# 一位服用risperidone 8週的病人報告新發生的乳房壓痛、溢乳及閉經。護理師的最佳判讀為何？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391729&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位服用risperidone 8週的病人報告新發生的乳房壓痛、溢乳及閉經。護理師的最佳判讀為何？

## 選項

1. 這代表因藥物失效而懷孕。
2. 這是risperidone的預期作用，不需要通知醫療提供者。
3. 這是D2阻斷造成高泌乳素血症的症狀，應通知醫療提供者。 **✔ 正確答案**
4. 這是藥物有效作用的正常徵象。

**正確答案: 3**

## 解析

正確 (2)：Risperidone 比其他非典型抗精神病藥更容易引起高催乳素血症，因為它在結節漏斗路徑有強烈的D2受體阻斷作用。症狀包括溢乳、男性女乳症、閉經、性慾降低及勃起功能障礙。通知醫師—處理方式包括降低劑量、換成不影響催乳素的非典型藥物如aripiprazole，或短期使用多巴胺促效劑。(1) 非良性—慢性高催乳素血症會加速骨密度流失。(3) 仍應排除懷孕，但不是主要解釋。(4) 非治療效果。

## 深入解析

Memory Tip: Highest prolactin — Risperidone + Paliperidone.

## 臨床情境

Scenario 24-year-old female on risperidone 4 mg PO daily × 8 weeks with galactorrhea.

## 重要概念

- **Hyperprolactinemia** — Elevated serum prolactin; antipsychotic-induced via D2 blockade.
- **Tuberoinfundibular pathway** — Dopamine pathway suppressing prolactin secretion.
- **Prolactin-sparing antipsychotic** — Atypicals that do not significantly elevate prolactin.

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