# 一位個案預定接受首次 fingolimod 劑量。哪項計畫是適當的？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522881&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位個案預定接受首次 fingolimod 劑量。哪項計畫是適當的？

## 選項

1. 在家給藥，僅在發生暈厥時致電。
2. 無需心電圖即可給藥，因為個案年輕。
3. 僅使用脈搏血氧儀監測三十分鐘。
4. 進行所需的基準評估，並在心電圖監測下觀察脈搏和血壓至少 6 小時。 **✔ 正確答案**

**正確答案: 4**

## 解析

Fingolimod 可能導致首次給藥後心動過緩及房室傳導延遲。所需的基準評估和至少 6 小時的脈搏和血壓檢查觀察是安全開始治療的一部分。

## 深入解析

快速解答
將首次 fingolimod 劑量視為需監測的心臟事件。

為什麼這是正確的
當給藥後發現符合標示的風險標準時，需要額外或過夜監測。

簡單類比或心像
建立藥物安全鏈：識別新的線索，將其與藥物機制或標示限制連結，停止可預防的暴露，穩定個案，並驗證可測量的反應。

記憶點
藥物、緊急線索、保護性措施和再評估終點。

NCLEX 決策規則
選擇能預防最直接藥物相關危害的措施，同時保留指示治療和所需監測。

為什麼其他選項是錯誤的
繼續可疑暴露、將標示的危險線索正常化、替代未經授權的劑量或延遲升級的選項，都會使個案處於危險之中。參考資料
1DailyMed: GILENYA (fingolimod)首次給藥後心動過緩及觀察要求

## 臨床情境

藥物安全審查
驗證適應症、當前評估、劑量和途徑、器官功能、交互作用、緊急毒性線索、授權行動和可測量的後續追蹤。

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