— 藥理與非經腸給藥 · HARD · MCQ —
病人服用 ACE 抑制劑後發生急性血管性水腫，護理師預期醫師會開立哪種藥物？
A nurse is caring for a client who develops acute angioedema after starting an ACE inhibitor. Which medication should the nurse anticipate the provider will order?
- ANaloxone納洛酮
- BEpinephrine✓ 正解腎上腺素
- CDiphenhydramine苯海拉明
- DMethylprednisolone甲潑尼松龍
— Explanation · 中文詳解 —
ACE 抑制劑引起的血管性水腫（Angioedema）與緩激肽（Bradykinin）累積有關，雖然其機轉不同於 IgE 介導的過敏反應，但當血管性水腫發生在呼吸道周圍時，可能造成致命的呼吸道梗阻。Epinephrine（腎上腺素）是處理急性嚴重血管性水腫的急救首選藥物，能快速緩解呼吸道腫脹，同時必須立即停用 ACE 抑制劑。
ACE inhibitor–induced angioedema is associated with bradykinin accumulation; although the mechanism differs from IgE-mediated allergic reactions, when angioedema involves the upper airway it can cause fatal obstruction. Epinephrine is the first-line emergency drug for managing acute severe angioedema, rapidly relieving airway swelling, and the ACE inhibitor must be discontinued immediately.