[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-038":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":66},"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-038","nurse-115-2-basic-medicine-038",115,2,38,"下列何者無法用於治療發炎性腸道疾病（inflammatory bowel disease）？",{"A":15,"B":16,"C":17,"D":18},"famotidine","5-aminosalicylates","infliximab","tofacitinib","A",null,[],"本題考點是發炎性腸道疾病用藥的類別範圍。發炎性腸道疾病(潰瘍性結腸炎與克隆氏症)的治療以抑制腸道黏膜免疫發炎為主軸,依序有 5-胺基柳酸鹽、類固醇、免疫調節劑(azathioprine、methotrexate)與生物製劑或小分子標靶藥。Famotidine 是組織胺 H2 受體拮抗劑,作用位置在胃壁細胞、功能是抑制胃酸分泌,對腸道免疫發炎無治療作用,故選 A。選項 B 的 5-胺基柳酸鹽作用於腸道黏膜局部抗發炎,是輕中度潰瘍性結腸炎的基礎用藥。選項 C 的 infliximab 是抗腫瘤壞死因子單株抗體。選項 D 的 tofacitinib 是 JAK 抑制劑,兩者皆為發炎性腸道疾病的標靶治療選項。","把治療階梯與病灶分布搭配記憶效率最高。5-胺基柳酸鹽的劑型設計反映病灶位置:sulfasalazine 需靠大腸細菌的偶氮還原酶切開才釋出活性 mesalamine,故對結腸病灶有效而對小腸克隆氏症幫助有限;mesalamine 的緩釋與腸溶劑型、灌腸劑與塞劑則對應不同節段。類固醇只用於急性發作的誘導緩解,不作長期維持,因為長期毒性(骨質疏鬆、血糖上升、感染風險、腎上腺抑制)不可接受。抗腫瘤壞死因子製劑(infliximab、adalimumab)用藥前須篩檢潛伏結核與 B 型肝炎,因為腫瘤壞死因子在抑制肉芽腫內結核菌上扮演關鍵角色,這是機轉推副作用的經典題型。JAK 抑制劑走細胞內訊息傳遞,口服給藥,但帶血栓與帶狀疱疹風險。對照複習:sulfasalazine 也用於類風濕性關節炎,顯示「腸道發炎與關節發炎共用免疫路徑」,可延伸到發炎性腸道疾病的腸外表現(關節炎、虹彩炎、原發性硬化性膽道炎、結節性紅斑)。",[25,28,30,32,34],{"term":26,"count":27},"發炎性腸道疾病",1,{"term":29,"count":27},"5-胺基柳酸鹽",{"term":31,"count":27},"抗腫瘤壞死因子製劑",{"term":33,"count":27},"JAK 抑制劑",{"term":35,"count":27},"H2 受體拮抗劑",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-2-basic-medicine-039","下列骨質疏鬆症治療藥物中，何者可以口服方式給藥，但易產生食道炎或食道潰瘍之副作用？",39,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-106-2-basic-medicine-005","有關兩性骨盆的比較，下列何者男性大於女性？",5,106,{"webId":47,"stem":48,"number":49,"year":50,"session":27},"nurse-107-1-basic-medicine-019","當迷走神經興奮時，對心臟的影響下列何者正確？",19,107,{"webId":52,"stem":53,"number":54,"year":55,"session":27},"nurse-108-1-basic-medicine-057","下列抗精神病藥物中，何者的錐體外症狀（Extrapyramidal symptoms）副作用最強？",57,108,{"webId":57,"stem":58,"number":59,"year":60,"session":11},"nurse-109-2-basic-medicine-021","與正常人相比較，部分呼吸道狹窄的患者，其第一秒內用力呼氣體積（forced expiratory volume at the first second）與用力呼氣肺活量（forced vital capacity）之改變，下列何者正確？",21,109,{"webId":62,"stem":63,"number":64,"year":65,"session":11},"nurse-110-2-basic-medicine-055","非典型抗憂鬱藥物，下列何者可降低菸癮者對尼古丁的渴求？",55,110,"2026-08-06",1787299017731]