護理師正在檢視一位新開立二甲雙胍（metformin）處方的病人出院指導。護理師應包含哪項指示？
A nurse is reviewing discharge instructions for a client with a new prescription for metformin. Which instruction should the nurse include?
- ADiscontinue the medication if you experience diarrhea.若出現腹瀉請停止用藥。
- BTake the medication with meals to minimize gastrointestinal upset.✓ 正解隨餐服用藥物以減少腸胃不適。
- CReport any muscle weakness immediately.立即報告任何肌肉無力症狀。
- DTake the medication with grapefruit juice to enhance absorption.以葡萄柚汁送服藥物以增強吸收。
二甲雙胍（metformin）是第二型糖尿病的第一線口服藥，作用機制是抑制肝臟糖質新生並提升周邊組織對胰島素的敏感性。 選項 B 正確：最常見的副作用是腸胃不適（噁心、腹脹、腹瀉），約 30% 病人出現。隨餐服用或飯後服用可顯著降低 GI 副作用發生率與嚴重度，是標準衛教重點。 選項 D 錯誤：葡萄柚汁可影響部分藥物代謝，但對 metformin 並無「促進吸收」效果，不應如此衛教。 選項 C 錯誤：肌肉無力雖不是常見副作用，但若出現可能是罕見且致命的「乳酸中毒（lactic acidosis）」徵象——病人應立即就醫而非僅報告，需區別輕重。 選項 A 錯誤：腹瀉是常見副作用，多隨身體適應而緩解，未經醫師指示不可自行停藥；停藥會使血糖失控。
Metformin is the first-line oral agent for type 2 diabetes, acting by inhibiting hepatic gluconeogenesis and improving peripheral insulin sensitivity. B is correct: The most common side effects are GI (nausea, bloating, diarrhea), occurring in ~30% of patients. Taking metformin with meals significantly reduces GI side effects and is a standard teaching point. D is incorrect: Grapefruit juice does not enhance metformin absorption. C is incorrect: Muscle weakness is not a common side effect, but if present may signal rare, life-threatening lactic acidosis—client should seek immediate care, not merely report. A is incorrect: Diarrhea typically resolves with adaptation; stopping without medical advice causes loss of glycemic control.
美國糖尿病衛教學會（AADE）的衛教資源提供多樣化的用藥指導方式；台灣則常利用健保卡上的用藥紀錄進行個別化衛教。