Patients admitted to Skilled Nursing Facilities (SNF) for post-acute care often have
complex medication regimens. Frequently the medication schedule is modified during
prior hospitalization. SNF patients are vulnerable to adverse drug events (ADE) during
these times of transition. Insulin is a medication that is frequently associated with
ADE in SNFs. The increasing prevalence of obesity linked to insulin resistance in
the United States has created the need to use larger doses of insulin. Since 1994
a Regular insulin U-500 vial, a concentrated form of regular insulin (500 units/ml),
is available. The Institute for Safe Medication Practices has advocated for the development
of a dedicated U-500 device since 2013. In July 2016 the FDA approved a dedicated
syringe for the administration of U-500 insulin. This is now the only device approved
for the use and administration of the U-500 insulin vial. Using the wrong delivery
device or failure to use the correct conversion factor when using the traditional
U-100 syringe can lead to catastrophic episodes of hypoglycemia.
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© 2017 Published by Elsevier Inc.
