# 術後個案使用opioid止痛，開始docusate sodium 100 mg PO BID。哪一句話表示正確理解此藥？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391816&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

術後個案使用opioid止痛，開始docusate sodium 100 mg PO BID。哪一句話表示正確理解此藥？

## 選項

1. 這個藥用來減慢腹瀉。
2. 這個藥會軟化糞便讓它較容易排出，但不會直接刺激腸道；我也應多喝水並增加纖維。 **✔ 正確答案**
3. 這個藥治療opioid過量。
4. 這個藥會在30分鐘內產生排便。

**正確答案: 2**

## 解析

正確 (2)：Docusate是軟便劑（界面活性劑），降低表面張力，讓水分/脂肪進入糞便。不直接刺激腸蠕動，在opioid誘發便秘中常與senna併用。效果需1-3天。(1) 不是快速作用。(3) 不是止瀉藥。(4) Opioid過量由naloxone逆轉。

## 深入解析

記憶提示 Docusate =「軟化，不推動」。Opioid誘發便秘可合併senna或使用methylnaltrexone、naloxegol等OIC藥物。

## 臨床情境

情境 45歲男性術後第1天，因疼痛使用opioid；開立docusate 100 mg PO BID預防便秘。

## 重要概念

- **軟便劑** — Docusate；界面活性劑，軟化糞便，不是刺激性瀉藥。
- **Opioid誘發便秘** — 常見opioid副作用；可用軟便劑加刺激性瀉藥或PAMORA預防/治療。
- **PAMORA周邊拮抗劑** — 周邊作用mu-opioid受體拮抗劑，如methylnaltrexone、naloxegol，用於OIC。

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