# 一名重度COPD個案開始口服roflumilast 500 mcg每日一次。護理師應教導個案監測並通報哪一種不良反應？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391796&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名重度COPD個案開始口服roflumilast 500 mcg每日一次。護理師應教導個案監測並通報哪一種不良反應？

## 選項

1. 高血糖
2. 體重減輕、情緒變化（包括新出現憂鬱或自殺意念）、腸胃症狀（噁心、腹瀉、頭痛） **✔ 正確答案**
3. 耳鳴
4. 高血壓

**正確答案: 2**

## 解析

正確 (2)：Roflumilast（PDE4抑制劑）的重要不良反應包括：體重減輕（常超過體重5%）、包含憂鬱與自殺意念的神經精神症狀，以及噁心、腹瀉、頭痛等腸胃症狀。需監測體重、情緒與排便型態。中重度肝病禁忌。(1,3,4) 不是roflumilast關鍵副作用。

## 深入解析

記憶提示 Roflumilast =「注意心情與體重」。用於重度COPD合併慢性支氣管炎且有急性惡化史的追加治療。

## 臨床情境

情境 64歲男性，重度COPD且常有急性惡化，開始roflumilast 500 mcg PO每日一次。正在接受門診衛教。

## 重要概念

- **羅氟司特** — 磷酸二酯酶4抑制劑；可減少重度COPD合併慢性支氣管炎的急性惡化。
- **羅氟司特不良反應** — 體重減輕、情緒變化（憂鬱、自殺意念）、腸胃症狀、頭痛。
- **PDE4抑制劑** — 降低氣道發炎細胞活性；每日口服一次。

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