— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師為服用苯妥英（Phenytoin）治療癲癇的病人進行出院衛教，下列哪些指導是必要的？（選所有適合的）
A nurse is preparing discharge instructions for a client taking phenytoin for epilepsy. Which instructions are essential? (Select all that apply.)
- ABrush and floss teeth daily to prevent gingival hyperplasia✓ 正解每日刷牙及使用牙線以預防牙齦增生
- BStop the medication immediately if a skin rash develops若出現皮疹，立即停止用藥
- CNotify the provider if any suicidal thoughts occur✓ 正解若出現自殺念頭，應通知醫師
- DObtain regular blood tests to monitor drug levels✓ 正解定期抽血以監測藥物濃度
- EAvoid consuming alcohol to prevent CNS depression✓ 正解避免飲酒以防止中樞神經抑制
— Explanation · 中文詳解 —
苯妥英常見副作用包括牙齦增生，需加強口腔衛生。此類抗癲癇藥物有導致自殺意念的黑框警告，且治療窗窄需定期監測血中濃度。酒精會加重中樞神經抑制，應避免攝取。皮膚紅疹雖需注意，但不可自行停藥，應先諮詢醫師。
Phenytoin therapy requires meticulous oral hygiene to prevent gingival hyperplasia, a common side effect. Patients must be educated on the narrow therapeutic index necessitating regular blood level monitoring, the risk of CNS depression when combined with alcohol, and the black box warning regarding increased suicidal ideation. While skin rashes require medical evaluation, patients should never stop the medication abruptly without provider guidance.
✦ 台美臨床差異
台灣較常由醫師親自提醒藥物監測，美國則強調藥師在處方篩檢與藥物諮詢中的角色。