. A MEDLINE search revealed the rates of hypoglycemia from insulin glargine but we found no previously described cases of severe hypoglycemia due to patient misuse of an insulin glargine pen. Our patient mistakenly injected the entire contents of the pen and became unresponsive and severely hypoglycemic. The long duration properties of insulin glargine likely prolonged the patient's hospital course. According to the Naranjo scale, the adverse reaction experienced by our patient was highly probable.Conclusions: Medication changes can be confusing for patients, and pharmacists have a unique opportunity to counsel and educate patients on the proper use of their medications, thus helping to prevent adverse events such as hypoglycemia from improper use of an insulin glargine pen.
机译：目的：报告一例因患者误用甘精胰岛素笔而导致的严重低血糖症。病例摘要：一名患有2型糖尿病，肥胖，高血压，终末期肾病和收缩性心力衰竭的2岁糖尿病史的男性因严重低血糖症被送往急诊室（ED）。最近，患者的治疗方法从甘精胰岛素换成了甘精胰岛素笔，并误注射了整个胰岛素笔。在家中发现他昏昏欲睡，反应迟钝，最初血糖为11 mg / dL进入急诊室。在急诊室给他6安瓿葡萄糖50％，开始输注葡萄糖10％，随后转移到医疗重症监护病房（MICU）。在他留在MICU的整个过程中，该患者接受了20％的葡萄糖输液和总共11安瓿的50％葡萄糖以保持血糖水平高于100 mg / dL。经过为期6天的住院治疗，患者稳定下来并接受西他列汀出院。讨论：任何接受胰岛素治疗的患者都存在低血糖的问题。 MEDLINE搜索揭示了甘精胰岛素胰岛素引起的低血糖发生率，但我们之前未发现由于患者误用甘精胰岛素笔而导致严重低血糖的病例。我们的病人错误地注射了笔的全部内容物，变得反应迟钝，严重降血糖。甘精胰岛素的长期特性可能会延长患者的住院时间。根据Naranjo量表，我们的患者极有可能发生不良反应。结论：药物变化可能会使患者感到困惑，药剂师有独特的机会为患者提供咨询和教育，以正确使用药物，从而有助于预防不良事件，例如由于不适当使用甘精胰岛素笔导致的低血糖症。

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