Extra care is warranted on special occasions when two types of medications are being taken.
These are when you are injecting yourself with insulin for diabetes or when using the asthma inhaler, says Specialist Physician Dr. Chamari Lochana Weeraratne who is also a Senior Lecturer at the Department of Pharmacology, Faculty of Medicine, University of Colombo.
n Insulin injections – There are different items to be assembled before you take the insulin injection, stresses Dr. Weeraratne, explaining that they consist of the insulin syringe with a volume of 1 millilitre with 100 units demarcated on it, fixed to the needle.
The ideal needle gauge should be 29 and you should use a 27 -gauge needle only if the former is not available, according to her.
There are several types of insulin vials, with each one having 100 units of insulin per one ml.
Advising that it would be better to inject insulin just after a shower or a bath, Dr. Weeraratne says the area of the body where it should be injected must be cleaned well with soap and water.
Insert the insulin vial in a small box and store in the refrigerator between 2-80 Centrigade. Never place it in the freezer or the door of the fridge, she says, stressing that it should be taken out about ¼ hour before dosing yourself.
Clean the rubber stopper of the vial with a clean cotton wool swab soaked in surgical spirit. If you are using an insulin preparation with a milky appearance, keep the vial between your palms and roll it to mix the liquid well. However, if you are using soluble or regular insulin which is a transparent liquid this action is not necessary, MediScene learns.
Thereafter, hold the syringe with the needle uppermost and pull the plunger down to the number of units that you need, filling it up with air, first. Next insert the needle through the rubber stopper of the vial while holding the vial upside down. Now push the plunger to release the air trapped in the syringe to the bottle, then pull the plunger down getting the required dosage of insulin into the syringe. If air bubbles have entered the syringe, get rid of them while the needle is in the vial and get the needle out.
The sites at which you can inject insulin are upper arm, abdomen and thigh- after several shots of insulin to one site, move to another.
Injecting insulin to the leg or abdomen – Raise a fold of skin in your leg or abdomen, especially if you are thin, says Dr. Weeraratne, adding that you should then place the needle and syringe at a 90 degree angle against the skin. If you are thin it should be a 45 degree angle. Quickly insert the needle through the skin to the fat layer beneath and push the plunger, releasing the insulin as quickly as possible. Then let go the skin fold but keep the needle embedded in the skin for about 10 seconds and take it out thereafter.
Here are a few tips to reduce the pain when injecting insulin:
- Be sure to take the insulin vial out of the fridge a ¼ hour before injection.
- Tap the syringe and remove any air bubbles mixed with the insulin in the syringe before injecting.
- Use a 29-gauge needle with the insulin syringe.
- Make the pricking of the needle and removal from skin as quick as possible.
- Inject insulin rapidly into the fat layer beneath the skin.
- Use an insulin pen with a slim 31-gauge needle.
Once the injecting is done, remove any drops of insulin left in the syringe, insert the needle in its cover, put it along with the insulin vial back in its small box and replace in the fridge at 2-80 Centigrade.
Although the syringe and needle are disposable and meant to be used only once, if it is difficult to keep buying them over and over again due to the cost, you may use them several times. However, if the needle-point becomes blunt, turns crooked or gets stained with blood, discard it she says, and get a new one immediately.
Usage of the inhaler for asthma – Asthma inhalers can be divided into two main groups, with each one being used in a different manner. They are:1. Metered dose inhaler (MDI) or aerosol inhaler
2. Dry powder inhaler (DPI)
Metered dose inhaler (MDI) or aerosol inhaler – when this inhaler is activated, the medication which is stored in it in liquid form comes under pressure and goes into the lungs as a spray. The parts of the inhaler are
- The cylinder which contains the liquid medication
- The outer plastic covering
- The mouthpiece
- The mouthpiece cover
How to use the MDI – Shake the inhaler well; remove the cover of the mouthpiece; take a deep breath and release it; tilt back your head slightly; wedge the mouthpiece tightly between your lips, and as you press the top of the cylinder with your fingers inhale the spray taking it into your lungs, hold your breath for 10 seconds, take the inhaler out of your mouth and exhale.
Use of spacer – Sometimes doctors recommend that children, the elderly or those with neurological or joint problems should use a plastic spacer to ensure maximum inhalation of the liquid medication especially if it is a steroid.
The inhaler should be fixed to one end of the spacer and the other end wedged between your lips. When the inhaler is pressed, the medication would go to the spacer first and then through your mouth to your lungs as you inhale and exhale a few times.
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| Pix courtesy getty images |
Dry powder inhaler (DPI) – when this inhaler is activated, the medication which is in the form of a tablet turns into a thin powder which can be inhaled into the lungs.
How to use the inhaler – Open the inhaler and insert the capsule with the medication in the allotted slot. Activate the inhaler according to the instructions on the leaflet. Release a deep breath, keep the mouthpiece of the inhaler between your lips and press the inhaler, allowing the medication to come out of the capsule and inhale deeply. Hold your breath for about 10 seconds and exhale, repeating the process to allow all the medication to be absorbed by the lungs. Then remove the empty capsule from the inhaler.
It is important to read the instructions leaflet included with the inhaler to learn how to use it effectively, urges Dr. Weeraratne, while seeking advice from your doctor or pharmacist. “It is better to demonstrate how you will be using it to your doctor or pharmacist to ensure that you are doing it right. If the required effect is not forthcoming, you should inform your doctor.” |
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