# 護理師給一名急性氣喘惡化的成人使用霧化albuterol。哪個發現應視為預期短期作用，而不是不良反應？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391767&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師給一名急性氣喘惡化的成人使用霧化albuterol。哪個發現應視為預期短期作用，而不是不良反應？

## 選項

1. 嘴唇腫脹與stridor
2. 瞳孔縮小與心搏過慢
3. 心率增加20，且手部有輕微細顫 **✔ 正確答案**
4. 5分鐘內支氣管痙攣惡化

**正確答案: 3**

## 解析

正解 (2): Albuterol是beta-2選擇性短效作動劑，但臨床劑量仍可能有beta-1 spillover，造成輕微心搏過速與骨骼肌顫抖。這些是可預期、劑量相關的反應，此程度不是毒性。(1) 反常支氣管痙攣少見但嚴重。(3) 過敏性休克。(4) 膽鹼性/opioid樣徵象，不是beta agonist作用。

## 深入解析

Memory Tip Beta-2 agonist副作用 = Tremor, Tachy, Twitchy，也會使K進入細胞造成低血鉀。CPG 頻繁給藥或併用利尿劑時需檢查K+。

## 臨床情境

Scenario 28歲女性急性氣喘惡化，接受albuterol 2.5 mg nebulizer。治療前HR 92，治療後HR 112，手部有輕微細顫。

## 重要概念

- **Beta-2 agonist** — Albuterol、levalbuterol、salmeterol、formoterol，透過beta-2受體作動達到支氣管擴張。
- **Beta-1 spillover** — 較高劑量也會影響beta-1受體，造成心搏過速與心悸。
- **Albuterol誘發低血鉀** — Beta-2刺激使K+移入細胞；頻繁給藥或合併利尿劑時需監測。

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