# 一位服用aripiprazole的個案表示過去一週出現新的動作不安且無法靜坐。護理師最佳的判斷為何？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391731&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位服用aripiprazole的個案表示過去一週出現新的動作不安且無法靜坐。護理師最佳的判斷為何？

## 選項

1. 這是需要緊急處置的抗精神病藥惡性症候群。
2. 這是遲發性運動不能，屬永久性問題，需要立即停藥。
3. 這是靜坐不能，一種應通報的運動相關副作用，可能對減量或β阻斷劑有反應。 **✔ 正確答案**
4. 這是復發徵象，需要增加aripiprazole劑量。

**正確答案: 3**

## 解析

正確答案 (2)：靜坐不能（Akathisia）— 主觀內心不安伴隨可觀察到的動作不安 — 是 aripiprazole 常見的急性錐體外症候群（EPS），因其部分 D2 致效作用所致。治療選項包括：降低劑量、更換藥物，或添加 propranolol 或短期使用 benzodiazepine。(1) 復發（Relapse）表現為正向精神病症狀（幻覺、妄想），而非動作不安。(3) 遲發性運動障礙（Tardive dyskinesia）在數月至數年後出現，表現為重複的不自主運動（咂嘴、伸舌）。(4) 抗精神病藥物惡性症候群（NMS）需有發燒、肌肉僵硬及自律神經不穩定 — 此處全無。

## 深入解析

Memory Tip: Akathisia ≠ Tardive dyskinesia ≠ NMS.

## 臨床情境

Scenario 32-year-old male on aripiprazole 15 mg daily × 2 weeks with motor restlessness; no fever/rigidity.

## 重要概念

- **Akathisia** — Subjective and motor restlessness; common acute EPS of antipsychotics.
- **Partial D2 agonist** — Action of aripiprazole stabilizing dopamine signaling.
- **Tardive dyskinesia** — Late-onset involuntary repetitive movements.

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