Nurses Compass
Drug Guide
Insulin Glargine-yfgn
Classification
Therapeutic: Antidiabetic agent
Pharmacological: Long-acting insulin analog
FDA Approved Indications
- Management of diabetes mellitus in adults and children requiring basal insulin
Mechanism of Action
Insulin glargine-yfgn is a long-acting insulin analog that binds to insulin receptors, promoting glucose uptake in muscles and fat tissue, and inhibiting hepatic glucose production, thereby lowering blood glucose levels.
Dosage and Administration
Adult: Dosage individualized based on patient needs; typically administered once daily subcutaneously at the same time each day.
Pediatric: Dosage individualized based on patient needs; administered once daily subcutaneously, with careful monitoring.
Geriatric: Dose adjustments based on glycemic response; increased caution due to potential hypoglycemia.
Renal Impairment: Adjust dose as needed; monitor closely due to altered insulin requirements.
Hepatic Impairment: Use with caution; no specific adjustment but monitor blood glucose levels.
Pharmacokinetics
Absorption: Slow, steady absorption after subcutaneous administration.
Distribution: Minimal binding to plasma proteins.
Metabolism: Metabolized by insulin-degrading enzymes.
Excretion: Excreted primarily in urine as metabolites.
Half Life: Approximate half-life of 12 hours, providing a flat, basal insulin level.
Contraindications
- Hypoglycemia
- Allergy to insulin glargine or excipients
Precautions
- Monitor for hypoglycemia, especially during dose adjustments.
- Use caution in patients with hepatic or renal impairment.
- Monitor for lipohypertrophy at injection sites.
- Adjust doses in response to changing clinical conditions.
Adverse Reactions - Common
- Hypoglycemia (Common)
- Injection site reactions (erythema, redness, swelling) (Uncommon)
Adverse Reactions - Serious
- Severe hypoglycemia (Rare)
- Anaphylaxis (Rare)
Drug-Drug Interactions
- Corticosteroids, diuretics, thiazides - may increase blood glucose levels; hypoglycemia with other antidiabetics.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood glucose levels regularly, especially during dose changes.
Diagnoses:
- Risk for unstable blood glucose levels
- Knowledge deficit related to insulin use
Implementation: Administer subcutaneously once daily at the same time each day. Rotate injection sites.
Evaluation: Assess for signs of hypo- and hyperglycemia; evaluate blood glucose control.
Patient/Family Teaching
- Instruct on proper injection technique and site rotation.
- Educate on recognizing signs and symptoms of hypoglycemia and hyperglycemia.
- Advise on maintaining a consistent meal schedule and carbohydrate intake.
- Inform about the importance of regular blood glucose monitoring.
Special Considerations
Black Box Warnings:
- Increased risk of cardiovascular events in patients with preexisting cardiovascular disease if used in high doses.
Genetic Factors: None specific.
Lab Test Interference: May affect blood glucose monitoring results depending on the method used.
Overdose Management
Signs/Symptoms: Hypoglycemia: sweating, trembling, confusion, seizures, loss of consciousness.
Treatment: Immediate ingestion of fast-acting carbohydrate (glucose tablets or gel), or glucagon injection if unconscious. Follow-up with complex carbohydrates and protein once stabilized.
Storage and Handling
Storage: Store unopened vials in the refrigerator (36°F to 46°F/2°C to 8°C). Once in use, vials can be kept at room temperature (up to 86°F/30°C) for up to 28 days.
Stability: Stable under recommended storage conditions as per manufacturer’s instructions.