[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-038":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-038","nurse-115-1-basic-medicine-038",115,1,38,"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？",{"A":15,"B":16,"C":17,"D":18},"抑制血小板凝集，避免粥狀硬化灌流不足區更加狹窄","減少心臟前負荷，降低心輸出量，使心肌需氧量降低","擴張動脈血管，減少心臟後負荷，降低心臟壓力","增加平滑肌細胞內 cAMP，擴張冠狀動脈以增加血流量","B",null,[],"本題考點是有機硝酸鹽緩解典型心絞痛的核心機轉。心絞痛的本質是心肌需氧與供氧失衡，治療策略以降低需氧量為主。有機硝酸鹽在血管平滑肌釋出一氧化氮，在治療劑量下對靜脈系統的擴張作用最顯著，使血液滯留於周邊、回心血量下降，於是前負荷、心室舒張末容積與心壁張力都降低，心肌耗氧隨之減少，故選 B。A 是抗血小板藥物的機制。C 的動脈擴張降後負荷屬較高劑量時的次要作用，非主要機制。D 錯在訊息傳遞分子，硝酸鹽作用於環單磷酸鳥苷而非環單磷酸腺苷。","一氧化氮進入平滑肌後活化可溶性鳥苷酸環化酶，環單磷酸鳥苷上升活化蛋白激酶 G，使肌凝蛋白輕鏈去磷酸化而鬆弛，這條路徑同時解釋兩個常考延伸：其一，第五型磷酸二酯酶抑制劑抑制環單磷酸鳥苷分解，與硝酸鹽併用會造成嚴重低血壓，屬絕對禁止併用；其二，硝酸鹽需要含硫基提供者參與轉化，持續暴露會出現耐受性，故長效劑型須安排每日十至十二小時的無藥期。心壁張力可用拉普拉斯定律理解：張力與心室半徑及壓力成正比，降前負荷即縮小半徑。副作用中的搏動性頭痛與臉部潮紅同樣源自血管擴張。可連結概念：一氧化氮與 cGMP、拉普拉斯定律、硝酸鹽耐受性。",[25,27,29,31],{"term":26,"count":11},"一氧化氮與 cGMP 途徑",{"term":28,"count":11},"靜脈擴張降前負荷",{"term":30,"count":11},"心肌需氧量",{"term":32,"count":11},"硝酸鹽耐受性",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-039","有關影響內分泌藥物的敘述，下列何者錯誤？",39,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-035","人類免疫不全病毒（Human Immunodeficiency Virus）主要是藉由結合淋巴球細胞表面何種目標物進入淋巴球細胞？",35,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-049","林先生因誤食農藥巴拉松（parathion）而被送醫急救，當抵達急診室時，林先生已出現意識模糊、瞳孔縮小、全身輕微抽搐等症狀，此時，進行下列何種處置最適當？",49,2,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-007","有關胸膜與腹膜的敘述，下列何者錯誤？",7,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-051","迷幻藥 LSD 主要影響腦部的何種神經系統？",51,109,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-110-2-basic-medicine-005","下列何者不通過肺門？",5,110,"2026-08-06",1787299087863]