— 藥理與非經腸給藥 · HARD · MCQ —
一位氣喘病史的病人被處方 propranolol 來控制高血壓。為何此藥物可能為禁忌？
A client with a history of asthma is prescribed propranolol for hypertension. Why is this medication potentially contraindicated?
- AIt increases mucus production in the lungs它會增加肺部黏液分泌
- BIt interacts with common asthma inhalers它會與常見氣喘吸入劑產生交互作用
- CIt may cause severe tachycardia它可能導致嚴重的心搏過速
- DIt blocks beta-2 receptors in the bronchioles✓ 正解它會阻斷支氣管的 beta-2 受體
— Explanation · 中文詳解 —
Propranolol 屬非選擇性 beta-受體阻斷劑，會同時拮抗 beta-1（心臟）與 beta-2（支氣管）受體。對氣喘病人而言，阻斷 beta-2 受體會導致支氣管收縮，進而誘發或加重氣喘發作，因此屬臨床禁忌。
Propranolol is a non-selective beta-blocker that antagonizes both beta-1 and beta-2 receptors. In clients with asthma, blocking beta-2 receptors in the bronchioles can induce bronchoconstriction, potentially triggering or worsening an asthma attack. Therefore, it is contraindicated for these patients due to the risk of respiratory compromise.
✦ 台美臨床差異
美台臨床醫師皆傾向對氣喘患者改用選擇性 Beta-1 阻斷劑（如 Atenolol），兩地醫療指引一致。