# 一位個案因監測性開始使用多非利特（dofetilide）而入院。護理師在第一劑藥物給予前應報告哪種居家藥物？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513816&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位個案因監測性開始使用多非利特（dofetilide）而入院。護理師在第一劑藥物給予前應報告哪種居家藥物？

## 選項

1. 左旋甲狀腺素 75 mcg 每天早上口服
2. 乙醯胺酚 650 mg 口服，需要時用於止痛
3. 氫氯噻嗪 25 mg 每天口服 **✔ 正確答案**
4. 多庫酯鈉 100 mg 每天兩次口服，需要時使用

**正確答案: 3**

## 解析

氫氯噻嗪（Hydrochlorothiazide）與多非利特（dofetilide）併用是禁忌，因為它會增加多非利特的暴露量並延長 QT 間期。

## 深入解析

快速解答
在給予多非利特之前，報告 氫氯噻嗪。

為何這是正確的
DailyMed 將同時使用氫氯噻嗪列為禁忌，因為它會顯著增加多非利特濃度和 QT 間期效應。

簡單類比或心像
多非利特是一條狹窄的電氣通道。氫氯噻嗪將藥物暴露和 QT 風險都推入該通道，因此在進入前需要阻斷這種組合。

記憶點
多非利特加上氫氯噻嗪是禁忌。

NCLEX 決策規則
在高風險抗心律不整藥物開始使用前的藥物核對期間，識別標示的禁忌症，並在第一劑藥物給予前通知處方團隊。

為何其他選項是錯誤的
其他列出的藥物並非正在測試的標示禁忌組合。它們的存在不能取代全面交互作用和實驗室檢查的需求。References
1DailyMed: DofetilideHydrochlorothiazide contraindication and QT prolongation

## 臨床情境

給藥前審查
在監測性多非利特開始使用計畫啟動前，核對處方藥、非處方藥和最近停用的藥物。

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