[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-107-1-psychiatric-community-026":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"精神科與社區衛生護理學","psychiatric-community",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":10},"nurse-107-1-精神科與社區衛生護理學-026","nurse-107-1-psychiatric-community-026",107,1,26,"古先生為富二代獨子，母親早逝與權威父親經常對立且常有衝突，經常在外與朋友以毒品自我麻醉，目前診斷為海洛因之物質障礙症，住院後下列治療之說明何者正確？",{"A":14,"B":15,"C":16,"D":17},"古先生的戒癮治療以心理復健為主要架構，以期達到有效治療和預防復發的目標","古先生日後門診可以選擇替代治療，經由精神專科醫師處方使用美沙酮（Methadone）治療，領藥後在家自行服用","美沙酮（Methadone）替代療法，用於海洛因的急性解毒和長期維持治療的雙重角色，具低成癮性","古先生較適合使用制癮劑（Disulfiram），10 分鐘內會產生嫌惡反應，而達治療效果","C",null,[],"本題考點是海洛因物質障礙症的美沙酮(Methadone)替代療法定位。依替代療法原理,美沙酮為長效類鴉片致效劑,可穩定佔據受體、緩解戒斷與渴求,兼具急性解毒與長期維持治療的雙重角色,故選 C。A 錯在把戒癮化約為「以心理復健為主要架構」,成癮治療應是生理、心理、社會的整合模式,替代藥物與復健並重。B 錯在「領藥後在家自行服用」,美沙酮須在指定機構於觀察下每日給藥,以防轉售、過量與濫用,不可帶回自行服用。D 錯在藥物與適應症皆不符:Disulfiram(戒酒發泡錠)用於酒精而非海洛因,其嫌惡反應是飲酒後產生,非「10 分鐘內」的固定機轉。相較之下 C 正確描述美沙酮的臨床角色。","美沙酮的關鍵藥理:口服長效、交叉耐受,能平緩地取代海洛因的高低起伏,降低靜脈注射相關感染與犯罪。官方答案採 C,惟須留意其「低成癮性」屬相對而非絕對——美沙酮本身仍具依賴性,只是危害與波動遠低於海洛因。給藥須「督導下每日服用(DOT)」是防濫用重點。Disulfiram 屬酒癮嫌惡療法,和鴉片類無關。可連結:替代療法(丁基原啡因 Buprenorphine)、交叉耐受、督導下給藥、成癮的生理心理社會模式。",[24,26,28,30],{"term":25,"count":10},"美沙酮替代療法",{"term":27,"count":10},"海洛因成癮治療",{"term":29,"count":10},"督導下給藥",{"term":31,"count":10},"Disulfiram適應症",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-107-1-psychiatric-community-027","承上題，古先生問題的心理復健，請問下列說明何者最適切？",27,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-107-2-psychiatric-community-043","應用流行病學方法判定因果關係時，那一項是必要條件，否則無法成立？",43,2,{"webId":43,"stem":44,"number":45,"year":46,"session":41},"nurse-108-2-psychiatric-community-057","成人空腹 8 小時以上，血清三酸甘油酯高於多少，即屬於高血脂？",57,108,{"webId":48,"stem":49,"number":50,"year":51,"session":10},"nurse-110-1-psychiatric-community-015","牛先生，最近被診斷為憂鬱症，醫師開立服用 sertraline（Zoloft ® ）藥物治療，有關 Zoloft 之敘述，下列何者正確？①選擇性血清素回收抑制劑（SSRIs） ②血清素－正腎上腺素回收抑制劑（SNRIs） ③一般持續服用 2 週以上才有療效出現 ④服藥會有嗜睡、噁心嘔吐等副作用",15,110,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-111-1-psychiatric-community-059","有關食品添加物之敘述，下列何者錯誤？",59,111,{"webId":58,"stem":59,"number":60,"year":61,"session":41},"nurse-112-2-psychiatric-community-013","下列有關精神疾病盛行率的敘述，何者正確？",13,112,"2026-09-04",1788510704243]