[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"lastmod":62},"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-115-2-基礎醫學-034","nurse-115-2-basic-medicine-034",115,2,34,"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）？",{"A":15,"B":16,"C":17,"D":18},"fluoxetine","venlafaxine","imipramine","nortriptyline","A",null,[],"本題考點是抗憂鬱劑依作用機轉的分類。選擇性血清素回收抑制劑(SSRI)的定義是專一阻斷突觸前膜的血清素轉運體,使突觸間隙血清素濃度上升而不明顯影響正腎上腺素或多巴胺回收;fluoxetine 是 SSRI 的代表藥,完全符合「選擇性抑制血清素回收」的描述,故選 A。選項 B 的 venlafaxine 屬血清素與正腎上腺素雙重回收抑制劑(SNRI),作用範圍不只血清素。選項 C 的 imipramine 與選項 D 的 nortriptyline 都是三環抗憂鬱劑,同時抑制兩種單胺回收,並額外阻斷膽鹼性、組織胺與 α1 受體,選擇性差。","抗憂鬱劑五大類可用機轉串起來:SSRI(fluoxetine、sertraline、paroxetine、escitalopram)、SNRI(venlafaxine、duloxetine)、TCA(imipramine、amitriptyline、nortriptyline)、MAOI(phenelzine、selegiline)、非典型(bupropion 走多巴胺與正腎上腺素、mirtazapine 走 α2 自體受體拮抗)。SSRI 之所以成為第一線,關鍵在安全性而非療效更強:TCA 過量會阻斷心臟鈉離子通道造成 QRS 增寬與致命心律不整,抗膽鹼作用還帶來口乾、便祕、尿滯留、視力模糊與意識混亂;MAOI 與富含酪胺的食物(陳年乳酪、發酵食品)併用會引發高血壓危機。共同的重要藥效學特性是療效延遲兩到四週,對應的是受體下調與神經可塑性變化,而非單純的單胺濃度上升,這一點常被拿來出「為什麼吃了一週沒效」的題。血清素症候群(躁動、發抖、反射過強、肌肉抽動、高燒、腹瀉)出現在多個血清素性藥物疊加時,是 SSRI 章節必背的併用風險。",[25,26,29,31],{"term":15,"count":11},{"term":27,"count":28},"選擇性血清素回收抑制劑",1,{"term":30,"count":28},"SNRI",{"term":32,"count":28},"三環抗憂鬱劑",[34,38,42,47,52,57],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-2-basic-medicine-035","下列關於 cimetidine 之敘述，何者錯誤？",35,{"webId":39,"stem":40,"number":28,"year":41,"session":11},"nurse-106-2-basic-medicine-001","皮膚上所見到的雞皮疙瘩現象，與下列何者較無關係？",106,{"webId":43,"stem":44,"number":45,"year":46,"session":28},"nurse-107-1-basic-medicine-015","下列何者支配耳下腺（parotid gland）的分泌？",15,107,{"webId":48,"stem":49,"number":50,"year":51,"session":28},"nurse-108-1-basic-medicine-053","下列何者不是治療骨質疏鬆症的藥物？",53,108,{"webId":53,"stem":54,"number":55,"year":56,"session":11},"nurse-109-2-basic-medicine-017","一莫耳葡萄糖（即180克）溶解於1公升水中所產生的滲透壓濃度為多少Osmol\u002FL？",17,109,{"webId":58,"stem":59,"number":60,"year":61,"session":11},"nurse-110-2-basic-medicine-051","治療糖尿病的用藥中，下列何者的主要作用是刺激胰臟β細胞釋放insulin？",51,110,"2026-08-06",1787299017695]