# 一位患有斑塊狀乾癬的病人預計開始服用 deucravacitinib。在第一劑之前，哪項發現需要澄清？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522934&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位患有斑塊狀乾癬的病人預計開始服用 deucravacitinib。在第一劑之前，哪項發現需要澄清？

## 選項

1. 病人上個月完成了非活性流感疫苗接種。
2. 病人計畫早餐時服用藥片。
3. 病人患有未經治療的潛伏性結核病，並預計下週接種活性疫苗。 **✔ 正確答案**
4. 病人使用無香料保濕劑來滋潤乾燥皮膚。

**正確答案: 3**

## 解析

在服用 deucravacitinib 之前，病人需要評估結核病並完成適當的免疫接種。活動性結核病是停藥條件，潛伏感染需要治療計畫，且治療期間應避免活性疫苗。

## 深入解析

快速解答
在服用 deucravacitinib 之前，澄清 未經治療的結核病風險和計畫中的活性疫苗。

為何這是正確的
TYK2 抑制可能增加感染風險。篩檢和預防計畫在免疫調節前進行；用餐時間和例行皮膚護理不會造成相同的即時安全衝突。

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: SOTYKTU (deucravacitinib)感染和結核病篩檢、嚴重感染中斷、免疫接種計畫和避免活性疫苗

## 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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