— 藥理與非經腸給藥 · EASY · MCQ —
病人剛開始服用 Lisinopril，反應有持續性乾咳。護理師的最佳回應為何？
A client with a new prescription for Lisinopril reports a dry, persistent cough. What is the nurse's best response?
- ADiscontinue the medication immediately立即停止用藥
- BContact the physician to discuss switching to an ARB✓ 正解聯絡醫師討論轉換為ARB類藥物
- CIncrease fluid intake to soothe the throat增加水分攝取以舒緩喉嚨
- DTake an over-the-counter cough suppressant服用非處方止咳藥
— Explanation · 中文詳解 —
乾咳是血管張力素轉換酶抑制劑（ACEI）常見副作用，主因是緩激肽（bradykinin）堆積。若症狀影響生活，醫師通常會評估更換為血管張力素受體阻斷劑（ARB），後者較少引起咳嗽。護理師不應自行建議停藥或使用成藥，應協助溝通處方調整。
A persistent dry cough is a common side effect of ACE inhibitors like lisinopril, caused by bradykinin accumulation. The nurse should contact the physician to discuss switching the client to an angiotensin II receptor blocker (ARB), which is less likely to cause this adverse effect. The nurse should not discontinue the medication abruptly or rely on over-the-counter remedies, as these do not address the underlying cause or safety risks.
✦ 台美臨床差異
在台灣，若病人出現明顯 ACEI 副作用，醫師通常會選擇更換藥物，護理衛教應著重於提醒病人不可自行停藥。