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藥理與非經腸給藥 · MEDIUM · MCQ

護理師正在指導一位新診斷的一型糖尿病病人關於甘精胰島素(Insulin glargine)的知識。護理師應包含下列哪項資訊?

The nurse is teaching a client with newly diagnosed type 1 diabetes about insulin glargine. Which information should the nurse include?

  • AMix insulin glargine in the same syringe with regular insulin
    將甘精胰島素與常規胰島素混合於同一支注射器中
  • BInject insulin glargine twice daily at breakfast and dinner
    於早餐和晚餐時每日注射兩次甘精胰島素
  • CExpect the insulin to start working within 15 minutes of injection
    預期胰島素在注射後 15 分鐘內開始作用
  • DThis insulin has no peak action and lasts for about 24 hours✓ 正解
    此胰島素無作用高峰,持續時間約為 24 小時
Explanation · 中文詳解

Insulin glargine(Lantus)是一種長效胰島素(Long-acting insulin)。其關鍵特點是:無明顯高峰時間(Peakless)、作用時間長(維持約 24 小時)。這使得它非常適合作為基礎胰島素(Basal insulin)來維持全天血糖穩定。A 選項錯誤,長效胰島素「絕對不能」與其他任何胰島素在同一針筒內混合,這會改變其 pH 值進而影響吸收;B 選項通常每天注射一次;C 選項是速效胰島素(如 Lispro)的特點。護理師必須精確掌握各類胰島素的藥效動力學,以預防低血糖並確保治療效果。這題測驗內分泌藥物護理的核心特徵。

Insulin glargine is a long-acting, peakless basal insulin designed to provide a steady blood level for approximately 24 hours with a single daily injection. It should never be mixed with other insulins because its acidic pH can cause precipitation and alter absorption. Unlike rapid-acting insulins, glargine has an onset of 1 to 2 hours, not 15 minutes.

✦ 台美臨床差異

美國護理教育中,胰島素的「Mixing rules」是重點。台灣臨床上,雖然現在多使用預混型或筆型胰島素,但對於「長效不可混抽」的藥理原則仍是護理師必須具備的基礎知識,以應對各種臨床情境。

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