[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-033":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-033","nurse-115-2-basic-medicine-033",115,2,33,"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）？",{"A":15,"B":16,"C":17,"D":18},"haloperidol","clozapine","olanzapine","risperidone","A",null,[],"本題考點是典型與非典型抗精神病藥物的受體選擇性差異。典型（第一代）藥物的定義是以強力阻斷多巴胺 D2 受體為主要機轉，而抗正性症狀的療效來自中腦邊緣（mesolimbic）路徑的 D2 阻斷。haloperidol 屬 butyrophenone 類高效價藥，對 D2 受體親和力最高、對血清素受體的作用相對薄弱，是典型抗精神病藥的代表，選 A。clozapine 與 olanzapine 對 D2 親和力低，而對 5-HT2A、H1、蕈毒鹼與 α1 受體作用廣泛，屬非典型藥。risperidone 雖對 D2 有相當作用，但同時強力阻斷 5-HT2A，分類上仍歸非典型，且治療劑量下 EPS 明顯少於 haloperidol。","四條多巴胺路徑決定療效與副作用的分工，一次記全：中腦邊緣路徑被阻斷 → 正性症狀（幻覺、妄想）改善，這是療效來源；中腦皮質路徑被阻斷 → 負性症狀與認知功能反而惡化，因此不是療效路徑；黑質紋狀體路徑被阻斷 → 錐體外症狀（EPS）；下視丘漏斗路徑被阻斷 → 泌乳素上升，造成泌乳、月經失調與男性乳房發育。非典型藥之所以 EPS 較少，關鍵在同時阻斷 5-HT2A，解除血清素對紋狀體多巴胺釋放的抑制，紋狀體多巴胺得以維持。EPS 中最需正名的是遲發性運動障礙（tardive dyskinesia）：它是口舌與軀幹的不自主動作「過多」，與動作缺乏的 akinesia 意思相反，翻成「動作不能」會記錯。clozapine 另有兩項標誌性議題：用於難治型思覺失調症，以及必須監測顆粒性白血球缺乏（agranulocytosis）。",[25,28,30,32],{"term":26,"count":27},"典型與非典型抗精神病藥分類",1,{"term":29,"count":27},"多巴胺 D2 受體親和力",{"term":31,"count":27},"中腦邊緣與中腦皮質路徑",{"term":33,"count":27},"5-HT2A 阻斷與 EPS",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-2-basic-medicine-034","下列憂鬱症治療劑中，何者之作用機轉是選擇性抑制血清素（serotonin）被神經細胞回收（uptake）？",34,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-106-1-basic-medicine-080","下列有關廣東住血線蟲（Angiostrongylus cantonensis）之敘述，何者正確？",80,106,{"webId":45,"stem":46,"number":47,"year":48,"session":27},"nurse-107-1-basic-medicine-014","有關肝圓韌帶的敘述，下列何者錯誤？",14,107,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-108-1-basic-medicine-052","下列刺激胃腸蠕動的藥物中，何者的作用機轉為拮抗多巴胺 D 2 受體？",52,108,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-109-2-basic-medicine-016","交感神經中的大內臟神經（greater splanchnic nerve）其節前神經纖維來自下列何者？",16,109,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-110-2-basic-medicine-050","Cabamazepine 主要作用於下列何種離子通道（ion channel），而用於 partial seizure 之治療？",50,110,"2026-08-06",1787299017691]