[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-037":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"lastmod":63},"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-037","nurse-115-1-basic-medicine-037",115,1,37,"下列何種抗組織胺（antihistamines）較不易有昏睡之副作用？",{"A":15,"B":16,"C":17,"D":18},"loratadine","bromopheniramine","diphenhydramine","clemastine","A",null,[],"本題考點是第一代與第二代抗組織胺的中樞穿透性差異。抗組織胺的嗜睡副作用來自阻斷中樞的組織胺第一型受體，因此關鍵在藥物能否進入腦部。氯雷他定屬第二代抗組織胺，極性較高、脂溶性低，且是排出型幫浦 P 糖蛋白的受質，會被主動排回血液，穿越血腦障壁的量很少，故較不易造成昏睡，選 A。B、C、D 三者的溴苯那敏、苯海拉明與克立馬汀均屬第一代抗組織胺，脂溶性高且易入中樞，鎮靜與抗膽鹼副作用明顯。","第一代與第二代的分野可用三個問題釐清：能否入中樞、有無抗膽鹼作用、對受體是否專一。第一代脂溶性高、兼具抗膽鹼與抗吐、抗暈作用，所以苯海拉明也被用於動暈與助眠，但老年人易出現意識混亂、尿液滯留與跌倒，屬潛在不適當用藥。第二代如氯雷他定、cetirizine、菲索非那定專一性高、鎮靜輕微，適合白天長期使用治療過敏性鼻炎與蕁麻疹。安全性上另有歷史教材：早年的特非那定與阿司咪唑因阻斷心臟鉀離子通道延長 QT 而下市，這也是抗組織胺常與藥物交互作用一起出題的原因。可連結概念：血腦障壁、P 糖蛋白、抗膽鹼副作用、QT 延長。",[25,27,29,31],{"term":26,"count":11},"組織胺第一型受體",{"term":28,"count":11},"第二代抗組織胺氯雷他定",{"term":30,"count":11},"血腦障壁與 P 糖蛋白",{"term":32,"count":11},"第一代抗組織胺鎮靜作用",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-038","有機硝酸鹽（organic nitrates）用於治療典型心絞痛，主要的藥理機制為何？",38,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-034","一位 13 歲男孩因腎病症候群（nephrotic syndrome）住院，他被發現有明顯下肢水腫，腎臟科醫師開立蛋白質輸液以減輕病人的水腫。含下列何種蛋白質的輸液最能改善此病人的症狀？",34,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-048","波特氏病（Pott disease）與那種病變最有關係？",48,2,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-006","下列何者直接與副睪相連？",6,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-050","下列藥物中，何者較適合用於患有糖尿病的高血壓患者？",50,109,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-110-2-basic-medicine-004","下列何者同時供應小腸與大腸？",4,110,"2026-08-06",1787299087853]