# 使用餐時胰島素的個案將開始使用普蘭林肽 (pramlintide)。哪項指導是優先事項？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522883&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

使用餐時胰島素的個案將開始使用普蘭林肽 (pramlintide)。哪項指導是優先事項？

## 選項

1. 將普蘭林肽和胰島素混合在同一支注射器中。
2. 第一週保持平常的餐時胰島素劑量。
3. 依醫囑將餐時胰島素減少 50%，並密切監測血糖，尤其是在餐後最初 3 小時內。 **✔ 正確答案**
4. 睡前服用普蘭林肽，不搭配食物。

**正確答案: 3**

## 解析

普蘭林肽可能導致嚴重的胰島素誘導性低血糖。仿單上的起始計畫是將餐時胰島素減少 50%，使用單獨注射，並加強血糖監測。

## 深入解析

快速解答
開始使用普蘭林肽時，餐時胰島素減半並密切監測餐後血糖。

為什麼這是正確的
此藥物不適用於確診胃輕癱或低血糖無感症的個案。

簡單類比或心像
建立藥物安全鏈：識別新的線索，將其與藥物作用機制或仿單限制連結，停止可預防的暴露，穩定個案，並驗證可測量的反應。

記憶點
藥物、緊急線索、保護措施和再評估終點。

NCLEX 決策規則
選擇能預防最直接藥物相關危害的措施，同時保留指示治療和必要的監測。

為什麼其他選項是錯誤的
繼續可疑暴露、將仿單標示的危險線索正常化、替代未經授權的劑量或延遲升級的選項，都會使個案處於風險之中。References
1DailyMed: SYMLINPEN (pramlintide)Mealtime-insulin reduction and severe hypoglycemia prevention

## 臨床情境

藥物安全審查
核實適應症、當前評估、劑量和途徑、器官功能、交互作用、緊急毒性線索、授權行動和可測量的後續追蹤。

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