Houston Cardiovascular Associates Houston Cardiovascular Associates

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How to prepare a mixed dose of insulin

You will mix insulin from two bottles (vials). The order in which you mix the cloudy (long-acting) and clear (short or rapid-acting) insulin is important. Follow the order of the steps below.

Roll the cloudy insulin bottle gently between your hands.

slide 1 of 9
    
slide 1 of 9, Roll the cloudy insulin bottle gently between your hands.,

Roll the cloudy insulin bottle until all the white powder has dissolved.

Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator.

Do not shake an insulin bottle.

Clean the lids of the bottles.

slide 2 of 9
    
slide 2 of 9, Clean the lids of the bottles.,

If you are using a bottle for the first time, remove the protective cover from the rubber lid.

If the rubber lid of the insulin bottle is dirty, clean it with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry.

Draw air into the syringe for the cloudy insulin dose.

slide 3 of 9
    
slide 3 of 9, Draw air into the syringe for the cloudy insulin dose.,

  1. Remove the plastic cap that covers the needle on your insulin syringe. Important: Do not touch the needle.

  2. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given.

Force air into the cloudy insulin bottle.

slide 4 of 9
    
slide 4 of 9, Force air into the cloudy insulin bottle.,

  1. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle.

  2. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin.

  3. Remove the needle from the bottle.

Draw air into the syringe for the clear insulin dose.

slide 5 of 9
    
slide 5 of 9, Draw air into the syringe for the clear insulin dose.,

Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given.

Force air into the clear insulin bottle.

slide 6 of 9
    
slide 6 of 9, Force air into the clear insulin bottle.,

  1. Push the needle of the syringe into the rubber lid of the clear insulin bottle. Note: You will draw the clear insulin into the syringe first, then the cloudy insulin (Step 8). It is important to follow this order.

  2. Push the plunger to force the air into the bottle. Leave the needle in place.

Draw clear insulin into the syringe.

slide 7 of 9
    
slide 7 of 9, Draw clear insulin into the syringe.,

  1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.

  2. Pull back the plunger to fill the syringe with slightly more than the correct number of units of clear insulin to be given.

  3. Tap the barrel of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Important: Make sure that you have the correct number of units of insulin in your syringe.

  4. Remove the needle from the clear insulin bottle.

Insert the needle into the cloudy insulin bottle.

slide 8 of 9
    
slide 8 of 9, Insert the needle into the cloudy insulin bottle.,

Insert the needle into the rubber lid of the cloudy insulin bottle.

Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle. If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle.

Draw cloudy insulin into the syringe.

slide 9 of 9
    
slide 9 of 9, Draw cloudy insulin into the syringe.,

  1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.

  2. Slowly pull back the plunger of the syringe to fill the syringe with the correct number of units of cloudy insulin to be given. This will prevent air bubbles entering the syringe.

  3. Remove the needle from the bottle. You should now have the total number of units for the clear and cloudy insulin in your syringe. For example, if you need 10 units of clear and 15 units of cloudy, you should have 25 units in your syringe. Now you are ready to give the shot.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Dear patient

I am excited to announce that I will be relocating my practice to Houston Methodist DeBakey Cardiology Associates. Starting November 4, 2024, my new address will be:

5115 Fannin, Suite 801
Houston, TX 77004

Please note that my phone number and fax number will also change to the following:
24-Hour Telephone: 713-441-1100
Fax: 713-790-2643
Clinical Support Telephone (M-F, 8-5): 713-441-3515

I am excited about caring for you in my new office and hope you will make the transition with me. I will also continue to refill your medications as I have in the past. To assist, please provide your pharmacy with my new contact information.

Please consider checking your prescription refills to verify that you have enough medication on hand to last you until your next visit. Please note that your medical records will remain at my former office until you authorize their transfer. If you choose for me to continue providing your medical care, please complete and sign the enclosed “Authorization for Release of Medical Records” form and fax it to 713-790-2643. Once we receive your authorization, we will be happy to process the request for you.

Thank you for entrusting me with your medical care. My new team and I are dedicated to making this transition as seamless as possible. For help scheduling an appointment and transitioning your care, please call my new office number above.

I look forward to continuing your care at my new location.

Sincerely,
Gopi A. Shah, MD

Dear patient

Dr. Albert Raizner, Dr. Michael Raizner, and Dr. Mohamed El-Beheary are excited to announce that our practice, Interventional Cardiology Associates, will merge with Houston Cardiovascular Associates on November 1, 2024.

Our new offices are similarly located in Houston, near the Texas Medical Center and in Sugar Land. Our in-hospital care will continue at Houston Methodist Hospital in the Texas Medical Center and Houston Methodist Sugar Land Hospital. Importantly, our new offices expand our services with state-of-the-art equipment and amenities. Our core values will always be, as they began over 40 years ago when Dr. Albert Raizner founded ICA:

Integrity – Compassion – Accountability

Our new address and contact information are:

Your medical records are confidential and remain available at our new locations. We consider it a privilege to serve as your cardiologists and look forward to your continuing with us. However, should you desire to transfer to another physician, you may request a copy of your records by contacting us at our new addresses and phone numbers listed above.

We thank you for your trust and loyalty. As always, we will continue to be here to take care of you. Please do not hesitate to contact us if you have any questions or concerns.

Sincerely,

Dr. Albert Raizner,
Dr. Michael Raizner,
Dr. Mohamed El-Beheary