護理師準備靜脈給予苯妥英(Phenytoin)。哪種靜脈液體與苯妥英相容?
A nurse is preparing to administer Phenytoin (Dilantin) intravenously. Which IV fluid is compatible with Phenytoin?
- A0.45% Normal Saline0.45% 生理食鹽水
- BLactated Ringer's (LR)乳酸林格氏液 (LR)
- C0.9% Normal Saline (NS)✓ 正解0.9% 生理食鹽水 (NS)
- D5% Dextrose in Water (D5W)5% 葡萄糖水 (D5W)
苯妥英(Phenytoin,商品名 Dilantin)是一種常用的抗癲癇藥物,在需要快速控制癲癇發作時,常會以靜脈注射方式給予。然而,苯妥英的化學性質使其在靜脈輸注時,對於輸液溶液的選擇有非常嚴格的要求。苯妥英的配方中含有丙二醇(propylene glycol)和乙醇(ethanol),以維持其溶解度。 當苯妥英與大多數含葡萄糖的靜脈輸液(例如 D5W、D5NS)混合時,會發生沉澱反應。這種沉澱物可能導致藥物失效,更重要的是,可能在血管中形成微粒,引起栓塞(embolism),對病人造成嚴重危害。因此,為確保藥物安全有效,苯妥英靜脈注射必須且只能與 0.9% 生理食鹽水(Normal Saline, NS)混合或推注,以避免沉澱反應的發生。這是藥物配製和給藥時的關鍵安全考量。
Phenytoin must only be administered with 0.9% Normal Saline to prevent precipitation, as dextrose solutions like D5W cause the drug to crystallize immediately. Mixing phenytoin with other fluids, including Lactated Ringer's or half-normal saline, can lead to drug instability and potential embolism from particulate matter. Using the correct diluent is a critical safety measure to ensure the medication remains effective and safe for intravenous use.