# 一名因甲狀腺眼病接受teprotumumab治療的病人，在下次輸注前回來。請標示需要及時藥物追蹤的發現。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522600&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一名因甲狀腺眼病接受teprotumumab治療的病人，在下次輸注前回來。請標示需要及時藥物追蹤的發現。

| 領域 | 發現 |
| --- | --- |
| 血糖 | 空腹血糖從 108 升高到 248 mg/dL，伴有多尿 |
| 聽力 | 新發耳鳴和理解言語困難 |
| 胃腸道 | 血便腹瀉伴腹部痙攣和便急 |
| 輸注 | 上次輸注期間出現蕁麻疹和血壓 86/50 mm Hg |
| 眼睛 | 病人使用處方人工淚液 |
| 營養 | 病人吃了均衡早餐 |
| 通路 | 已安排追蹤預約 |
| 皮膚 | 今天沒有皮疹 |

## 解析

顯著高血糖、新發持續性耳鳴或聽力下降、伴有痙攣的血便腹瀉，以及輸注相關的低血壓皮疹是teprotumumab重要的安全訊號。

## 深入解析

快速解答
升高血糖、聽力、腸道和輸注毒性。

為什麼這是正確的
Teprotumumab 可能會惡化血糖、導致嚴重且有時是永久性的聽力障礙、加劇或揭示發炎性腸道疾病，並引發輸注反應。

簡單類比或心像
使用閉環式用藥安全流程：識別免疫或細胞毒性暴露、連結新發現、中斷進一步傷害、穩定病人，並隨時間驗證反應。

記憶點
暴露、免疫作用、器官毒性、感染風險、立即行動和系列性再評估。

NCLEX決策規則
選擇能降低最直接的藥物相關風險，同時保留診斷評估和授權治療的行動。

為什麼其他選項是錯誤的
繼續暴露、僅治療單一症狀或延遲再評估的選項會使毒性或感染過程持續活躍。References
1DailyMed: TEPEZZA (teprotumumab)高血糖、發炎性腸道疾病、嚴重或永久性聽力障礙和輸注反應

## 臨床情境

腫瘤學、移植和生物製劑安全審查
核實適應症、免疫狀態、感染篩查、交互作用藥物、當前器官發現、授權行動和可測量的追蹤。

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