# 護理師正在教導一位剛開始服用 levodopa-carbidopa 的個案關於飲食時間的安排。哪一項個案的說法表示教導已有效？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391755&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師正在教導一位剛開始服用 levodopa-carbidopa 的個案關於飲食時間的安排。哪一項個案的說法表示教導已有效？

## 選項

1. 「我只會和高脂肪點心一起服藥。」
2. 「我會用一杯牛奶配藥，保護胃。」
3. 「我會在高蛋白餐前30分鐘或餐後1小時服藥。」 **✔ 正確答案**
4. 「我會多吃高蛋白食物來增強藥效。」

**正確答案: 3**

## 解析

正確 (2)：膳食蛋白質（特別是大分子中性胺基酸）會與 levodopa 競爭在小腸的吸收以及通過血腦屏障的運輸，從而減弱藥效。最佳做法：在富含蛋白質的餐前 30 分鐘或餐後 1 小時服用 levodopa。(1) 牛奶富含蛋白質。(3) 額外的蛋白質會降低藥效。(4) 高脂肪會延遲吸收，但無助於藥效。

## 深入解析

Memory Tip Levodopa + Protein = 競爭。空腹最理想；若噁心，可搭配少量低蛋白點心如餅乾。Caution 若未與carbidopa併用，應避免vitamin B6（pyridoxine）補充品，因B6會加速周邊levodopa分解。

## 臨床情境

Scenario 64歲女性，新診斷Parkinson病，開始levodopa-carbidopa 25/100 mg PO TID，正在門診接受飲食衛教。

## 重要概念

- **大型中性胺基酸競爭** — 飲食蛋白質在腸道與腦部和levodopa吸收競爭。
- **Levodopa-carbidopa** — Carbidopa抑制周邊decarboxylase，使更多levodopa能通過血腦障壁。
- **Pyridoxine交互作用** — Vitamin B6會加速周邊levodopa代謝，降低CNS效果；carbidopa可降低此問題。

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