護理師正在教導病人關於 Atorvastatin 的事項。應包含哪些？（選所有適合的）
A nurse is teaching a client about Atorvastatin. What should be included? (Select all that apply.)
- AReport unexplained muscle pain or weakness✓ 正解報告無法解釋的肌肉疼痛或無力
- BAvoid drinking grapefruit juice✓ 正解避免飲用葡萄柚汁
- CMonitor liver function tests✓ 正解監測肝功能檢查
- DTake the medication in the morning於早晨服用藥物
- EContinue a heart-healthy diet✓ 正解繼續心臟健康飲食
Atorvastatin（史他汀類）主要副作用為橫紋肌溶解症，若出現不明原因肌肉疼痛需立即回報。葡萄柚汁會干擾肝臟代謝酵素（CYP450），導致藥物濃度上升而增加毒性。肝功能監測與持續的飲食控制皆是治療關鍵。此藥多建議夜間服用，因膽固醇合成於夜間較旺盛，故 D 選項不正確。
The principal serious adverse effect of atorvastatin (a statin) is rhabdomyolysis; any unexplained muscle pain must be reported immediately. Grapefruit juice interferes with hepatic CYP450 metabolism, leading to elevated drug levels and increased toxicity. Liver function monitoring and ongoing dietary control are essential elements of therapy. Statins are generally recommended to be taken in the evening because cholesterol synthesis is more active at night, so option D is incorrect.
美國藥師常會提醒病患避免葡萄柚，台灣病人常因自行購買保健品（如紅麴）與 statin 共用而產生肝功能異常，此為重要衛教點。