[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"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":27},"nurse-115-1-基礎醫學-034","nurse-115-1-basic-medicine-034",115,1,34,"緩解支氣管平滑肌痙攣（bronchospasm），使用下列何種藥物最佳？",{"A":15,"B":16,"C":17,"D":18},"ipratropium","phentolamine","physostigmine","atropine","A",null,[],"本題考點是支氣管平滑肌張力的自主神經調控與對應藥物。支氣管平滑肌受副交感迷走神經支配，乙醯膽鹼作用於毒蕈鹼性受體造成收縮，因此阻斷該受體即可緩解支氣管痙攣。異丙托銨屬四級銨結構的吸入型抗膽鹼藥，帶電不易吸收與進入中樞，作用集中在氣道局部，全身副作用少，是本題最佳選擇，故選 A。B 的酚妥拉明是甲型腎上腺素受體阻斷劑，不擴張支氣管。C 的毒扁豆鹼抑制膽鹼酯酶，會增強乙醯膽鹼作用而加重痙攣。D 的阿托品雖同屬抗膽鹼藥，但為三級胺、全身性副作用明顯，非吸入首選。","四級銨與三級胺的結構差異可解釋一連串臨床設計：異丙托銨與噻托銨帶永久正電、吸入後幾乎不吸收，所以少見口乾、心跳加快、尿液滯留與中樞混亂；阿托品可穿血腦障壁，中毒時出現皮膚乾紅、發熱、視力模糊、心跳加快與意識混亂等口訣化表現。氣道用藥的分工也常一起考：急性發作以短效乙二型交感致效劑為主，抗膽鹼藥為輔並在慢性阻塞性肺病扮演主力；吸入性類固醇處理發炎而非急救。毒扁豆鹼相反地用於抗膽鹼中毒解毒，因為它是可穿中樞的膽鹼酯酶抑制劑。可連結概念：毒蕈鹼性受體、乙二型交感致效劑、抗膽鹼中毒。",[25,28,30,32],{"term":26,"count":27},"膽鹼酯酶抑制劑",3,{"term":29,"count":11},"毒蕈鹼性受體拮抗",{"term":31,"count":11},"吸入型抗膽鹼藥異丙托銨",{"term":33,"count":11},"四級銨結構限制吸收",[35,39,44,49,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-1-basic-medicine-035","下列何者不是三環類抗憂鬱藥物之作用機制？",35,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-106-1-basic-medicine-031","胃腺之何種細胞負責分泌胃泌素（gastrin）？",31,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-basic-medicine-045","急性腎盂腎炎（acute pyelonephritis）之病因為何？",45,2,{"webId":50,"stem":51,"number":27,"year":52,"session":11},"nurse-108-1-basic-medicine-003","下列何者連接顱腔與椎管？",108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-047","重症肌無力（myasthenia gravis）的主要病變是發生在何處？",47,109,{"webId":59,"stem":60,"number":11,"year":61,"session":48},"nurse-110-2-basic-medicine-001","細胞膜的成分，下列何者錯誤？",110,"2026-08-06",1787299087820]