[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-039":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-039","nurse-115-1-basic-medicine-039",115,1,39,"有關影響內分泌藥物的敘述，下列何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"metyrapone 可用於治療庫欣氏症候群（Cushing syndrome）","aminoglutethimide 可降低雄性素（androgens）和動情素（estrogens）的生成","mifepristone 可作為 glucocorticoid 受體的拮抗劑，也可作為黃體素（progestins）受體的拮抗劑","spironolactone 可競爭 glucocorticoid 受體，進而減少腎對鈉的再吸收","D",null,[],"本題考點是作用於類固醇合成與受體的內分泌藥物分類。史匹諾內酯是醛固酮受體，也就是礦物性皮質素受體的競爭性拮抗劑，作用位置在腎臟集尿管，藉此減少鈉再吸收並保留鉀，它競爭的並非糖皮質素受體，故錯誤的敘述是 D。A 正確，美替拉酮抑制第十一位羥化酶，減少皮質醇生成而用於庫欣氏症候群。B 正確，胺基麩胺醯亞胺抑制膽固醇側鏈裂解等步驟，使雄性素與動情素生成下降。C 正確，美服培酮同時是糖皮質素受體與黃體素受體的拮抗劑。","把腎上腺皮質類固醇合成路徑當骨架，就能把這幾個藥掛上去：膽固醇經側鏈裂解酶進入路徑，往三個方向分出礦物性皮質素、糖皮質素與性荷爾蒙。抑制上游的側鏈裂解會全面降低，抑制第十一位羥化酶則使去氧皮質醇堆積，這也是傳統美替拉酮試驗用來評估腦下垂體促腎上腺皮質素儲備的原理。受體端則要分清兩組拮抗：美服培酮拮抗糖皮質素受體，用於庫欣氏症候群合併高血糖，拮抗黃體素受體則是其終止妊娠的用途；史匹諾內酯除了保鉀利尿與心衰竭預後用藥，還因兼有抗雄性素作用而可能造成男性乳房增大。可連結概念：類固醇合成路徑、保鉀利尿劑、高血鉀、抗雄性素副作用。",[25,27,29,31],{"term":26,"count":11},"礦物性皮質素受體拮抗劑",{"term":28,"count":11},"第十一位羥化酶抑制",{"term":30,"count":11},"美服培酮雙重受體拮抗",{"term":32,"count":11},"類固醇合成路徑",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-040","下列何種抗生素會抑制細菌的 DNA 依賴型之 RNA 聚合酶（DNA-dependent RNA polymerase）的活性？",40,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-036","下列何種腫瘤之發生最符合基因雙重打擊理論（two hit hypothesis）？",36,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-050","下列有關腎上腺素（epinephrine）的敘述，何者正確？",50,2,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-008","下列何者的靜脈血，不經由肝門靜脈進入肝臟？",8,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-052","下列何種藥物可抑制 tumor tyrosine kinase 活性，因而可用於 chronic myeloid leukemia 及 gastrointestinal stromal tumor？",52,109,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-110-2-basic-medicine-006","有關消化道肌肉層的敘述，下列何者正確？",6,110,"2026-08-06",1787299087866]