Airshots from Flex Pens (question)

[Jill-O]

Hi, folks --

I use a Novolog 70/30 Flex pen and was taught to do a 2 unit (cc?) air shot before each dose. I've been doing this.

If my prescibed amount goes up just a teeny bit more, I will need more than 5 pens a month when I factor in the air shots.

It's dawned on me that I can see the plunger move as I give myself the shots (am & pm). I'd see if it was somehow pouring out the side of the syringe so only place it would go w/o me seeing is in me.

My question is, how many of you that use pens do an air shot before each shot? I'm wondering if it is reasonably okay to only do it the first time you start using that pen?

Thanks,
Jill

[Penny]

I do not do the air shots....I use almost 2 pens a week, and hate the waste. When the plunger will not go down any further, there is still close to 20 units left in the vial. I have been using my nighttime Lantus syringe and taking it out to inject that way......just too much waste for me, not to.

[owlyn]

You must do the air shot or you may not get the correct dose (you may get too little). Think about it- there is air in the needle tip that must be cleared, plus there may be some in a bubble near the top of the cartridge.

[Geoff]

Hi Jill I think it is best to do it with every shot that you take because you may have a blockage in you needle that you would no see with out the air shot.

[Penny]

You must do the air shot or you may not get the correct dose (you may get too little). Think about it- there is air in the needle tip that must be cleared, plus there may be some in a bubble near the top of the cartridge.

OK, that makes sense.....it will do the air shot.

[Funnygrl]

2 unit (cc?)

Ok, sorry, but you hit one of my pet peeves. A unit and a cc is not the same thing.

A cc is a cubic centimeter. That's the same thing as a milliliter.

Insulin is U-100, that means there's 100 units/ml. So, 1 cc = 100 units. Therefore, you do a 2 unit air shot, but not a 2 cc air shot.

[Olidus]

Wow - I never knew about this.
"Air Shot"
This is to be done every time you rpleace the cart.? Or every time you replace your needle?

I just looked it up and went though the demo at;
NovoLog®: helpful resources for diabetes patients (http://www.novolog.com/devices-flexpen_demo.asp?s=ds&h=235)
It did not say if it was per needle or per insulin cart.

Can someone please clear this up for me?

[Jill-O]

Ok, sorry, but you hit one of my pet peeves. A unit and a cc is not the same thing.

A cc is a cubic centimeter. That's the same thing as a milliliter.

Insulin is U-100, that means there's 100 units/ml. So, 1 cc = 100 units. Therefore, you do a 2 unit air shot, but not a 2 cc air shot.

Well, sorry. I guess I could have taken the pet peeve to the next level by referring to it as 2-click-turns ;)

[Jill-O]

Wow - I never knew about this.
"Air Shot"
This is to be done every time you rpleace the cart.? Or every time you replace your needle?

I just looked it up and went though the demo at;
NovoLog®: helpful resources for diabetes patients (http://www.novolog.com/devices-flexpen_demo.asp?s=ds&h=235)
It did not say if it was per needle or per insulin cart.

Can someone please clear this up for me?

I think you are supposed to use a new needle for each injection. So, it sounds like a new needle and a new air shot prior to each injection.

[Olidus]

If that is true - and you are supose to replace your needle everytime you inject - that is 6 units a day going to waste.
If you put on a new needle and you see a bubble at the end of it - I would think you are ok no?

[Jill-O]

I'm gathering that's not okay from what they are saying here. That's what I was wondering. I take a shot in the morning and a shot in the evening, and a new needle each time and will continue to do 2 air shots of 2 units / click-turns each time (so shooting 4 units into the air a day).

[BlueSky]

I only do the air-shots when I change cartridges and needles, which is about once a month. Doing a 2 unit prime each time would increase my insulin usage by 50%!. Having said that, you should really prime the pen each time you put a new needle on. But you may be able to get away with a one-unit air-shot.

[andypoo]

Sometimes I do an air shot sometimes I don't my question is what would the needle be clogged with,unless it's something wrong with the needle itself,right?And also,a few times I have seen a little tiny air bubble inside the syringe and I'll flick the pen so it goes towards the needle end and give an air shot,but it won't expell,so I just keep an eye on it when I inject and make sure it kinda stays away from that end. When I used regular syringes,I could always get rid of the air bubbles,easily. Also,I have been removing the last bit of insulin from the cartridges with a regular syringe to utilize it. And it is approximately 18-20 units remaining,that could be wasted if you don't remove it this way. It's always good to have extra regular syringes handy for this.

[owlyn]

Sometimes I do an air shot sometimes I don't my question is what would the needle be clogged with,unless it's something wrong with the needle itself,right?And also,a few times I have seen a little tiny air bubble inside the syringe and I'll flick the pen so it goes towards the needle end and give an air shot,but it won't expell,so I just keep an eye on it when I inject and make sure it kinda stays away from that end. When I used regular syringes,I could always get rid of the air bubbles,easily. Also,I have been removing the last bit of insulin from the cartridges with a regular syringe to utilize it. And it is approximately 18-20 units remaining,that could be wasted if you don't remove it this way. It's always good to have extra regular syringes handy for this.

It's per shot- each time you inject. I sometimes cheat if I'm down at the end and I know I'll be one unit short if I do a 2 unit air shot, so I may do 1 unit if that particular cart or pen hasn't had a lot of air bubbles.

[Peggy]

I've been using the Novolog Flexpen for over a year and never have heard of doing an 'airshot'. Not from my endo who taught me how to use the pen or anyone else. As expensive as meds are these days I think it would be a waste and it will take a lot more than I've heard here to convince me it is neccessary. My husband uses insulin with a regular syringe so I also draw out the remainder in the pen before throwing it away.

[owlyn]

I've been using the Novolog Flexpen for over a year and never have heard of doing an 'airshot'. Not from my endo who taught me how to use the pen or anyone else. As expensive as meds are these days I think it would be a waste and it will take a lot more than I've heard here to convince me it is neccessary. My husband uses insulin with a regular syringe so I also draw out the remainder in the pen before throwing it away.

Read the instructions that come with it:

"Insulin prefilled syringes Novolin® N FlexPen™ may contain a small amount of air. To prevent an injection of air and make certain insulin is delivered, an air shot must be done before each injection. Directions for performing an air shot are provided on the reverse side of this insert."

[shabbie6247]

my needles get changed once a day for each pen.
i always prime my pens before EACH shot.
i only prime 1 click on each pen before use. (for levemir thats 1 unit, and for novorapid its half a unit)(i use the NP3 demi).
i would never inject unless i'm confident the pens are going to deliver the goods! i get the occasional new needle isnt in properly which either needs changing again or half unscrew then re-screw it back in again (sometimes does the trick).
and ive never managed to clear the air out of my pens with an airshot, so i prime my pens with the needle pointing downwards, i always know that air bubble is well outa the way.

hope that helps ;)

[Alice]

I only do the air shots when changing cartridges (lantus) or starting a new pen (Humalog). I change the needle with each use and remove after injections. I've never had a problem with dosing amount.

I do get a good bit of air when using a new cartridge/pen. I think I dial about 5 units...get air...then do another 5 and get a solid stream. That's it for me.

[Jeannie]

I'm on the NovoLog 70/30 flexpen as well as the fast acting one. I do the air shots every time I inject, and I change needles every shot. I was told that if I left a needle on ..the insulin could leak out. I was shown how to do the air shot by my dr...and it's done without clicking. He just rolled the pen a few times between his hands, then inverted it as well several times..then flicked the pen with his finger...then pressed the button...you can't press it much because it's not actually clicked to a number.. There's a little bead of insulin at the tip of the needle..showing it's working fine...then turn the dial to the dose needed and inject. That's how I've been doing it and seems to work just fine.

[pdxdennisj]

If I am right in assuming that the Byetta pens operate in the same way Insulin pens operate, I don't do air shots ... never heard of one. I do the priming shot when I start a new cartridge and I don't change the needle until I start the next cartridge (next month). When I was given my instructions on how to inject insulin I was told the clear the syringe of air but not to worry if I injected some - it will dissipate in the fat tissue and is not the same as air injected into a vein or artery.

[Alice]

Question for those of you who don't change needles with each use...are you leaving the needles in the pen?

I'd rather use a new needle each time than deal with those alcohol swabs. (Don't use them...sometimes I do for finger testing in public...normally just blot on tissue in purse)