# 一位個案正在服用 propylthiouracil。請標示需要立即藥物追蹤的發現。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522073&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位個案正在服用 propylthiouracil。請標示需要立即藥物追蹤的發現。

| 領域 | 發現 |
| --- | --- |
| 感染 | 體溫 38.7 C 伴有新發喉嚨痛 |
| 肝臟 | 深色尿液和黃鞏膜 |
| 肝臟 | 新發右上腹痛 |
| 血液 | 絕對嗜中性白血球計數為 700/mm3 |
| 治療 | 按規定時間服藥 |
| 生命徵象 | 心率從 108/分 降至 82/分 |
| 皮膚 | 無皮疹或腫脹 |
| 追蹤 | 已安排內分泌科門診 |

## 解析

發燒和喉嚨痛可能預示粒細胞缺乏症，而深色尿液、黃疸和右上腹痛可能預示嚴重的肝損傷。

## 深入解析

快速解答
升級感染和肝損傷警示症狀。

為何這是正確的
PTU 帶有嚴重肝損傷的黑框警語，並可能引起粒細胞缺乏症；這些症狀需要立即評估，而非例行追蹤。

簡單類比或心像
將藥物安全想像成一個控制面板：識別危險信號，改變正確的控制，並驗證反應。

記憶點
提示、行動、反應、再評估。

NCLEX 決策規則
選擇能預防最即時藥物相關危害的行動，同時保留持續的適應症。

為何其他選項是錯誤的
延遲升級、忽略禁忌症或未經授權改變治療的選項，並未完成安全循環。References
1DailyMed: PropylthiouracilBoxed severe liver injury warning, agranulocytosis, symptom recognition, and restricted use

## 臨床情境

藥物安全審查
驗證適應症、當前評估、實驗室趨勢、時機、交互作用、授權行動和可衡量的追蹤。

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