[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-040":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-040","nurse-115-1-basic-medicine-040",115,1,40,"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？",{"A":15,"B":16,"C":17,"D":18},"clindamycin","cephalosporin","daptomycin","rifampin","D",null,[],"本題考點是抗生素依作用標的的分類。利福平的機制是與細菌 DNA 依賴型 RNA 聚合酶的 β 次單位結合，阻斷轉錄起始而抑制信息核糖核酸合成，且此酵素與人體的 RNA 聚合酶結構不同，故具選擇毒性，答案為 D。A 的克林達黴素結合核糖體 50S 次單位，抑制轉位而阻斷蛋白質合成。B 的頭孢子菌素屬 β-內醯胺類，抑制轉胜肽酶使細胞壁交聯失敗。C 的達托黴素插入革蘭氏陽性菌細胞膜造成去極化與鉀離子外流，導致細胞死亡，皆非作用於轉錄。","以中心法則排序記憶最有效率：抑制細胞壁者為 β-內醯胺類與萬古黴素；作用細胞膜者為達托黴素與多黏菌素；干擾去氧核糖核酸複製者為氟喹諾酮類抑制拓樸異構酶；干擾轉錄者只有利福黴素家族；作用轉譯者依次單位分為 30S 的胺基醣體與四環素、50S 的巨環類、克林達黴素與氯黴素；干擾葉酸代謝者為磺胺類與三甲氧苯二氨嘧啶。利福平還有兩個護理上必考點：誘導肝臟細胞色素 P450 3A4，加速口服避孕藥、抗凝血劑與抗癲癇藥代謝；以及使尿液、汗水與淚液呈橘紅色，屬預期反應而非過敏。單用易產生抗藥性，故結核治療須合併多藥。可連結概念：中心法則、細胞色素 P450 誘導、抗藥突變。",[25,27,29,31],{"term":26,"count":11},"利福平抑制 RNA 聚合酶",{"term":28,"count":11},"50S 蛋白質合成抑制",{"term":30,"count":11},"β-內醯胺類細胞壁抑制",{"term":32,"count":11},"達托黴素細胞膜去極化",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-1-basic-medicine-041","有關革蘭氏陽性細菌的敘述，下列何者正確？",41,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-1-basic-medicine-037","下列何者最可能導致脂肪肝？",37,106,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-106-2-basic-medicine-051","吸入性全身麻醉劑的 MAC（minimal alveolar concentration）數值越小，其所代表的意義為何？",51,2,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-009","胎兒心臟的卵圓孔，連通的是那兩個腔室？",9,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-053","下列何者可用於預防和改善暈車和暈船（motion sickness）作用？",53,109,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-110-2-basic-medicine-007","脊髓的齒狀韌帶由下列何者衍生構成？",7,110,"2026-08-06",1787299087869]