病人正接受兩性黴素 B（Amphotericin B）靜脈滴注。護理師預期給予哪些預防性藥物以減輕副作用？

核心概念：兩性黴素 B（Amphotericin B）輸注的預防性藥物與副作用管理。 為何正確答案對： A. 兩性黴素 B 是廣效抗黴菌藥物，但其常見且嚴重的副作用包括發燒、寒顫、噁心、嘔吐，以及腎毒性。為了減輕這些輸注相關的副作用，臨床上常在給藥前給予乙醯胺酚（Acetaminophen）來退燒與止痛，並給予苯海拉明（Diphenhydramine）作為抗組織胺，以減少發燒、寒顫及潛在的過敏反應。 為何其他選項錯： B. 華法林（Warfarin）和肝素（Heparin）是抗凝血劑，與抗黴菌藥物治療無關。 B. 呋塞米（Furosemide）和螺內酯（Spironolactone）是利尿劑，用於治療水腫或高血壓，與兩性黴素 B 的副作用管理無直接關聯，且兩性黴素 B 本身就可能損害腎功能，需謹慎使用利尿劑。 D. 胰島素（Regular Insulin and NPH）用於治療糖尿病，與兩性黴素 B 的治療或副作用管理無關。 臨床思路（Pharmacological Therapies/Safety）：兩性黴素 B 的毒性較高，預防性用藥是為了提高病人的耐受性，使其能完成必要的抗黴菌治療，同時降低發生嚴重不良反應的風險。

Core concept: pre-medication and adverse-effect management for amphotericin B infusion. Why the correct answer is right: A. Amphotericin A is a broad-spectrum antifungal agent, but it commonly causes severe adverse effects including fever, chills, nausea, vomiting, and nephrotoxicity. To minimize these infusion-related reactions, acetaminophen is commonly given prior to administration to reduce fever and pain, while diphenhydramine is given as an antihistamine to attenuate fever, chills, and potential allergic reactions. Why the other options are wrong: B. Warfarin and heparin are anticoagulants and are unrelated to antifungal therapy. C. Furosemide and spironolactone are diuretics used to treat edema or hypertension; they are not directly related to the adverse-effect management of amphotericin B, and because amphotericin B itself may impair renal function, diuretics must be used cautiously. D. Regular insulin and NPH are used to treat diabetes and are unrelated to amphotericin B therapy or its adverse-effect management. Clinical reasoning (Pharmacological Therapies / Safety): Amphotericin A is highly toxic, and prophylactic pre-medication is used to improve patient tolerance so that necessary antifungal therapy can be completed while reducing the risk of severe adverse reactions.