— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位病人正在接受萬古黴素的連續輸注。護理師應監測病人的最低藥物濃度 (trough level) 以達到什麼目的？
A client is receiving a continuous infusion of vancomycin. The nurse should monitor the client's trough level to:
- AEnsure the peak level is therapeutic.確保峰值濃度具有治療效果
- BAssess for nephrotoxicity.評估腎毒性
- CPrevent Red Man Syndrome.預防紅人症
- DEnsure therapeutic efficacy and minimize toxicity.✓ 正解確保治療效力並最小化毒性
— Explanation · 中文詳解 —
監測萬古黴素的最低藥物濃度 (trough level) 是確保藥物達到有效治療濃度（預防治療失敗）並避免過高濃度（降低腎毒性、耳毒性等副作用）的關鍵。高峰濃度 (peak level) 也會被監測，但 trough level 直接反映了累積毒性和持續療效。
Monitoring the vancomycin trough level is key to ensuring the drug reaches a therapeutic concentration (preventing treatment failure) and avoiding excessively high levels (reducing side effects such as nephrotoxicity and ototoxicity). The peak level is also monitored, but the trough level directly reflects cumulative toxicity and sustained therapeutic effect.
✦ 台美臨床差異
美國的抗感染藥物監測指南會詳細規範萬古黴素 trough level 的目標值；台灣的藥師也會協助判讀，並提供給臨床醫師參考。