# 一名因Parkinson病使用selegiline 10 mg/日的病人詢問護理師應避免哪些食物。此劑量下最正確的回答是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391765&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名因Parkinson病使用selegiline 10 mg/日的病人詢問護理師應避免哪些食物。此劑量下最正確的回答是什麼？

## 選項

1. 吃高蛋白飲食以讓selegiline效果最佳
2. 避免所有綠色蔬菜以預防交互作用
3. 所有劑量都必須嚴格無tyramine飲食
4. 每日10 mg以下時selegiline具MAO-B選擇性，通常不需例行tyramine限制；但較高劑量或經皮貼片>6 mg/24 hr時需限制高tyramine食物 **✔ 正確答案**

**正確答案: 4**

## 解析

正解 (2): Selegiline在低劑量（≤10 mg PO daily或6 mg/24-hr patch）時選擇性抑制MAO-B，周邊MAO-A仍保留，tyramine分解大致完整，通常不需飲食限制。較高劑量或高強度貼片會失去MAO-B選擇性，需像非選擇性MAOI一樣嚴格限制tyramine。(1) 過度限制。(3) 無關。(4) 蛋白質會妨礙levodopa吸收。

## 深入解析

Memory Tip 低劑量MAO-B selective（selegiline, rasagiline）= 不需嚴格tyramine飲食。非選擇性MAOI（phenelzine, tranylcypromine）= 永遠嚴格限制tyramine。

## 臨床情境

Scenario 64歲女性因Parkinson病使用selegiline 10 mg/日（MAO-B選擇性抑制劑），門診詢問飲食衛教。

## 重要概念

- **MAO-B選擇性抑制劑** — 治療Parkinson劑量的selegiline或rasagiline；保留周邊MAO-A功能。
- **Tyramine誘發高血壓危象** — MAO-A被阻斷時tyramine累積造成嚴重血壓上升；低劑量selegiline通常不會。
- **Selegiline經皮貼片** — 較高劑量貼片（>6 mg/24 hr）會失去MAO-B選擇性並需限制tyramine。

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