[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-056":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":64},"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-056","nurse-107-2-basic-medicine-056",107,2,56,"Flecainide 可用於治療具威脅生命之心室心律不整，但也容易引發致命的心律不整，主要原因為何？",{"A":15,"B":16,"C":17,"D":18},"過度抑制鈣離子管道，導致房室傳導阻斷（A-V block）","過度抑制鉀離子管道，導致心室期外收縮","過度抑制鈉離子管道，導致心傳導過慢","過度抑制鈉鈣離子交換，導致心室期外收縮","C",null,[],"本題考點是 Flecainide 致心律不整的機轉。依抗心律不整藥分類,flecainide 屬第 IC 類鈉離子通道阻斷劑,強力且持久地抑制鈉通道,大幅減慢心臟傳導速度;過度減慢傳導會促成折返性心律不整,故本身可誘發致命心律不整,選 C。A 錯,其主要標的是鈉通道而非鈣通道所致的房室阻斷。B 錯,鉀通道阻斷（延長再極化)是第 III 類藥的特性,非 flecainide 主機轉。D 錯,鈉鈣交換抑制非其致心律不整的主要機制。CAST 試驗即顯示 flecainide 用於心肌梗塞後反增死亡率。","分類記憶（Vaughan-Williams):第 I 類＝鈉通道阻斷,再分 IA（quinidine,中度、延長動作電位)、IB（lidocaine,弱、縮短)、IC（flecainide、propafenone,強力抑制傳導、對動作電位時程影響小);第 II 類＝β 阻斷劑;第 III 類＝鉀通道阻斷（amiodarone、sotalol);第 IV 類＝鈣通道阻斷。IC 類強力減慢傳導→易在受損心肌形成折返,故 CAST 研究顯示心肌梗塞後使用增加猝死,現多限用於結構正常心臟的病人。致心律不整性（proarrhythmia)是抗心律不整藥的共同弔詭風險。可連結:折返機轉、動作電位相、CAST 試驗。",[25,27,30,32],{"term":26,"count":11},"鈉離子通道阻斷",{"term":28,"count":29},"flecainide 第 IC 類",1,{"term":31,"count":29},"傳導減慢與折返",{"term":33,"count":29},"致心律不整性",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-107-2-basic-medicine-057","下列抗血小板凝集藥物中，何者之作用機制為抑制磷酸雙酯酶（phosphodiesterase）？",57,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-108-1-basic-medicine-073","關於類鐸受體（Toll-like receptor, TLR）的敘述，下列何者正確？",73,108,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-109-1-basic-medicine-007","下列那一塊骨頭中不具有副鼻竇的構造？",7,109,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-110-1-basic-medicine-045","病人突然發生呼吸短促、呼吸困難。顯微鏡下可見支氣管壁的平滑肌肥大，黏膜下腺體增生，伴有炎症反應，特別是嗜酸性白血球（eosinophils）增多。上列敘述最可能是那一種病症的組織反應？",45,110,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-111-2-basic-medicine-009","下列何者是由勃起組織（erectile tissue）構成，與男性的陰莖（penis）有相似的構造，受刺激時會充血勃起？",9,111,{"webId":60,"stem":61,"number":62,"year":63,"session":29},"nurse-113-1-basic-medicine-003","下列何者為控制反射動作的反射弧（reflex arc）之最終端構造？",3,113,"2026-09-04",1788510723810]