[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-009":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":65},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-115-1-基礎醫學-009","nurse-115-1-basic-medicine-009",115,1,9,"利尿劑主要作用機制為下列何者？",{"A":15,"B":16,"C":17,"D":18},"滲透性利尿劑主要作用在遠曲小管","環利尿劑主要作用在鈉—氫協同運輸","醛固酮拮抗劑主要作用在集尿管","鈉通道阻斷劑主要作用在近曲小管","C",null,[],"本題考點在於各類利尿劑的作用部位與標的運輸蛋白。依腎小管分段藥理,醛固酮拮抗劑競爭集尿管主細胞的礦物皮質素受體,減少鈉再吸收同時減少鉀排出,屬保鉀型利尿劑,故選 C。A 錯在部位,滲透性利尿劑靠管腔內滲透壓留住水分,主要作用於近曲小管與亨氏環降支。B 錯在標的,環利尿劑抑制的是亨氏環上升支粗段的鈉鉀二氯共同運輸體,不是鈉氫協同運輸。D 錯在部位,鈉通道阻斷劑抑制的是集尿管上皮鈉通道,而非近曲小管,近曲小管被抑制的是碳酸酐酶。","把腎小管當一條產線,由前往後把藥物排好就不會錯:近曲小管有碳酸酐酶抑制劑(acetazolamide)與滲透性利尿劑;亨氏環上升支粗段有環利尿劑(furosemide,擋 NKCC2,效力最強);遠曲小管有 thiazide 類(擋 NCC);集尿管有保鉀二人組——醛固酮拮抗劑(spironolactone,擋受體)與鈉通道阻斷劑(amiloride,擋 ENaC)。電解質後果同步記:環與 thiazide 都排鉀,易低血鉀;集尿管兩者留鉀,易高血鉀;環利尿劑排鈣、thiazide 留鈣(故用於含鈣結石與骨質保留)。延伸可連結鈉鉀二氯共同運輸體與內耳毒性、醛固酮的鈉鉀交換機制,以及低血鉀病人使用毛地黃時中毒風險上升。",[25,28,30,32,34],{"term":26,"count":27},"滲透性利尿劑",2,{"term":29,"count":11},"醛固酮拮抗劑",{"term":31,"count":11},"集尿管礦物皮質素受體",{"term":33,"count":11},"環利尿劑與鈉鉀二氯共同運輸體",{"term":35,"count":11},"上皮鈉通道",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-1-basic-medicine-010","負責消化道運動功能之主要結構組織層為下列何者？",10,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-106-1-basic-medicine-006","行走於前臂的內側，並與上臂深層的靜脈會合成腋靜脈的是那一條血管？",6,106,{"webId":47,"stem":48,"number":49,"year":45,"session":27},"nurse-106-2-basic-medicine-020","下列何種神經傳遞物質，生成後並不儲存於突觸囊泡內？",20,{"webId":51,"stem":52,"number":53,"year":54,"session":27},"nurse-107-2-basic-medicine-058","一位年輕人時常服用止痛劑來緩解頭痛，最近發現有胃潰瘍情形，下列何種藥物比較有效改善此種胃潰瘍現象？",58,107,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-1-basic-medicine-022","下列關於牽張反射（stretch reflex）之敘述，何者正確？",22,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-1-basic-medicine-056","下列何者不是 phenytoin 的副作用？",56,110,"2026-08-06",1787299087546]