[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-049":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":11},"nurse-107-2-基礎醫學-049","nurse-107-2-basic-medicine-049",107,2,49,"肝臟代謝藥物的反應可分為第一相（phase I）及第二相（phase II）。有關藥物代謝的敘述，下列何者正確？",{"A":15,"B":16,"C":17,"D":18},"藥物皆須經過第一相及第二相的代謝反應才能排出體外","藥物的代謝皆須依序先經第一相反應，再經第二相反應","細胞色素（cytochrome）P450 酵素系統參與第一相代謝反應","水解作用（hydrolysis）及結合作用（conjugation）屬於第一相代謝反應","C",null,[],"本題考點是肝臟藥物代謝第一相與第二相的原理。依藥理學,細胞色素 P450 酵素系統負責第一相反應（氧化、還原、水解),為藥物引入或暴露官能基,故 C 正確。A 錯,並非所有藥物都要經歷兩相;有些僅經第一相或僅經第二相即可排出。B 錯,兩相「無固定先後」,藥物可直接進入第二相,不必先經第一相。D 錯,水解屬第一相,但結合作用（conjugation,如與葡萄糖醛酸結合)屬「第二相」,把兩者都歸第一相是錯的。第一相多使藥物極性略增,第二相結合後大幅提高水溶性以利排出。","分相記憶:第一相＝「引官能基」的氧化／還原／水解,主角是 CYP450（肝微粒體酵素),產物極性略增、有時活性反增或生成活性代謝物;第二相＝「加大分子」的結合反應（glucuronidation、sulfation、acetylation、與 glutathione 結合),使藥物水溶性大增、易由膽汁或尿排出。路徑彈性:可只第一相、只第二相、或第一後第二,順序非絕對。臨床連結:CYP450 誘導（如 rifampin、phenytoin)與抑制（如 grapefruit juice、ketoconazole)造成藥物交互作用;前驅藥需第一相活化。可連結:首渡效應、藥物交互作用、活性代謝物。",[25,27,30,32],{"term":26,"count":11},"肝臟藥物代謝",{"term":28,"count":29},"細胞色素 P450 第一相",1,{"term":31,"count":29},"第二相結合作用",{"term":33,"count":29},"代謝相無固定先後",[35,39,44,48,53,57],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-107-2-basic-medicine-050","Clozapine 比典型抗精神病藥產生較少的中樞副作用（錐體外症狀, extrapyramidal syndromes），其原因為何？",50,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-108-1-basic-medicine-066","下列自體免疫疾病中，何者為自體抗體模擬特定分子結合在受體上導致細胞活化及增生，而非造成該細胞的破壞及死亡？",66,108,{"webId":45,"stem":46,"number":47,"year":43,"session":11},"nurse-108-2-basic-medicine-080","目前認為下列那種吸蟲感染與人類膽管癌的發生最有關係？",80,{"webId":49,"stem":50,"number":51,"year":52,"session":29},"nurse-110-1-basic-medicine-038","有關微量變化疾病（minimal change disease）之敘述，下列何者正確？",38,110,{"webId":54,"stem":55,"number":11,"year":56,"session":11},"nurse-111-2-basic-medicine-002","二氧化碳在血液中最主要的運送形式是：",111,{"webId":58,"stem":59,"number":60,"year":61,"session":62},"nurse-112-3-basic-medicine-046","下列何種黴菌較常存在於鴿糞中，且會造成腦膜炎？",46,112,3,"2026-09-04",1788510723746]