# 護理師教導一名新開立loratadine 10 mg每日一次治療季節性過敏的個案。哪一句話表示教學有效？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391789&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

護理師教導一名新開立loratadine 10 mg每日一次治療季節性過敏的個案。哪一句話表示教學有效？

## 選項

1. 我只有嚴重皮疹時才會使用這個藥。
2. 我應該喝酒來增強效果。
3. 我可以每天服用這個藥，不太會有明顯嗜睡。 **✔ 正確答案**
4. 服用後接下來幾小時我會避免開車。

**正確答案: 3**

## 解析

正確 (2)：Loratadine是第二代抗組織胺，進入中樞神經很少，鎮靜作用低，對司機、飛行員與重機械操作員較安全。(1) 嗜睡不常見。(3) 酒精不需要，且可能加重任何輕微鎮靜。(4) Loratadine用於每日過敏控制，不是嚴重皮疹時才用的PRN藥。

## 深入解析

記憶提示 第二代抗組織胺 =「不太嗜睡、抗膽鹼少、每日一次」：loratadine、cetirizine、fexofenadine、desloratadine、levocetirizine。Cetirizine比loratadine/fexofenadine稍微更易嗜睡。

## 臨床情境

情境 32歲商用卡車司機，有季節性過敏性鼻炎，開始使用loratadine 10 mg PO每日一次。正在接受門診衛教。

## 重要概念

- **第二代抗組織胺** — 選擇性周邊H1拮抗劑，低血腦屏障穿透；如loratadine、cetirizine、fexofenadine。
- **過敏性鼻炎** — 由環境過敏原造成打噴嚏、流鼻水、搔癢、鼻塞；第二代抗組織胺為第一線。
- **鎮靜程度比較** — 鎮靜可能性：diphenhydramine > hydroxyzine > cetirizine > loratadine/fexofenadine。

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