[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-032":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"lastmod":62},"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":11},"nurse-115-1-基礎醫學-032","nurse-115-1-basic-medicine-032",115,1,32,"下列抗生素之敘述，何者最不適當？",{"A":15,"B":16,"C":17,"D":18},"penicillins 與 aminoglycosides 合用具有協同作用","aminoglycosides 類藥物胃腸吸收效果佳，可達到適當殺菌濃度","amoxicillin 與 clavulanic acid 合用效果比單獨使用佳","ampicillin 屬於廣效性抗生素","B",null,[],"本題考點是抗生素的藥物動力學與併用原理。胺基醣體類抗生素分子帶多個正電荷、水溶性極高且脂溶性差，無法有效穿過腸道黏膜，口服吸收率極低，達不到全身殺菌濃度，臨床須以注射給藥，口服僅用於腸道局部作用，故最不適當的敘述是 B。A 正確，青黴素類破壞細胞壁後有助胺基醣體進入菌體，兩者具協同作用。C 正確，克拉維酸為 β-內醯胺酶抑制劑，可保護安莫西林不被水解。D 正確，安比西林對部分革蘭氏陰性菌也有效，屬廣效性青黴素。","「帶電就進不去」是一條可通用的藥動原則：胺基醣體類與四級銨類藥物皆因高極性而口服吸收差、不易穿血腦障壁，也因此幾乎全由腎臟以原型排除，腎功能不良時需調整劑量並監測血中濃度。它們的兩大毒性是腎毒性與耳毒性（前庭與聽力），常與尖峰、低谷濃度監測一起考；併用環利尿劑或萬古黴素會加重。殺菌動力學上屬濃度依賴型且有濃度後效應，所以現行常採一天一次高劑量給法，兼顧療效與降低腎累積。對照 β-內醯胺類則屬時間依賴型，重點在維持濃度高於最低抑菌濃度的時間。可連結概念：治療濃度監測、濃度後效應、β-內醯胺酶抑制劑。",[25,27,29,31],{"term":26,"count":11},"胺基醣體類口服吸收差",{"term":28,"count":11},"細胞壁破壞與協同作用",{"term":30,"count":11},"β-內醯胺酶抑制劑",{"term":32,"count":11},"廣效性青黴素",[34,38,43,48,52,57],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-033","藥物動力學（pharmacokinetics）探究藥物的範疇，不包括下列那一項？",33,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-029","缺氧引起之肺血管收縮是為了：",29,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-043","有關克隆氏疾病（Crohn disease）的臨床病理特徵，下列敘述何者正確？",43,2,{"webId":49,"stem":50,"number":11,"year":51,"session":11},"nurse-108-1-basic-medicine-001","下列何者的內襯上皮具有纖毛？",108,{"webId":53,"stem":54,"number":55,"year":56,"session":11},"nurse-109-1-basic-medicine-045","一位 25 歲的女性近來莫名嗜睡且神智不清，影像學檢查發現胰臟有一個 2 公分的腫瘤，手術摘除後症狀完全消失，病理檢查結果為胰臟的神經內分泌瘤（neuroendocrine tumor）。她最可能罹患的是：",45,109,{"webId":58,"stem":59,"number":60,"year":61,"session":11},"nurse-110-1-basic-medicine-079","下列何種酵素與麴菌屬（Aspergillus）之毒性無關？",79,110,"2026-08-06",1787299087788]