下列哪些藥物需要嚴格監測血鉀濃度？（選所有適合的）
Which of the following medications require strict monitoring of potassium levels? (Select all that apply.)
- ASpironolactone✓ 正解Spironolactone（螺內酯）
- BFurosemide✓ 正解Furosemide（呋塞米）
- CLisinopril✓ 正解Lisinopril（賴諾普利）
- DHydrochlorothiazide✓ 正解Hydrochlorothiazide（氫氯噻嗪）
- EDigoxinDigoxin（地高辛）
螺內酯（spironolactone）為保鉀利尿劑，會導致高血鉀；呋塞米（furosemide）與氫氯噻嗪（HCTZ）為排鉀利尿劑，易引起低血鉀；賴諾普利（lisinopril）作為 ACEI 抑制醛固酮分泌而導致鉀滯留，這四類藥物本身會直接改變血鉀。Digoxin 本身不直接改變血鉀，但低血鉀會大幅增加其毒性風險（致命心律不整），臨床上也需密切監測，惟在嚴格區分「需監測 K+ 的藥物」這一題型下，Digoxin 不被列為主類正解。
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia; furosemide and hydrochlorothiazide (HCTZ) are potassium-wasting diuretics that easily cause hypokalemia; lisinopril, as an ACE inhibitor, suppresses aldosterone secretion and leads to potassium retention. These four medications directly alter serum potassium. Digoxin does not directly alter potassium itself, but hypokalemia substantially increases its toxicity risk (causing fatal arrhythmias), and close monitoring is clinically warranted; however, under the strict NCLEX framework of 'medications requiring K+ monitoring,' digoxin is not classified in the primary group of correct answers.
兩地對此類藥物的用藥安全監測標準一致，均強調利尿劑與 ACEI 合併使用時的血鉀追蹤。