# 一位護理師在給一位偏頭痛個案皮下注射sumatriptan 6毫克前，檢閱其病歷。哪一項發現最需要暫停給藥？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391762&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位護理師在給一位偏頭痛個案皮下注射sumatriptan 6毫克前，檢閱其病歷。哪一項發現最需要暫停給藥？

## 選項

1. 有控制良好的氣喘病史，偶爾使用albuterol
2. 目前接受fluoxetine 20 mg治療憂鬱症
3. 慢性穩定性高血壓，以飲食控制良好
4. 不穩定心絞痛病史且最近壓力測試陽性 **✔ 正確答案**

**正確答案: 4**

## 解析

正確選項(2)：Triptans經由5-HT1B/1D受體促效作用引起血管收縮——禁忌症包括缺血性心臟病、未控制高血壓、近期心肌梗塞、Prinzmetal心絞痛、周邊血管疾病及中風。同時使用麥角胺類藥物或24小時內使用另一種triptan亦為禁忌。(1,3,4)非禁忌症。

## 深入解析

Memory Tip Triptan會讓血管收縮；有缺血時避免。Caution 與SSRI/SNRI/MAOI併用需監測serotonin syndrome；每月使用超過10天需注意藥物過度使用頭痛。

## 臨床情境

Scenario 54歲男性因嚴重偏頭痛準備接受sumatriptan 6 mg SC。病歷顯示有不穩定心絞痛病史且最近壓力測試陽性。

## 重要概念

- **Triptan** — 5-HT1B/1D作動劑，用於終止偏頭痛發作，具有血管收縮作用。
- **心血管禁忌** — 缺血性心臟病、近期MI、未控制HTN、Prinzmetal心絞痛、PVD、中風。
- **Serotonin syndrome風險** — Triptan加上SSRI、SNRI、MAOI等serotonergic drug會增加serotonin syndrome風險，需監測。

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