病人正接受靜脈滴注 Aminophylline。護理師應監測哪項中毒徵兆？
A client is receiving an IV infusion of Aminophylline. The nurse should monitor for which sign of toxicity?
- AConstipation便秘
- BSeizures✓ 正解抽搐
- CBradycardia心動過緩
- DDrowsiness嗜睡
Aminophylline 是茶鹼類（Theophylline）的靜脈製劑，主要用於緩解支氣管痙攣。其治療區間（Therapeutic range）非常狹窄（通常為 10-20 mcg/mL），極易發生中毒。中毒時，藥物會過度刺激中樞神經系統（CNS）與心血管系統。輕微中毒可能表現為噁心、嘔吐、失眠與心悸；嚴重中毒（濃度 >20 mcg/mL）則會導致致命性的抽搐（Seizures）與惡性心律不整（如室性心搏過速）。護理思路應將「病人安全」置於首位，一旦出現神經系統興奮徵兆，應立即懷疑毒性反應並監測藥物血中濃度，防止進一步發展為不可逆的神經損傷或心臟驟停。
Aminophylline is the intravenous form of theophylline and is used primarily to relieve bronchospasm. Its therapeutic range is very narrow (usually 10–20 mcg/mL), making toxicity extremely likely. In toxicity, the drug excessively stimulates both the central nervous and cardiovascular systems. Mild toxicity may present with nausea, vomiting, insomnia, and palpitations; severe toxicity (levels > 20 mcg/mL) can produce life-threatening seizures and malignant dysrhythmias (such as ventricular tachycardia). The nurse's clinical reasoning should place client safety first—when signs of nervous system excitation appear, toxicity should be suspected, drug levels should be monitored, and progression to irreversible neurological injury or cardiac arrest should be prevented.
在美國，由於更安全且長效的 Beta-2 效能劑與抗膽鹼藥物的普及，Aminophylline 的臨床使用頻率已大幅下降。但在台灣部分基層醫療或呼吸照護病房，仍偶爾可見使用。NCLEX 考題仍保留此藥物，主因其治療區間狹窄，具高度考點價值。