# 將每項監測或逆轉敘述拖曳至最相符的抗凝血劑。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393517&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

將每項監測或逆轉敘述拖曳至最相符的抗凝血劑。

**1.** 輸注通常以 aPTT 或 anti-factor Xa 分析法進行滴定調整

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**2.** Protamine sulfate 為預期的專一性逆轉藥物

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**3.** INR 為用於調整治療的關鍵常規檢查

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**4.** 緊急重大出血逆轉可能包含 vitamin K 和 four-factor PCC

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**5.** 此藥物直接抑制凝血酶

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**6.** Idarucizumab 為專一性逆轉劑

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**7.** 此藥物直接抑制 factor Xa

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

**8.** Andexanet alfa 可用於危及生命出血成人之逆轉

Select a category
Apixaban
Warfarin
Dabigatran
Unfractionated heparin

## 解析

Unfractionated heparin 通常以 aPTT 或 anti-factor Xa 進行滴定調整，並可用 protamine 逆轉。Warfarin 以 INR 監測；vitamin K 和 four-factor prothrombin complex concentrate 可用於緊急重大出血的逆轉。Idarucizumab 專一性逆轉 dabigatran，而 andexanet alfa 可逆轉 apixaban 在成人身上的 factor Xa 作用。

## 深入解析

快速解答
Heparin：aPTT 或 anti-Xa 及 protamine。Warfarin：INR 及 vitamin K 加 PCC。Dabigatran：idarucizumab。Apixaban：andexanet alfa。

此為正確答案的原因
抗凝血劑作用於凝血過程的不同環節，因此有用的檢測與逆轉策略不可互換。Protamine 和 vitamin K 無法逆轉 apixaban，而 idarucizumab 專一於 dabigatran。

NCLEX 決策原則
先穩定活動性出血，確認抗凝血劑與最後劑量，再配對醫囑的逆轉策略，並於逆轉後監測血栓形成。參考資料
1FDA heparin 處方資訊
2FDA warfarin 處方資訊
3FDA idarucizumab 處方資訊
4FDA apixaban 處方資訊

## 臨床情境

重大出血用藥整合
四名成人因服用不同抗凝血劑而出現嚴重出血就診。護理師確認確切的藥物與最後一次劑量，支持穩定生命徵象，並預期藥物特定的監測或逆轉。每項敘述僅有一個最佳配對。

## 重要概念

- **Four-Factor PCC** — 一種維生素 K 依賴性凝血因子的濃縮製劑，用於重大出血時快速逆轉維生素 K 拮抗劑的作用。
- **Idarucizumab** — 一種專一性結合劑，可逆轉 dabigatran 的抗凝血作用。
- **Andexanet Alfa** — 一種逆轉劑，可拮抗某些 factor Xa 抑制劑（如 apixaban）的抗凝血作用。

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