# 護理師教導新開立 phenytoin 的病人口腔自我照護。哪項指示最能預防常見的長期副作用？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391739&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師教導新開立 phenytoin 的病人口腔自我照護。哪項指示最能預防常見的長期副作用？

## 選項

1. 避免深綠色葉菜以預防藥物交互作用
2. 只在高脂肪餐時服藥
3. 每天刷牙兩次、使用牙線，並每3-6個月安排牙科清潔 **✔ 正確答案**
4. 增加水分攝取以稀釋藥物

**正確答案: 3**

## 解析

正解 (2): 牙齦增生可因牙齦組織纖維母細胞增生而發生於多達50%的 phenytoin 使用者。確實口腔衛生，包括刷牙、牙線與每3-6個月洗牙，可明顯降低嚴重度。(1) 限制深綠色蔬菜是warfarin衛教。(3) 不需要高脂肪餐。(4) 補水不會明顯影響phenytoin濃度。

## 深入解析

記憶提示 Phenytoin 的5個H：牙齦Hyperplasia、Hirsutism多毛、Hyperglycemia、兒童Hyperkinesia、IV時Hypotension。病人衛教 每次看牙醫都要告知正在使用phenytoin。

## 臨床情境

情境 22歲大學生新診斷為全身強直陣攣性癲癇，開始phenytoin 300 mg PO daily，正在接受門診用藥衛教。

## 重要概念

- **牙齦增生** — 牙齦組織過度生長；phenytoin常見不良反應，可藉口腔衛生減輕。
- **口腔衛生** — 刷牙、牙線與牙科追蹤；預防phenytoin引起牙齦增生的措施。
- **多毛症** — 毛髮過度生長；phenytoin的外觀相關副作用，青少年尤其可能困擾。

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