一位病人安排接受含碘顯影劑的電腦斷層掃描（CT Scan）。護理師應預期在檢查後暫停哪種藥物 48 小時？
A client is scheduled for a computed tomography (CT) scan with intravenous contrast. Which medication should the nurse expect to withhold for 48 hours after the procedure?
- AFurosemideFurosemide（呋塞米）
- BMetformin✓ 正解Metformin（二甲雙胍）
- CLevothyroxineLevothyroxine（左旋甲狀腺素）
- DAmlodipineAmlodipine（氨氯地平）
Metformin（美福明）與含碘顯影劑之間存在嚴重的交互風險。顯影劑可能導致急性腎功能損傷（Contrast-induced nephropathy），而 Metformin 主要經由腎臟排泄。如果腎功能受損導致 Metformin 在體內積聚，會引發極高死亡率的『乳酸中毒』（Lactic Acidosis）。標準臨床指引建議，在接受顯影劑檢查前應停用 Metformin，且在檢查完成後 48 小時內必須續停，直到確認腎功能（肌酸酐數值）恢復正常後方可重新用藥。這題是藥理安全中關於藥物與檢查交互作用的經典考題，也是護理師在執行檢查前評估的必備知識。
A serious interaction exists between metformin and iodinated contrast media. Contrast may cause contrast-induced nephropathy (acute renal injury), and because metformin is primarily excreted by the kidneys, impaired renal function leading to metformin accumulation can precipitate lactic acidosis, which carries an extremely high mortality rate. Standard clinical guidelines recommend withholding metformin before contrast-enhanced imaging and continuing to withhold it for 48 hours after the procedure, resuming only after renal function (creatinine level) is confirmed to have returned to normal. This is a classic exam item on pharmacologic safety regarding drug-procedure interactions and represents essential knowledge for nursing assessment prior to diagnostic studies.
美國護理師在術前檢核清單（Pre-procedure Checklist）中對 Metformin 的確認極為嚴格；台灣醫院亦有此規範，但有時會依醫師個別判斷而略有不同，護理師應堅持 48 小時原則以確保病人安全。