— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位新開立 Lisinopril 的病人主訴有乾咳。護理師應如何向病人解釋？
A client with a new prescription for Lisinopril reports a dry, persistent cough. What should the nurse explain to the client?
- AThis is a sign of an allergic reaction and the medication must be stopped immediately這是過敏反應的跡象，必須立即停止用藥
- BIncrease fluid intake to help clear the throat and reduce the cough增加水分攝取以幫助清理喉嚨並減輕咳嗽
- CThe cough is a common side effect caused by the accumulation of bradykinin✓ 正解咳嗽是由於緩激肽堆積引起的常見副作用
- DThis indicates the medication is not effective for blood pressure control這表示藥物對血壓控制無效
— Explanation · 中文詳解 —
ACE 抑制劑（如 Lisinopril）會抑制緩激肽（bradykinin）的分解，導致其在呼吸道堆積引起乾咳。這是 ACEI 常見且非過敏性的副作用。若症狀嚴重影響生活，醫師通常會改開 ARB（血管收縮素受體阻斷劑）來取代，但病人不應自行停藥。
ACE inhibitors like lisinopril block the breakdown of bradykinin, leading to its accumulation in the respiratory tract and causing a dry, persistent cough. This is a common, non-allergic side effect, and clients should not stop the medication without consulting their provider.
✦ 台美臨床差異
台灣醫師在病人發生乾咳時，臨床較常直接轉換至 ARB 類藥物，做法與美國一致。