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.