[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-035":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-035","nurse-115-1-basic-medicine-035",115,1,35,"下列何者不是三環類抗憂鬱藥物之作用機制？",{"A":15,"B":16,"C":17,"D":18},"抑制正腎上腺素與血清素再回收","抑制單胺氧化酶之作用","阻斷毒蕈鹼性受體","阻斷組織胺受體","B",null,[],"本題考點是三環類抗憂鬱藥的作用機制與副作用來源。三環類的治療機轉是阻斷突觸前回收幫浦，抑制正腎上腺素與血清素再回收，使突觸間隙單胺濃度上升；它同時因結構不專一而阻斷毒蕈鹼性受體、組織胺受體與甲型一腎上腺素受體，分別造成口乾便祕尿液滯留、嗜睡體重增加、姿位性低血壓。抑制單胺氧化酶是另一類抗憂鬱藥單胺氧化酶抑制劑的機制，並非三環類所有，故不屬於其作用機制的是 B。A、C、D 均為三環類已知的受體作用。","把三環類的副作用直接由受體推導，是最省記憶的方式：抗膽鹼看口乾、視力模糊、便祕、尿液滯留與老年人意識混亂；抗組織胺看鎮靜與食慾增加；抗甲型一看起身頭暈跌倒風險。最危險的則與受體無關，而是奎尼丁樣的鈉離子通道阻斷作用，過量時造成 QRS 增寬與致命心律不整，因此治療指數窄、過量風險高，這也是選擇性血清素回收抑制劑取而代之成為第一線的理由。單胺氧化酶抑制劑那一側的關鍵考點是與富含酪胺食物併食引發高血壓危症，以及與血清素性藥物併用的血清素症候群。可連結概念：單胺假說、QRS 增寬、血清素症候群、酪胺反應。",[25,27,29,31],{"term":26,"count":11},"正腎上腺素與血清素再回收抑制",{"term":28,"count":11},"毒蕈鹼與組織胺受體阻斷",{"term":30,"count":11},"單胺氧化酶抑制劑",{"term":32,"count":11},"三環類抗憂鬱藥副作用",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-036","有關吸入性麻醉劑的最低肺泡濃度（minimum alveolar concentration, MAC）之敘述，下列何者最不適當？",36,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-032","食糜中的何種成分最容易刺激空腸黏膜分泌膽囊收縮素（cholecystokinin）？",32,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-046","最常見到的乳房良性腫瘤為下列何項？",46,2,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-004","上臂觸摸肱動脈脈搏的位置為下列何處？",4,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-048","庫辛氏病（Cushing’s disease）的原因為何？",48,109,{"webId":59,"stem":60,"number":47,"year":61,"session":47},"nurse-110-2-basic-medicine-002","小腿脛骨（tibia）的外形，屬於下列何種骨骼？",110,"2026-08-06",1787299087826]