[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-032":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":64},"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":27},"nurse-115-2-基礎醫學-032","nurse-115-2-basic-medicine-032",115,2,32,"下列藥物中，何者無法用於治療廣角性青光眼？",{"A":15,"B":16,"C":17,"D":18},"carbachol","pilocarpine","atropine","timolol","C",null,[],"本題考點是抗青光眼藥物的受體機轉分類。廣角（隅角開放）性青光眼的用藥目標只有兩條：增加房水排出，或減少房水生成。carbachol 與 pilocarpine 屬膽鹼性（蕈毒鹼）致效劑，使睫狀肌收縮並經由睫狀肌與小樑網的連結牽引小樑網張開，房水外流阻力下降，A、B 可用。timolol 為非選擇性 β 受體阻斷劑，抑制睫狀體上皮分泌房水而降眼壓，D 可用。atropine 則是蕈毒鹼受體拮抗劑，使睫狀肌鬆弛、對小樑網的牽引消失，房水排出阻力反而上升、眼壓上升，作用方向與治療目標相反，故無法用於治療廣角性青光眼，選 C。","抗蕈毒鹼藥在眼睛有兩個必記作用：散瞳（mydriasis，瞳孔放大肌不受抑制）與睫狀肌麻痺（cycloplegia，失去調視能力），臨床用於驗光與眼底檢查。要特別區辨兩套不同的升壓機轉，別混在一起講：在廣角情境，眼壓上升的機轉是睫狀肌鬆弛使小樑網張力下降、排出阻力增加；在隅角本來就狹窄的人身上，散瞳使虹膜根部與周邊隅角堆疊、房水通道被機械性阻斷，可能誘發急性閉角性青光眼，這是解剖性阻塞而非小樑網阻力問題。降眼壓藥的完整分類可一併整理：增加排出者有膽鹼性致效劑（小樑網途徑）與 prostaglandin 類似藥如 latanoprost（鞏膜葡萄膜途徑）；減少生成者有 β 阻斷劑 timolol、碳酸酐酶抑制劑 acetazolamide 與 α2 致效劑 brimonidine；急性期另有高滲透壓藥 mannitol。",[25,28,30,32],{"term":26,"count":27},"蕈毒鹼受體致效劑與拮抗劑",1,{"term":29,"count":27},"小樑網房水排出",{"term":31,"count":27},"β 受體阻斷劑減少房水生成",{"term":33,"count":27},"廣角性與閉角性青光眼機轉區辨",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-2-basic-medicine-033","下列何者拮抗多巴胺 D 2 受體之作用最明顯，屬於典型抗思覺失調症藥物（typical antipsychotics）？",33,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-106-1-basic-medicine-079","立克次體與病毒相似的特性為何？",79,106,{"webId":45,"stem":46,"number":47,"year":48,"session":27},"nurse-107-1-basic-medicine-013","肝臟的血液主要來自：",13,107,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-108-1-basic-medicine-051","下列何者為治療毛地黃中毒時，引發心室纖維顫動的首選藥物？",51,108,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-109-2-basic-medicine-015","從脊髓圓錐（conus medullaris）向下延伸，下列何者連結尾骨，可用來幫忙固定脊髓？",15,109,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-110-2-basic-medicine-049","治療青光眼的藥物中，下列何者是藉由直接作用於膽鹼性受體（cholinergic receptor）而降低眼壓？",49,110,"2026-08-06",1787299017679]