ON PENS AND NEEDLES A PRIMER ON INSULIN PENS AND PROPER INJECTION TECHNIQUES PETE KRECKEL, RPH

ON PENS AND NEEDLES A PRIMER ON INSULIN PENS AND PROPER INJECTION TECHNIQUES PETE KRECKEL, RPH

ON PENS AND NEEDLES - A PRIMER ON INSULIN PENS AND PROPER INJECTION TECHNIQUES ACTIVITY DESCRIPTION Insulin therapy remains a cornerstone of treatment for type 1 diabetes and, in many cases, type 2 diabetes. Very few doubt the efficacy of insulin therapy in the fight to achieve glycemic control and reduce the risks of long term diabetes complication. Nevertheless, insulin therapy remains underutilized in the US with less than 35% of adults with diabetes using insulin. Barriers to use are not limited to but include fear of needles, cost, and improper injection techniques. Levels of patient and provider satisfaction are higher with pen administration than with vial and syringe. Insulin pens have been found to be easier to use, more discreet, less painful and preferred over syringes by most providers and patients. Insulin pens have many safety and convenience features including enhanced dose accuracy and autocover/autoshield pen needles. The pharmacist's role in educating and counseling patients with diabetes on the appropriate use of insulin pens and needles can be critical in patient understanding, treatment satisfaction and quality of life of diabetes sufferers. TARGET AUDIENCE The target audience for this activity is pharmacists and pharmacy technicians in hospital, community, and retail pharmacy settings. LEARNING OBJECTIVES After completing this activity, the pharmacist will be able to: Review the goals of insulin therapy in patients with diabetes. Compare and contrast the currently available insulin pens and needles (to include efficacy, ease of use, length of needles, and safety features). Identify strategies to educate and counsel patients on the appropriate injection techniques for insulin pens. ACCREDITATION PHARMACY PharmCon, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. NURSING PharmCon, Inc. is approved by the California Board of Registered Nursing (Provider Number CEP 13649) and the Florida Board of Nursing (Provider Number 50-3515). Activities approved by the CA BRN and the FL BN are accepted by most State Boards of Nursing. CE hours provided by PharmCon, Inc. meet the ANCC criteria for formally approved continuing education hours. The ACPE is listed by the AANP as an acceptable, accredited continuing education organization for applicants seeking renewal through continuing education credit. For additional information, please visit http://www.nursecredentialing.org/renewalrequirements.aspx Universal Activity No.: 0798-0000-15-004-H01-P&T Credits: 1.0 contact hour (0.1 CEU) Release Date: April 1, 2015 Expiration Date: April 1, 2016 ACTIVITY TYPE Knowledge-Based Home Study Webcast FINANCIAL SUPPORT BY Becton Dickinson After completing this activity, the pharmacy technicians will be able to: List goals of insulin therapy in patients with diabetes List different insulin pens and needles 1

ABOUT THE AUTHOR "Professor Pete" Kreckel is a practicing retail pharmacist who works in Altoona Pennsylvania. Both he and his wife, Denise are 1981 graduates of the University of Pittsburgh School of Pharmacy. He has worked independent retail pharmacy for over 30 years. He has been teaching Pharmacology in the Physician Assistant program at St. Francis University since 2005. He has been a regular PharmCon favorite since 2008 covering topics of primary interest to the retail pharmacist. He was inducted into Pi Alpha the Physician Assistant honorary fraternity, and was named as "Preceptor of the Year" by the Pennsylvania Pharmacists Association for his dedicated work to the education of pharmacy students from Duquesne University, and from his Alma mater the University of Pittsburgh. Professor Kreckel was recently named the 2014 Preceptor of the Year by the NCPA! Pete Kreckel, RPh Adjunct Assistant Professor, Saint Francis University FACULTY DISCLOSURE It is the policy of PharmCon, Inc. to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer of any commercial product(s) and/or service(s) discussed in an educational activity. Pete Kreckel reports no actual or potential conflict of interest in relation to this activity. Peer review of the material in this CE activity was conducted to assess and resolve potential conflict of interest. Reviewers unanimously found that the activity is fair balanced and lacks commercial bias. Please Note: PharmCon, Inc. does not view the existence of relationships as an implication of bias or that the value of the material is decreased. The content of the activity was planned to be balanced and objective. Occasionally, authors may express opinions that represent their own viewpoint. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient or pharmacy management. Conclusions drawn by participants should be derived from objective analysis of scientific data presented from this monograph and other unrelated sources. 2

3

4

5

6

7

8

9

10

11

12

13

14

ACTIVITY TEST 1. By what percentage do the DPP$ inhibitors lower HbA1c? A. 0.5-1% B. 2% C. 3% D. 5% 2. In a healthy adult patient, by what percent do beta cells fail? A..1% in 10 years B. 3% in 10 years C. 15% in 10 years D. 40% in 10 years 3. In a patient with type 2 diabetes, by what percent do beta cells fail? A. 3% in 10 years B. 8% in 10 years C. 15% in 10 years D. 40% in 10 years 4. Which of the following hormones are produced in the alpha cells of the pancreas? A. Incretin B. Adiponectin C. Glucagon D. Insulin 5. Which of the following insulins have a duration of activity of 24 hours? A. Glargine B. NPH C. Glulisine D. Aspart 15

6. Which of the following fasting plasma glucose levels is considered to be impaired fasting glucose by the American Association of Clinical Endocrinologists? A. 103 B. 118 C. 165 D. 208 7. What is the maximum length of time may an insulin aspart (Novolog ) pen be left out of the refrigerator after first use? A. 14 days B. 21 days C. 28 days D. they must always be refrigerated 8. What needle length is optimal for a pen needle to deliver insulin in the subcutaneous tissue without pinching the skin? A. 2mm B. 4mm C. 8mm D. 12mm 9. When counseling a patient on insulin pens with a 4mm needle, which of the following is CORRECT? A. Pinch skin and insert needles B. Inject insulin at a 45 degree angle so as not to penetrate muscle C. Hold needle in the skin while counting to ten D. Wipe needle tip with alcohol and reuse to save costs 10. Which of the following is FALSE with regard to sharps disposal? A. All states require use of commercially sold sharps container for home disposal B. Container should be puncture resistant C. Container must be able to stand on its own D. Do not recap or break needles before discarding Please submit your final responses on freece.com. Thank you. 16