[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-108-2-basic-medicine-062":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":66},"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-108-2-基礎醫學-062","nurse-108-2-basic-medicine-062",108,2,62,"leucovorin 與下列何種抗癌藥物同時使用，可以減低抗癌藥物的不良副作用？",{"A":15,"B":16,"C":17,"D":18},"azacitidine","5-Fluorouracil","methotrexate","6-Mercaptopurine","C",null,[],"本題考點為 leucovorin（folinic acid）的解救（rescue）機轉。methotrexate 屬抗葉酸劑，抑制二氫葉酸還原酶（DHFR），阻斷四氫葉酸生成而干擾 DNA 合成，對正常細胞亦有毒性。依 leucovorin 已是還原型葉酸、不需經 DHFR 即可供給正常細胞四氫葉酸，故高劑量 MTX 後給予 leucovorin 可選擇性挽救正常細胞、降低骨髓與黏膜毒性，選 C。（A）azacitidine 為去甲基化藥物，機轉與葉酸代謝無關。（B）5-Fluorouracil 與 leucovorin 併用反而增強其抑制胸苷酸合成酶之作用，是增效而非減毒。（D）6-Mercaptopurine 屬嘌呤類似物，毒性由 xanthine oxidase 代謝影響，非 leucovorin 解救對象。","葉酸代謝軸：DHFR 將二氫葉酸還原為四氫葉酸，供給嘌呤與胸苷酸合成。MTX 卡在 DHFR 這一步，leucovorin 直接補進下游還原型葉酸，故稱『繞道解救』。關鍵對比：MTX＋leucovorin＝解毒；5-FU＋leucovorin＝增毒（leucovorin 穩定 5-FU 代謝物與 TS 的三元複合體）。同一藥搭不同抗癌藥竟走相反方向，正是本題設計的陷阱點，可用『卡上游用還原型葉酸救、卡下游用還原型葉酸壓』來區辨。",[25,26,29,31,33],{"term":17,"count":11},{"term":27,"count":28},"leucovorin 解救",1,{"term":30,"count":28},"二氫葉酸還原酶(DHFR)",{"term":32,"count":28},"四氫葉酸",{"term":34,"count":28},"5-FU 增效",[36,40,45,50,55,61],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-108-2-basic-medicine-063","關於 corticosteroid 的臨床用途，下列何者錯誤？",63,{"webId":41,"stem":42,"number":43,"year":44,"session":28},"nurse-109-1-basic-medicine-079","下列關於肺炎披衣菌（Chlamydophila pneumoniae）的敘述何者錯誤？",79,109,{"webId":46,"stem":47,"number":48,"year":49,"session":28},"nurse-110-1-basic-medicine-013","下列那一種器官主要負責尿液（urine）的形成？",13,110,{"webId":51,"stem":52,"number":53,"year":54,"session":28},"nurse-111-1-basic-medicine-051","下列藥物和作用機轉之配對，何者錯誤？",51,111,{"webId":56,"stem":57,"number":58,"year":59,"session":60},"nurse-112-3-basic-medicine-025","最常引起心肌炎（myocarditis）的原因為何？",25,112,3,{"webId":62,"stem":63,"number":64,"year":65,"session":28},"nurse-114-1-basic-medicine-019","當肱骨（humerus）的骨幹發生骨折，最可能直接傷及那一條手臂的神經？",19,114,"2026-09-04",1788510705349]