— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位第一型糖尿病病人處方了 10 單位清型胰島素（Regular）和 20 單位中效型胰島素（NPH）。護理師在同一個針筒混合時，正確順序為何？
A client with type 1 diabetes is prescribed 10 units of Regular insulin and 20 units of NPH insulin. What is the correct sequence for mixing these insulins in one syringe?
- ADraw Regular insulin first, then NPH insulin✓ 正解先抽取清型胰島素，再抽取中效型胰島素
- BMix the insulins in the syringe by shaking vigorously在針筒內劇烈搖晃以混合胰島素
- CInject air into the Regular vial, then air into the NPH vial先向清型胰島素瓶注入空氣，再向中效型胰島素瓶注入空氣
- DDraw NPH first, then Regular insulin先抽取中效型胰島素，再抽取清型胰島素
— Explanation · 中文詳解 —
胰島素混合的原則是「Clear before Cloudy」（先清後濁）。順序為：先往 NPH（濁）瓶內打空氣，再往 Regular（清）瓶內打空氣，接著抽取 Regular 藥液，最後抽取 NPH 藥液。這樣可以防止 NPH 中的蛋白質成分污染 Regular 瓶，確保藥物效力不變。混合後應儘速注射。
When mixing insulins in one syringe, the nurse should draw up the Regular (clear) insulin first to prevent contaminating the vial with NPH (cloudy) insulin. This 'clear before cloudy' technique ensures the accuracy and efficacy of both medications.
✦ 台美臨床差異
台美臨床原則一致；但美國現在多使用預填式胰島素筆（Insulin Pen），減少了手動混合的機會。