— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位類風濕性關節炎病人獲開立 methotrexate。下列哪項衛教內容為優先？
A client with rheumatoid arthritis is prescribed methotrexate. Which information is priority to include in the teaching?
- AAvoid crowds and people with infections✓ 正解避免人群和感染者
- BReport any hair loss immediately立即報告任何掉髮情形
- CMonitor for yellowing of the skin監測皮膚黃疸
- DTake the medication with a full glass of water用一杯滿的水送服藥物
— Explanation · 中文詳解 —
Methotrexate 是一種免疫抑制劑。臨床最常見且具致命性的副作用是骨髓抑制，這會導致白血球減少，使病人極易遭受感染。因此，避免接觸感染源是病人衛教中最重要的安全防護措施。儘管肝毒性（黃疸）也是關注點，但感染風險具有突發性與高致死率，屬於優先防範項目。
Methotrexate is an immunosuppressant. The most common and potentially fatal adverse effect clinically is bone marrow suppression, which causes leukopenia and leaves the client highly susceptible to infection. Avoiding sources of infection is therefore the most important safety teaching point. Although hepatotoxicity (jaundice) is also a concern, infection risk has a sudden onset and a high fatality rate, making it the priority for prevention.
✦ 台美臨床差異
美台皆將 methotrexate 的感染預防作為核心衛教，台灣藥師與護理師會同步衛教。