— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位第一型糖尿病病人於早上 8 點注射 NPH 胰島素。該病人於何時發生低血糖的風險最高？
A client with type 1 diabetes is receiving NPH insulin at 0800. At what time is the client at the highest risk for hypoglycemia?
- A18001800 (語境:此時藥效已趨緩，發生急性低血糖的機率較低。)
- B09000900 (語境:此時段通常為速效胰島素的作用高峰期，非 NPH 作用時間。)
- C1400✓ 正解1400 (語境:NPH 藥效在 6-8 小時後達到最大值，此時血糖最低，風險最高。)
- D22002200 (語境:此時已過藥物作用高峰，通常不會是低血糖的高風險期。)
— Explanation · 中文詳解 —
NPH 為中效胰島素，發揮作用時間通常在注射後 4-12 小時達到高峰。若於 0800 給藥，高峰值約在 1400 到 1600 之間，此時胰島素濃度最高，病人最易發生低血糖。0900 是速效胰島素作用時間，晚間則非 NPH 高峰。
NPH insulin is an intermediate-acting agent with a peak effect occurring approximately 6 to 8 hours after administration. Since the dose was given at 0800, the highest risk for hypoglycemia occurs around 1400 to 1600 when insulin activity is at its maximum. Monitoring blood glucose levels during this peak window is essential to prevent complications associated with excessive insulin action.
✦ 台美臨床差異
台美皆強調衛教胰島素作用曲線，但台灣醫護對於預防低血糖的衛教更強調澱粉類點心攝取。