# 一名學齡兒童開始服用孟魯司特治療氣喘。請標示出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=522647&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一名學齡兒童開始服用孟魯司特治療氣喘。請標示出需要立即藥物追蹤的發現。

| 領域 | 發現 |
| --- | --- |
| 睡眠 | 新的反覆惡夢和夢遊 |
| 行為 | 在學校出現新的攻擊性和明顯易怒 |
| 知覺 | 報告看到不存在的人 |
| 安全 | 說沒有活下去的理由 |
| 氣喘 | 正確使用書面急救計畫 |
| 技巧 | 照護者在日記中追蹤症狀 |
| 營養 | 吃平常的早餐 |
| 活動 | 完成了一項平靜的閱讀作業 |

## 解析

新出現的惡夢、攻擊性、幻覺樣行為和自殺言論是嚴重的神經精神信號，需要立即停藥並聯繫處方醫師。

## 深入解析

快速解答
升高新的行為、睡眠、知覺或自殘症狀。

為何這是正確的
孟魯司特的神經精神作用可能發生，無論之前是否有精神病史。當這些症狀出現時，家庭不應等待例行預約。

簡單類比或心像
採用以家庭為中心的用藥安全循環：確認年齡或懷孕狀況、識別暴露和新線索、預防進一步傷害、穩定個案，並確認反應。

記憶點
族群、適應症、劑量或途徑、禁忌症、緊急線索、保護措施和再評估。

NCLEX 決策規則
選擇能保護產婦、新生兒或兒科個案免受最直接藥物相關傷害，同時保留授權治療的措施。

為何其他選項是錯誤的
將危險徵兆正常化、替代未經批准的途徑或劑量，或延遲再評估的選項，會使個案暴露於可預防的傷害中。References
1DailyMed: montelukast sodiumBoxed warning for serious neuropsychiatric events, caregiver counseling, monitoring, and immediate discontinuation if symptoms occur

## 臨床情境

產婦、新生兒和兒科用藥安全審查
確認個案的年齡或懷孕階段、適應症、體重或實驗室背景、途徑、相互作用療法、禁忌症、照護者衛教和可衡量的後續追蹤。

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