# 一名因纖維肌痛服用pregabalin 150 mg每日兩次已8個月的病人告訴護理師，她覺得好轉所以打算突然停藥。護理師最好的衛教是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391753&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名因纖維肌痛服用pregabalin 150 mg每日兩次已8個月的病人告訴護理師，她覺得好轉所以打算突然停藥。護理師最好的衛教是什麼？

## 選項

1. 「Pregabalin應至少花1週逐漸減量，以避免失眠、焦慮、頭痛與癲癇發作等戒斷症狀。」 **✔ 正確答案**
2. 「改成只有疼痛時才服用。」
3. 「先把劑量加倍1週，然後完全停止。」
4. 「既然你覺得好多了，今天就可以停藥。」

**正確答案: 1**

## 解析

正解 (2): Pregabalin與gabapentin長期使用可造成身體依賴；突然停藥可能出現戒斷症狀，包括焦慮、失眠、冒汗、噁心、頭痛，少數可有癲癇發作。標準作法是至少1週逐步減量，劑量高或使用久者需更久。(1,3,4) 都不安全。

## 深入解析

Memory Tip Gabapentinoids = 停藥要漸減。即使gabapentin不是管制藥，也需逐步降低。CPG Pregabalin因依賴風險在美國屬Schedule V管制藥。

## 臨床情境

Scenario 45歲女性因纖維肌痛服用pregabalin 150 mg PO BID 8個月，詢問今天是否可突然停藥。

## 重要概念

- **Pregabalin** — Schedule V gabapentinoid，用於纖維肌痛、神經病理性疼痛與癲癇。
- **逐漸減量** — 為預防戒斷，在數天到數週內逐步降低劑量。
- **身體依賴** — 身體為避免戒斷而需要持續用藥的生理適應，與成癮不同。

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