# 一位病人最近開始服用 cenobamate，且劑量增加的速度快於處方滴定。病人現在出現發燒、瀰漫性皮疹、臉部腫脹和淋巴結腫大。哪項措施是優先的？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522932&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位病人最近開始服用 cenobamate，且劑量增加的速度快於處方滴定。病人現在出現發燒、瀰漫性皮疹、臉部腫脹和淋巴結腫大。哪項措施是優先的？

## 選項

1. 下一劑與抗組織胺一起服用。
2. 繼續目前的劑量直到例行訪視。
3. 在未通知處方者的情況下，將劑量減半。
4. 停用 cenobamate 並緊急評估是否為嗜酸性球增多及全身性症狀之藥物反應。 **✔ 正確答案**

**正確答案: 4**

## 解析

cenobamate 快速滴定後出現發燒、皮疹、臉部水腫和淋巴結病變，可能預示著 DRESS，這是一種潛在致命的多器官過敏反應，需要立即停藥評估。

## 深入解析

快速解答
將 cenobamate 滴定期間出現的皮疹合併全身性症狀視為可能的 DRESS。

為何這是正確的
cenobamate 必須從低劑量開始並緩慢滴定。當懷疑 DRESS 時，抗組織胺或部分劑量減少並不能使持續暴露變得安全。

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，穩定病人，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。

為何其他選項是錯誤的
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會使病人處於危險之中。References
1DailyMed: XCOPRI (cenobamate)DRESS 風險、所需緩慢滴定、過敏反應警告和緊急停藥評估

## 臨床情境

藥物安全審查
核實適應症、當前評估、劑量和途徑、器官功能、交互作用、緊急毒性線索、授權措施和可測量的後續追蹤。

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