[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-035":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"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":27},"nurse-115-2-基礎醫學-035","nurse-115-2-basic-medicine-035",115,2,35,"下列關於 cimetidine 之敘述，何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"可治療消化性潰瘍","長期使用會導致男性女乳症（gynecomastia）","增加肝臟細胞色素 P-450 代謝酶活性","為組織胺 H 2 受體拮抗劑","C",null,[],"本題考點是 cimetidine 的藥理分類與其肝臟酵素交互作用方向。Cimetidine 是第一代組織胺 H2 受體拮抗劑,並且是肝臟細胞色素 P-450 的抑制劑,會降低多種併用藥物的代謝速率而使其血中濃度上升,選項 C 寫成「增加 P-450 代謝酶活性」把方向寫反,故為錯誤敘述,選 C。選項 A 正確,阻斷胃壁細胞的 H2 受體可減少胃酸分泌,用於消化性潰瘍與胃食道逆流。選項 B 正確,cimetidine 具抗雄性素與抬升泌乳素的作用,長期使用可能出現男性女乳症與性功能障礙。選項 D 正確,H2 受體拮抗劑正是其藥理分類。","同類藥比較是本題延伸重點:cimetidine 因抑制 P-450 與內分泌副作用而漸被取代,ranitidine、famotidine、nizatidine 的酵素抑制作用弱且無明顯抗雄性素效果,臨床安全性較佳。P-450 抑制劑與誘導劑的方向必須背成兩欄,因為考題常用「併用後血中濃度變化」設問:抑制劑有 cimetidine、erythromycin、ketoconazole、grapefruit juice、ciprofloxacin(記憶:抑制劑讓別的藥「排不掉、濃度升、易中毒」);誘導劑有 rifampin、phenytoin、carbamazepine、phenobarbital、慢性酒精(記憶:誘導劑讓別的藥「代謝快、濃度降、失效」,口服避孕藥失效與 warfarin 抗凝失控都是典型後果)。抑酸藥的階梯也值得對照:制酸劑(中和已分泌的酸)→ H2 受體拮抗劑(阻斷組織胺途徑)→ 質子泵抑制劑(不可逆抑制 H+\u002FK+-ATPase,抑酸最強、作用時間最長)。可連結複習:幽門螺旋桿菌三合一療法的組成邏輯。",[25,28,30,32],{"term":26,"count":27},"組織胺 H2 受體拮抗劑",1,{"term":29,"count":27},"cimetidine",{"term":31,"count":27},"細胞色素 P-450 抑制",{"term":33,"count":27},"抗雄性素副作用",[35,39,43,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-2-basic-medicine-036","下列何種藥物可作為高血壓第一線單一藥物初始治療之選擇？",36,{"webId":40,"stem":41,"number":11,"year":42,"session":11},"nurse-106-2-basic-medicine-002","下列那一個腺體之組織學特徵具有膠體（colloid）的構造？",106,{"webId":44,"stem":45,"number":46,"year":47,"session":27},"nurse-107-1-basic-medicine-016","神經細胞受傷後，下列何種胞器常會發生「溶解」現象？",16,107,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-108-1-basic-medicine-054","有關抗癌藥物之敘述，下列何者錯誤？",54,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-2-basic-medicine-018","心肌不會發生收縮力加成作用（summation）的原因，主要是下列何者？",18,109,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-110-2-basic-medicine-052","動情素在臨床上用來治療攝護腺癌，是因為下列何種藥理作用？",52,110,"2026-08-06",1787299017698]