# 一位患有社區型細菌性肺炎的個案有口服 lefamulin 的處方。藥物清單中包含 pimozide，且心電圖顯示 QT 間期延長。護理師應採取何種措施？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一位患有社區型細菌性肺炎的個案有口服 lefamulin 的處方。藥物清單中包含 pimozide，且心電圖顯示 QT 間期延長。護理師應採取何種措施？ ## 選項 1. 給予兩種藥物並在明年重新檢查心電圖。 2. 給予額外的 lefamulin 劑量以縮短 QT 間期。 3. 暫停口服 lefamulin 並澄清處方，因為延長 QT 間期的敏感 CYP3A4 受質組合是禁忌的。 **✔ 正確答案** 4. 壓碎藥片以防止交互作用。 **正確答案: 3** ## 解析 口服 lefamulin 禁忌與延長 QT 間期的敏感 CYP3A4 受質併用，因為受質暴露可能增加並導致尖端扭轉性室性心動過速。現有的 QT 間期延長增加了澄清的急迫性。 ## 深入解析 快速回答 暫停並澄清 口服 lefamulin 與 pimozide 和 QT 間期延長。 為何這是正確的 改變藥片形式或增加劑量並不能消除藥物動力學和電生理風險。相互作用的治療方案在給藥前需要處方者和藥師審查。 簡單類比或心像 建立藥物安全鏈：識別變化的線索，將其與標示的毒性或交互作用連結，中斷可預防的暴露，穩定個案，並驗證可測量的反應。 記憶點 藥物、趨勢、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或延遲升級的選項會使個案處於風險之中。References 1DailyMed: XENLETA (lefamulin)QT prolongation, contraindicated oral coadministration with QT-prolonging sensitive CYP3A4 substrates, and ECG/electrolyte risk review ## 臨床情境 腫瘤藥物安全審查 驗證適應症、當前評估、實驗室和氧氣趨勢、交互作用、緊急毒性線索、授權行動和可測量的後續追蹤。 ## 相同主題題目 - [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=zh-tw) - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw) - [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=zh-tw) - [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522999&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_