# 護理師教導病人使用tiotropium HandiHaler。哪個指示最重要？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391778&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師教導病人使用tiotropium HandiHaler。哪個指示最重要？

## 選項

1. 每日使用此吸入器兩次，早上一次和睡前一次，用於控制COPD。
2. 每日一次，以水整顆吞服膠囊，以預防COPD惡化。
3. 每日一次吸入粉末；不要吞服膠囊，使用後漱口 **✔ 正確答案**
4. 將膠囊內容物溶解於 5 mL 生理食鹽水中，並透過霧化器每日使用兩次。

**正確答案: 3**

## 解析

正解 (2): Tiotropium HandiHaler膠囊只能吸入，絕不可吞服。將膠囊放入裝置、刺穿，然後用力吸入（DPI與MDI不同）。這是每日一次控制藥。漱口可減少抗膽鹼性口乾。(1) 不是BID/PRN。(3,4) 膠囊是吸入用，不是口服。

## 深入解析

Memory Tip Tiotropium = 每日一次、只吸入。DPI需快速用力吸；MDI需慢而深吸。Caution Spacer用於MDI，不用於DPI。

## 臨床情境

Scenario 70歲女性COPD，新開立tiotropium 18 mcg via HandiHaler once daily。第一次接受DPI裝置衛教。

## 重要概念

- **長效毒蕈鹼受體拮抗劑（LAMA）** — Tiotropium、umeclidinium、aclidinium、glycopyrronium；COPD每日支氣管擴張劑。
- **HandiHaler裝置** — 單膠囊DPI，需要用力吸入；使用前刺穿膠囊。
- **DPI與MDI技巧** — DPI快速用力吸入；MDI慢而深吸入。Spacer只用於MDI。

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