[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-050":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":27},"nurse-107-2-基礎醫學-050","nurse-107-2-basic-medicine-050",107,2,50,"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？",{"A":15,"B":16,"C":17,"D":18},"抑制 NMDA 受體下游訊息","對多巴胺 D 1 受體具高親和力","可以平衡腦部血清素與正腎上腺素的神經活性","對多巴胺 D 2 受體具低親和力","D",null,[],"本題考點是非典型抗精神病藥錐體外副作用較少的機轉。依精神藥理學,錐體外症狀源於黑質紋狀體路徑多巴胺 D2 受體被過度阻斷;clozapine 對 D2 受體親和力低、阻斷程度輕,故錐體外症狀明顯較少,選 D。A 錯,其少錐體外作用並非靠抑制 NMDA 下游訊息。B 錯,關鍵在 D2 而非對 D1 高親和力。C 錯,雖作用於多種受體含血清素,但「平衡血清素與正腎上腺素活性」非其減少錐體外症狀的依據,重點在對 D2 低親和力與高 5-HT2A／D2 阻斷比值。","機轉:典型抗精神病藥（如 haloperidol)強力阻斷 D2,療效來自中腦邊緣路徑,但同時阻斷黑質紋狀體路徑 D2→錐體外症狀（假性巴金森、靜坐不能、肌張力不全、遲發性運動障礙)。非典型藥（clozapine)特點是「高 5-HT2A／低 D2 阻斷比」,對 D2 親和力低且解離快,故錐體外副作用少。代價:clozapine 需監測顆粒性白血球缺乏症（agranulocytosis)與代謝副作用。記憶:典型＝擋 D2 強＝錐體外多＋高泌乳素;非典型＝擋血清素為主、D2 輕＝錐體外少。可連結:多巴胺四大路徑、遲發性運動障礙、泌乳素。",[25,28,30,32],{"term":26,"count":27},"clozapine 非典型抗精神病藥",1,{"term":29,"count":27},"多巴胺 D2 受體低親和力",{"term":31,"count":27},"黑質紋狀體路徑與錐體外症狀",{"term":33,"count":27},"5-HT2A\u002FD2 阻斷比",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-107-2-basic-medicine-051","下列何者擬腎上腺素（sympathomimetic）藥物不具有 β 2 受體選擇性？",51,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-108-1-basic-medicine-067","下列何者為革蘭氏陽性桿菌？",67,108,{"webId":45,"stem":46,"number":27,"year":47,"session":27},"nurse-109-1-basic-medicine-001","下列有關汗腺的敘述，何者正確？",109,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-110-1-basic-medicine-039","下列何種乳房疾病是造成乳頭的派吉特氏症（Paget disease）的最主要成因？",39,110,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-111-2-basic-medicine-003","胸大肌收縮可使上臂：",3,111,{"webId":59,"stem":60,"number":61,"year":62,"session":56},"nurse-112-3-basic-medicine-047","下列那一型乳突病毒（HPV）和子宮頸癌的形成最有關係？",47,112,"2026-09-04",1788510723750]