[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-036":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":27},"nurse-115-2-基礎醫學-036","nurse-115-2-basic-medicine-036",115,2,36,"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？",{"A":15,"B":16,"C":17,"D":18},"atropine","hydrochlorothiazide","amiodarone","dopamine","B",null,[],"本題考點是高血壓第一線用藥的類別範圍。依高血壓治療準則,可作為單一藥物起始治療的四大類為 thiazide 類利尿劑、ACE 抑制劑、血管收縮素受體阻斷劑與鈣離子通道阻斷劑;hydrochlorothiazide 屬 thiazide 類利尿劑,透過抑制遠曲小管鈉氯共同轉運體促進排鈉排水並降低周邊阻力,符合第一線單一藥物的定義,故選 B。選項 A 的 atropine 是抗膽鹼藥,阻斷蕈毒鹼受體會加快心跳,與降壓無關。選項 C 的 amiodarone 屬第三類抗心律不整藥,用於心律不整而非高血壓。選項 D 的 dopamine 是靜脈注射用的升壓藥,作用方向與降壓完全相反。","四大類的選藥邏輯值得整合成情境對照:合併糖尿病或蛋白尿的慢性腎病選 ACE 抑制劑或 ARB(降低腎絲球內壓、延緩腎病進展);合併心衰竭選 ACE 抑制劑、β 受體阻斷劑與利尿劑;年長者或單純收縮期高血壓對 thiazide 與長效二氫吡啶類 CCB 反應好;懷孕期絕對避開 ACE 抑制劑與 ARB(胎兒腎臟毒性)。Thiazide 的副作用組可用「三低三高」記:低血鉀、低血鈉、低血鎂,加高血鈣、高血糖、高尿酸(故痛風患者需留意),與環利尿劑 furosemide 的最大差別正是對血鈣的方向相反(thiazide 保鈣、furosemide 排鈣),這個對比幾乎年年入題。ACE 抑制劑的乾咳與高血鉀源自緩動素蓄積與醛固酮下降,ARB 因不影響緩動素而少乾咳,也是常見的機轉比較題。可連結複習:β 受體阻斷劑退居後線的理由、高血壓危機的處置藥物分類。",[25,28,30,31],{"term":26,"count":27},"高血壓第一線用藥",1,{"term":29,"count":27},"thiazide 類利尿劑",{"term":16,"count":27},{"term":32,"count":27},"遠曲小管鈉氯共同轉運體",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-2-basic-medicine-037","下列抗心律不整藥物中，何者於臨床上亦可作為局部麻醉劑使用？",37,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-2-basic-medicine-003","下列何者可使眼球向下內側看及向內旋轉？",3,106,{"webId":44,"stem":45,"number":46,"year":47,"session":27},"nurse-107-1-basic-medicine-017","有關脂質（lipid）與脂肪（fat）的敘述，下列何者正確？",17,107,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-108-1-basic-medicine-055","生物製劑之蛋白質藥物 Etanercept 可治療風濕性關節炎（Rheumatoid arthritis），此藥物之藥理作用為何？",55,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-2-basic-medicine-019","下列那個腦區受損會造成表達性的失語症？",19,109,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-110-2-basic-medicine-053","免疫抑制劑 mycophenolate mofetil 用於腎臟移植時，可減少淋巴細胞異常增殖而緩解腎臟排斥作用，其作用機轉為何？",53,110,"2026-08-06",1787299017709]