— 藥理與非經腸給藥 · HARD · MCQ —
護理師照顧一位有氣喘病史並被開立 propranolol 的病人，最需考量的疑慮為何？
A nurse is caring for a client with a history of asthma who is prescribed propranolol. What is the nurse's primary concern?
- APotential for bronchospasm✓ 正解支氣管痙攣的潛在風險
- BRisk of tachycardia心跳過速的風險
- CIncreased risk of hypoglycemia低血糖風險增加
- DDevelopment of hypertension高血壓的發展
— Explanation · 中文詳解 —
Propranolol 是非選擇性 β 受體阻斷劑，會阻斷 β2 受體，進而導致支氣管平滑肌收縮，極易誘發氣喘病人產生支氣管痙攣。雖然藥物也會遮蔽低血糖症狀，但對於氣喘病人而言，支氣管痙攣屬於危及生命之呼吸系統併發症，優先層級更高。
Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2 receptors. Beta-2 blockade causes bronchial smooth muscle constriction, which can precipitate severe bronchospasm in asthma patients. Although it also masks hypoglycemia symptoms, bronchospasm is the more immediate life-threatening concern in an asthmatic.
✦ 台美臨床差異
美台臨床對於氣喘病人使用 Beta-blocker 皆採取極為謹慎態度，通常改用選擇性 Beta-1 阻斷劑。