# 一名68歲女性使用zolpidem 10毫克口服睡前服用已4週，被家人在凌晨2點發現開車去雜貨店，次日早上對此事完全無記憶。優先的護理措施為何？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391736&lang=zh-tw  
> language: zh-TW  
> subject: Crisis Intervention  
> category: PSI

## 題目

一名68歲女性使用zolpidem 10毫克口服睡前服用已4週，被家人在凌晨2點發現開車去雜貨店，次日早上對此事完全無記憶。優先的護理措施為何？

## 選項

1. 安撫家人，這是正常的年齡相關健忘。
2. 暫停後續劑量，通知醫療提供者，並教導FDA對複雜睡眠行為的黑框警告。 **✔ 正確答案**
3. 加用benzodiazepine以增強整晚鎮靜。
4. 將劑量增加至12.5 mg，以加深睡眠並預防夜間遊走。

**正確答案: 2**

## 解析

正確 (2): 2019年FDA盒裝警告適用於使用eszopiclone、zaleplon和zolpidem時出現的複雜睡眠行為（睡眠駕駛、睡眠進食、睡眠行走）——即使在建議劑量下也可能發生。發生任何此類事件後，必須立即停用該藥物。老年人、女性及同時使用中樞神經抑制劑會增加風險。Beers標準亦標示非苯二氮平類鎮靜催眠藥對65歲以上成人有潛在風險。(1) 睡眠駕駛並非正常老化現象。(3) 較高劑量會放大風險。(4) 合併使用中樞神經抑制劑會加劇危險。

## 深入解析

Memory Tip: Z-drug, ZERO tolerance for sleep-driving.

## 臨床情境

Scenario 68-year-old female on zolpidem 10 mg HS × 4 weeks; sleep-driving event.

## 重要概念

- **Complex sleep behaviors** — Sleep-driving and similar events.
- **Z-drug** — Non-benzodiazepine sedative-hypnotic class.
- **Sex-specific dosing** — Halved zolpidem dose in females.

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