[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-039":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":65},"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-039","nurse-115-2-basic-medicine-039",115,2,39,"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？",{"A":15,"B":16,"C":17,"D":18},"denosumab","romosozumab","teriparatide","alendronate","D",null,[],"本題考點是骨質疏鬆症藥物的給藥途徑與其對應的局部副作用。四個選項中只有 alendronate 是口服雙磷酸鹽,其分子帶強極性、口服吸收率極低且對食道黏膜有直接腐蝕刺激性,藥錠若滯留食道即可能造成食道炎或食道潰瘍,這正是題目描述的組合,故選 D。選項 A 的 denosumab 是抗 RANKL 單株抗體,採皮下注射。選項 B 的 romosozumab 是抗骨硬化素單株抗體,同樣為皮下注射。選項 C 的 teriparatide 屬副甲狀腺素類似物,以皮下注射給藥;三者都不經口服吸收,不會有藥錠停留食道所致的黏膜傷害。","抗骨質疏鬆藥物依作用方向分兩大類最好記。抗骨質流失類(抑制骨蝕細胞):雙磷酸鹽(alendronate、risedronate 口服,zoledronic acid 靜脈注射)、denosumab、選擇性雌激素受體調節劑 raloxifene、抑鈣素。促骨質生成類:teriparatide、abaloparatide,以及兼具兩種作用的 romosozumab(抑制骨硬化素,同時促生成並抑吸收)。雙磷酸鹽的機轉延伸:它與骨表面的氫氧磷灰石結合,被骨蝕細胞吞入後抑制法尼基焦磷酸合成酶,使骨蝕細胞細胞骨架失能而凋亡,因此藥效在停藥後仍可持續相當時間。其他必記副作用有顎骨壞死(與侵入性牙科處置相關)與非典型股骨骨折。denosumab 的特殊性在於停藥後骨密度會快速回落並有多發性脊椎骨折的反彈風險,故不宜隨意中斷,這與雙磷酸鹽可安排藥物假期形成鮮明對比。可連結複習:骨密度 T 值的判讀切點(−2.5 以下為骨質疏鬆)與 RANKL\u002FOPG 骨代謝調控軸。",[25,28,30,31,33],{"term":26,"count":27},"骨質疏鬆症用藥",1,{"term":29,"count":27},"口服雙磷酸鹽",{"term":18,"count":27},{"term":32,"count":27},"食道黏膜刺激",{"term":34,"count":27},"皮下注射生物製劑",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-2-basic-medicine-040","下列單株抗體藥物中，何者可抑制上皮生長因子受體（epidermal growth factor receptor, EGFR）之作用，用於治療癌症？",40,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-2-basic-medicine-006","正常情形下，白血球中數量最多與直徑最大的分別是：",6,106,{"webId":46,"stem":47,"number":48,"year":49,"session":27},"nurse-107-1-basic-medicine-020","下列何種情況會使神經元產生去極化（depolarization）現象？",20,107,{"webId":51,"stem":52,"number":53,"year":54,"session":27},"nurse-108-1-basic-medicine-058","下列何種苯二氮平（Benzodiazepine）藥物，最易引起較嚴重之戒斷症狀（如：焦慮）？",58,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-basic-medicine-022","運動失調（ataxia）主要是因為腦部那一區域受損？",22,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-basic-medicine-056","成癮性物質中，下列何者之身體依賴性相對較高？",56,110,"2026-08-06",1787299017736]