# 一位服用 trazodone 100 毫克睡前口服的男性個案來電診所，主訴持續 3 小時的疼痛性勃起。護理師最適當的回應為何？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391734&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位服用 trazodone 100 毫克睡前口服的男性個案來電診所，主訴持續 3 小時的疼痛性勃起。護理師最適當的回應為何？

## 選項

1. 「這是正常副作用，會隨時間改善。」
2. 「冰敷並躺下；幾小時內應會自行緩解。」
3. 「現在就去急診，這可能是持續勃起症，屬於泌尿科急症。」 **✔ 正確答案**
4. 「再服用一劑trazodone來幫助入睡。」

**正確答案: 3**

## 解析

正確答案 (2)：陰莖持續勃起症（勃起 >4 小時）是 trazodone 罕見但嚴重的副作用，由 alpha-1 阻斷作用引起。勃起達 3 小時即需緊急評估——約 4 小時後可能發生不可逆的缺血性組織損傷及勃起功能障礙。急診處置可能包括海綿體抽吸、海綿體內注射 phenylephrine 或手術減壓。(1) 觀察等待有永久性損傷的風險。(3) 額外的 trazodone 會使問題惡化。(4) 非正常作用——此為泌尿科急症。

## 深入解析

Memory Tip: Trazodone — 4-hour priapism rule.

## 臨床情境

Scenario 38-year-old male on trazodone 100 mg HS × 6 weeks; 3-hour painful erection.

## 重要概念

- **Priapism** — Persistent painful erection >4 hours; urologic emergency.
- **Alpha-1 blockade** — Trazodone's mechanism for sedation and priapism risk.
- **Off-label sleep use** — Trazodone used off-label for insomnia at low doses.

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