[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-113-1-basic-medicine-037":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":65},"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-113-1-基礎醫學-037","nurse-113-1-basic-medicine-037",113,1,37,"Milrinone具有強心及擴張血管之功能，長期使用會引發心律不整，此藥物的藥理作用機制為何？",{"A":15,"B":16,"C":17,"D":18},"第一型磷酸雙酯酶（phosphodiesterase 1）抑制劑","第二型磷酸雙酯酶（phosphodiesterase 2）抑制劑","第三型磷酸雙酯酶（phosphodiesterase 3）抑制劑","第五型磷酸雙酯酶（phosphodiesterase 5）抑制劑","C",null,[],"本題考點在於 milrinone 的藥理機轉。依藥理分類，milrinone 為第三型磷酸雙酯酶（PDE3）抑制劑，抑制心肌與血管平滑肌中分解 cAMP 的 PDE3，使 cAMP 累積：心肌增加鈣內流而正性收縮（強心）、血管平滑肌則鬆弛（擴張血管），故選 C。因細胞內鈣升高，長期使用易誘發心律不整。A、B、D 為第一、二、五型 PDE，作用組織與臨床用途不同（如 PDE5 抑制劑為 sildenafil），故錯。","milrinone 屬「inodilator」（強心＋擴血管），繞過 β 受體直接升 cAMP，故對已下調 β 受體的心衰仍有效，用於急性失代償心衰的短期支持。代價是升高細胞內鈣與 cAMP 促心律不整、長期使用增死亡率。對比記憶：PDE3＝心臟（milrinone），PDE5＝肺與陰莖血管（sildenafil 治肺高壓\u002FED）。",[25,28,30,32],{"term":26,"count":27},"cAMP",4,{"term":29,"count":11},"milrinone",{"term":31,"count":11},"第三型磷酸雙酯酶",{"term":33,"count":11},"強心與擴張血管",[35,39,44,50,55,60],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-113-1-basic-medicine-038","治療糖尿病的用藥canagliflozin，其主要作用機制為何？",38,{"webId":40,"stem":41,"number":42,"year":10,"session":43},"nurse-113-3-basic-medicine-034","下列藥物中，何者為 calcitonin gene-related peptide（CGRP）受體拮抗劑，除了可緩解急性偏頭痛（acute migraine）症狀，亦可用於預防偏頭痛？",34,3,{"webId":45,"stem":46,"number":47,"year":48,"session":49},"nurse-114-2-basic-medicine-028","子宮頸癌（cervical cancer）最常見的病理組織形態為何？",28,114,2,{"webId":51,"stem":52,"number":53,"year":54,"session":11},"nurse-106-1-basic-medicine-026","胎血循環中，靜脈導管連接臍靜脈與下列何者？",26,106,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-107-1-basic-medicine-070","下列何者是李斯特菌（Listeria monocytogenes）主要傳染途徑？",70,107,{"webId":61,"stem":62,"number":63,"year":64,"session":49},"nurse-108-2-basic-medicine-024","一位 50 歲女性有低血鈣、高血磷與低尿磷等症狀，注射副甲狀腺素（PTH）治療會增加尿液中 cAMP 的濃度，此女士可能罹患下列何種疾病？",24,108,"2026-09-04",1788510749691]