33.有關類毒素（toxoids）之製備，下列敘述何者錯誤？
(A)細菌增殖後，將毒素之濾液經過濾、鹽析、清洗、透析純化後，再以甲醛去除毒性
(B)類毒素可與其他類毒素或疫苗混合施打
(C)類毒素所使用之強度單位為凝絮單位（flocculating, Lf）
(D)類毒素是提供被動免疫的生物製劑

以下想要以114-1的題目解析，並在後續進行考猜：

A. Processing involves addition of a concentrated salt solution to precipitate the toxin from the filtrate. After the precipitated toxin is washed and dialyzed to purify it, the toxin is detoxified with formaldehyde.

B. The product may also contain single, multiple, or mixed immunogens (e.g., tetanus and diphtheria toxoids adsorbed for adult use, which contains two toxoids for active immunization against different toxins).

C. The strength of a toxoid is in flocculating (Lf) units (e.g., tetanus toxoid, 4 to 5 Lf U/0.5 mL dose). A flocculating unit is the smallest amount of toxin that flocculates most rapidly one unit of standard antitoxin in a series of mixtures containing fixed amounts of antitoxin and varying amounts of toxin.

除此之外，在類毒素章節還提到了，類毒素會使用的佐劑：

The detoxified toxin (toxoid) may be plain or contain an adjuvant (e.g., alum, aluminum hydroxide, aluminum sulfate).

說完114-1，以下是之後對於「被動免疫」原文書重點整理並進行猜題：

1. Human Immune Sera and Globulins (Homologous Sera) 人類血清以及免疫球蛋白（同質血清）

重點一：The pooled plasma from adult donors must be free of hepatitis B antigen and antibodies to HIV.

重點二：Further purification takes place with a finished biologic product that contains not <15% and not more than 18% protein. There are of course exceptions (e.g., varicella-zoster immunoglobulins [VZIGs] contain not <10% protein).

重點三：These preparations are for intramuscular(IM) injection and should not be administered intravenously. However, immunoglobulin intravenous (3% to 12% protein) and cytomegalovirus immunoglobulin are administered intravenously.

重點四：Sera have the greatest value for the treatment of acute disease,

2.Animal Immune Sera (Heterologous Sera) 動物免疫血清（異質血清）

重點一：Most commonly employed immune sera are prepared by immunization of horses against the specific immunogen

重點二：After the plasma is harvested, it is separated by fractional precipitation into two components: immunologically active (immu-noglobulins) and immunologically inactive (albumins, clotting factors) ones.

重點三：Before using these products, precautions must be taken to ensure the safety of the patient, who may be sensitive to horse protein.

1. 善用比較，劑型之間的比較常考，可以多在此方面著手，若在未來選不出答案時，可以靠直覺去挑出一個最正確的答案。
2. 溶離度試驗或是其他藥典試驗出題頻率越來越高，推薦學弟妹可以多多閱讀藥典同章節。
3. 未來通靈題有變高的趨勢，例如114-1的微脂粒大小，都是從美國藥典或是Ansel's原文書出題，我建議可以直接放掉，畢竟同內容短期內不會再考，但可以像以上整理一樣，稍微閱讀考過的內容前後文，會有意想不到的幫助。