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Giriş: İnsülin acil servislerde sıklıkla kullanılan parenteral bir ilaçtır. Çoğu şiddetli insülin doz aşımı intihar girişimi olarak ortaya çıksa da, nedeni ilaç hataları da olabilir. Bu vakada tecrübe ettiğimiz gibi, acil servislerde insülin gibi kritik ilaçların yetersiz kontrolü ve ilaçların marka isimleri arasındaki benzerlikler nedeniyle ortaya çıkabilecek olası ilaç hatalarını vurgulamayı amaçladık. Olgu Sunumu: Aşırı insülin doz aşımı olan 75 yaşında diyabetik bir kadın sunmaktayız. Hastanın subkütan ve kas içi yollarla toplam 3000 UI insülin alımı oldu. Hastada intravenöz dekstroz, yüksek kalorili diyet ve glukagon uygulaması gerektiren, tipik ve atipik hipoglisemi atakları gelişti. Glukagonun klasik yan etkilerinin neredeyse tamamı yoğun bakım ünitesi takibi sırasında ortaya çıktı. Hasta hastaneye yatışından sonraki 5. günün sonunda herhangi bir sekel veya hipoglisemi nüksü olmadan taburcu oldu. Sonuç: İnsülin doz aşımı, hipoglisemiye neden olarak yaşamı tehdit eden bir durum olabilir. Nadir de olsa insülin doz aşımı hastanelerde ilaç hatası olarak ortaya çıkabilir. Acil servislerde bu tür olayları önlemek için, ilaçla ilgili hatalar objektif bir şekilde ortaya konulmalı ve akut bakımı olumsuz yönde etkilemeden proaktif stratejiler entegre edilmelidir.
Introduction: Insulin is a parenteral drug that is frequently used in emergency services. Although most severe insulin overdose occurs as a suicide attempt, the cause may also be drug errors. As we experienced in this case, we aimed to emphasize the possible drug errors that may arise due to insufficient control of critical drugs such as insulin in emergency services and similarities between the brand names of drugs. We present a 75-year-old woman with diabetes with excess insulin dosage. The patient received a total of 3,000 IU of insulin through the subcutaneous and intramuscular pathways. The patient developed typical and atypical hypoglycemic attacks, which require intravenous decstrosis, high-calorie diet and glucagon application. Almost all of the classic side effects of glucagon occurred during the intensive care unit tracking. At the end of the 5th day after hospitalization, the patient was dismissed without any scell or hypoglycemic nuts. The result: overdose of insulin may be a life-threatening condition caused by hypoglycemia. Although rare, overdose of insulin may occur as a drug error in hospitals. In order to prevent such events in emergency services, errors related to the drug should be objectively detected and proactive strategies should be integrated without negatively affecting emergency care.
Introduction: Insulin is a highly used parenteral medication in emergency departments. Although most severe insulin overdoses occur as suicide attempts, medication errors can be the reason. We aimed to highlight the potential medication errors in emergency departments due to the poor control of critical drugs like insulin and the similarities between the brand names of drugs, as we experienced during this case. Case Report: We present a 75-year-old diabetic woman with an extreme insulin overdose. A total of 3000 UI of insulin was administered by subcutaneous and intramuscular routes. She developed typical and atypical episodes of hypoglycemia requiring intravenous dextrose, a high-calorie diet, and glucagon administration. Almost all of the classic side effects of glucagon occurred during her intensive care unit follow-up. She recovered without any sequela or recurrence of hypoglycemia at the end of 5 days of admission. Conclusion: Insulin overdose can be a life-threatening condition by causing hypoglycemia. Albeit rare, insulin overdose can occur as a medication error in hospitals. To prevent such incidents for emergency departments, the medication errors should be objectively laid out, and proactive strategies should be integrated without adversely affecting acute care.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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