— 藥理與非經腸給藥 · HARD · MCQ —
一位病人正接受華法林（Warfarin）治療，護理師提供下列哪項飲食衛教最重要？
A client is prescribed warfarin therapy. Which dietary instruction is most important for the nurse to provide?
- AAvoid sudden changes in the intake of vitamin K-rich foods✓ 正解避免維生素 K 豐富食物的攝取量突然改變
- BIncrease intake of dark leafy green vegetables增加深色葉菜類蔬菜的攝取
- CEliminate all sources of caffeine from your diet從飲食中消除所有咖啡因來源
- DTake the medication with a high-fat meal for better absorption隨高脂餐服用藥物以獲得更好的吸收
— Explanation · 中文詳解 —
華法林透過拮抗維生素 K 來發揮抗凝血作用。若飲食中維生素 K 攝取量大幅變動，會嚴重影響抗凝血效能（INR 值）。重點不在於「禁止」攝取，而在於攝取量要「保持穩定」。突然的大量攝取會減弱藥效，突然禁食會增強藥效，兩者皆會導致凝血異常風險。
Warfarin exerts its anticoagulant effect by antagonizing vitamin K. Large variations in dietary vitamin K intake significantly affect anticoagulation effectiveness (the INR). The emphasis is not on prohibiting intake, but on keeping intake consistent. A sudden large increase weakens the drug's effect; a sudden cessation strengthens it; both can lead to risk of coagulation abnormalities.
✦ 台美臨床差異
美國有針對 warfarin 的衛教專職藥師或護理衛教；台灣臨床多由衛教護理師依據病人的飲食習慣提供個別化建議。