# 一名潰瘍性結腸炎個案開始使用美沙拉嗪，詢問護理師可能的不良反應。哪一項回答最正確？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391817&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名潰瘍性結腸炎個案開始使用美沙拉嗪，詢問護理師可能的不良反應。哪一項回答最正確？

## 選項

1. 預期會明顯增加體重
2. 這種藥沒有不良反應
3. 監測頭痛、噁心、側腹痛（間質性腎炎）與罕見過敏反應；建議基線與定期追蹤 BUN/Cr 及肝功能 **✔ 正確答案**
4. 預期每天會嚴重便祕

**正確答案: 3**

## 解析

正確（2）：美沙拉嗪（5-ASA）常見頭痛、腸胃不適與皮疹；嚴重反應包括間質性腎炎、胰臟炎，以及少見且可能類似UC惡化的過敏反應。需追蹤基線與定期 BUN/Cr/LFT。（1、3、4）不正確。

## 深入解析

記憶提示 5-ASA是腸道抗發炎藥；重點是腎功能警覺。Sulfasalazine還要想到磺胺過敏與葉酸缺乏。

## 臨床情境

情境 32歲女性潰瘍性結腸炎，開始使用美沙拉嗪 1.2 g PO TID。門診用藥衛教。

## 重要概念

- **美沙拉嗪（5-ASA）** — 用於潰瘍性結腸炎與輕度克隆氏症的局部抗發炎藥；有口服、灌腸與栓劑。
- **間質性腎炎** — 腎臟間質發炎，可能隱匿發生；需定期監測 BUN/Cr。
- **5-ASA 製劑** — 包含口服美沙拉嗪、柳氮磺吡啶、balsalazide、olsalazine等。

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