護理師正在為一位有酒精使用障礙史的病人進行用藥史評估。病人報告每天服用 Disulfiram（戒酒硫）。護理師應指導病人避免接觸下列哪些物質？（選所有適合的）
A nurse is conducting a medication history for a client with a history of alcohol use disorder. The client reports taking Disulfiram daily. Which substances should the nurse instruct the client to avoid? (Select all that apply.)
- AMouthwash containing ethanol✓ 正解含乙醇的漱口水
- BCough syrups with alcohol content✓ 正解含酒精成分的止咳糖漿
- CVanilla extract for baking✓ 正解用於烘焙的香草萃取液
- DHand sanitizers containing isopropyl alcohol含異丙醇的洗手乳
- EAftershave lotions and colognes✓ 正解含酒精的古龍水及刮鬍水
Disulfiram（戒酒硫）的作用機轉是抑制乙醛脫氫酶，使酒精代謝停留在乙醛階段，蓄積的乙醛會引起極度不適的反應（如嘔吐、心悸、低血壓）。衛教重點在於「絕對禁酒」，包括任何形式的隱藏酒精。口漱藥、止咳糖漿、烘焙用的香草精通常含有乙醇，接觸後會引發嚴重反應。刮鬍水與香水透過皮膚吸收或吸入也可能誘發輕微反應。至於異丙醇（外用酒精），雖然與乙醇機轉略有不同，但通常建議病人一併避免以策安全，不過在標準 NCLEX 教科書中，重點主要放在含有乙醇（Ethanol）的產品上。注意：洗手液（D）雖然含酒精，但通常非主要吸入或攝取途徑，且異丙醇非 Disulfiram 反應的主角，但在最嚴謹的指導中，口服與接觸乙醇產品（A, B, C, E）是必選的。
The mechanism of disulfiram is to inhibit aldehyde dehydrogenase, causing alcohol metabolism to halt at the acetaldehyde stage; accumulated acetaldehyde then produces severe unpleasant reactions (such as vomiting, palpitations, and hypotension). The teaching focus is "absolute alcohol avoidance," including any form of hidden alcohol. Mouthwash, cough syrup, and vanilla extract used in baking commonly contain ethanol and can trigger severe reactions on contact. Aftershave and cologne can also induce mild reactions through skin absorption or inhalation. As for isopropyl alcohol (rubbing alcohol), although its mechanism differs slightly from that of ethanol, it is generally advised to avoid it as well for safety; however, in standard NCLEX textbooks, the emphasis is mainly on products containing ethanol. Note: Hand sanitizer (D) contains alcohol but is usually not a main route of inhalation or ingestion, and isopropyl alcohol is not the primary cause of disulfiram reaction; in the strictest teaching, oral and contact exposure to ethanol-containing products (A, B, C, E) are the required answers.
在美國，Disulfiram 反應的衛教非常強調「標籤閱讀」（Label reading），因為美國許多非處方藥和食品添加物含酒。台灣的衛教則較常聚焦在「不要喝酒」本身，對於藥水或烹飪添加（如米酒）的細節提醒可能需要護理師更主動介入。