— 藥理與非經腸給藥 · EASY · MCQ —
護理師照護一位服用華法林（Warfarin）的病人。應監測哪項檢驗值以評估藥物療效？
A nurse is caring for a client receiving warfarin. Which laboratory value should the nurse monitor to evaluate the effectiveness of the therapy?
- AInternational normalized ratio (INR)✓ 正解國際正常化比值 (INR)
- BPartial thromboplastin time (PTT)部分凝血活酶時間 (PTT)
- CPlatelet count血小板計數
- DHemoglobin and hematocrit血紅素和血球容積比
— Explanation · 中文詳解 —
華法林為維生素 K 拮抗劑，主要影響外在凝血途徑，臨床上以 INR 作為療效指標，通常治療範圍維持在 2.0-3.0 之間。A 監測肝素（Heparin）療效。C 監測是否有血小板低下風險。D 僅能評估貧血或出血程度，無法直接反映凝血藥物的抗凝血強度。
Warfarin is a vitamin K antagonist that primarily affects the extrinsic coagulation pathway; clinically, the INR is used as the indicator of therapeutic effect, with a typical therapeutic range of 2.0–3.0. Option B monitors heparin therapy. Option C assesses for thrombocytopenia. Option D only evaluates the degree of anemia or bleeding and cannot directly reflect the strength of anticoagulant therapy.
✦ 台美臨床差異
台美對於抗凝血藥物的衛教與監測標準一致，皆高度依賴 INR 數值調整劑量。