— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備靜脈推注 phenytoin，下列哪項行動對保障病人安全至關重要？
A nurse is preparing to administer phenytoin via IV push. Which action is essential to ensure client safety?
- AAdminister the drug at a rate not exceeding 50 mg/min✓ 正解以不超過 50 mg/min 的速度給藥
- BMonitor for symptoms of hypoglycemia during administration給藥期間監測低血糖症狀
- CEnsure the medication is administered through a central line only確保僅通過中心導管給藥
- DDilute the medication with dextrose 5% in water以 5% 葡萄糖水稀釋藥物
— Explanation · 中文詳解 —
Phenytoin 靜脈推注速度過快會引發嚴重的心臟毒性，如低血壓或心跳過慢，甚至心搏停止。臨床規範要求速度不得超過 50 mg/min（老年人需更慢）。此外，此藥與含葡萄糖溶液會產生沉澱，應使用生理食鹽水給藥。
Administering phenytoin IV push too rapidly can produce severe cardiac toxicity, including hypotension, bradycardia, and even cardiac arrest. Clinical guidelines specify a rate not exceeding 50 mg/min (slower in older adults). In addition, phenytoin precipitates in dextrose-containing solutions, so normal saline must be used.
✦ 台美臨床差異
美台對於 Phenytoin 的給藥規範高度一致，皆嚴格限制注射速率以預防危急心血管事件。