一位新診斷為高血壓的病人被處方服用賴諾普利（Lisinopril）。護理師應最密切監測哪種副作用？
A client with a new diagnosis of hypertension is prescribed Lisinopril. Which side effect should the nurse monitor for most closely?
- AHypokalemia低血鉀症
- BPersistent dry cough✓ 正解持續性乾咳
- CHyperglycemia高血糖症
- DConstipation便秘
Lisinopril 是一種血管收縮素轉化酶抑制劑（ACE Inhibitor）。ACEI 藥物最著名且常見的副作用是「持續性乾咳（Persistent dry cough）」，這與緩激肽（Bradykinin）在肺部的累積有關。雖然這種咳嗽無害，但往往讓病人難以忍受，甚至導致自行停藥。護理師應告知病人，若出現咳嗽應回報醫師，通常會更換為 ARB 類藥物（如 Losartan）。另一個嚴重的潛在副作用是血管神經性水腫（Angioedema），雖然較罕見但具致命性。選項 A 錯誤，ACEI 會導致「高血鉀」而非低血鉀。掌握 ACEI 的「Cough、Potassium、Angioedema」三大考點是藥理學得分關鍵。
Lisinopril is an angiotensin-converting enzyme inhibitor (ACE inhibitor). The best-known and most common side effect of ACE inhibitors is a persistent dry cough, which is related to bradykinin accumulation in the lungs. Although this cough is harmless, it is often intolerable for clients and may lead to self-discontinuation of the drug. The nurse should advise the client to report any cough to the prescriber, who will typically switch the medication to an ARB (such as losartan). Another serious but rarer potential adverse effect is angioedema, which can be fatal. Option A is incorrect because ACE inhibitors cause hyperkalemia, not hypokalemia. Mastery of the ACE inhibitor 'cough, potassium, angioedema' triad is the key to scoring on pharmacology questions.
在美國臨床中，ACEI 是高血壓的首選藥物之一，護理師對「ACEI Cough」的識別非常敏銳。台灣病人有時會誤以為是感冒而去看胸腔內科，護理師應在給藥初期就進行衛教，幫助病人辨識藥物副作用。