[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-3-basic-medicine-032":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":27},"nurse-113-3-基礎醫學-032","nurse-113-3-basic-medicine-032",113,3,32,"下列安眠藥中，何者能活化 melatonin receptor（褪黑激素受體）？",{"A":15,"B":16,"C":17,"D":18},"zolpidem","suvorexant","temazepam","ramelteon","D",null,[],"本題考點在於安眠藥的作用機轉分類。ramelteon 是選擇性褪黑激素受體(MT1\u002FMT2)促效劑,模擬褪黑激素作用於下視丘視交叉上核以調節睡眠—清醒週期、縮短入睡時間,故能活化 melatonin receptor,選 D。A zolpidem 屬非苯二氮平類的 Z 藥,作用於 GABA-A 受體的苯二氮平位點增強氯離子內流,與褪黑激素受體無關。B suvorexant 是食慾素(orexin)受體拮抗劑,經阻斷促醒的 orexin 訊號助眠,機轉不同。C temazepam 是苯二氮平類,同樣作用於 GABA-A 受體。掌握「ramelteon＝褪黑激素受體促效劑」這一獨特分類即可作答。","失眠用藥依機轉分類:GABA-A 增強劑(苯二氮平類如 temazepam、非苯二氮平 Z 藥如 zolpidem、zaleplon、eszopiclone)、褪黑激素受體促效劑(ramelteon、tasimelteon)、食慾素受體拮抗劑(suvorexant、lemborexant)、具鎮靜作用的抗組織胺與低劑量抗憂鬱劑(如 doxepin)。ramelteon 不作用於 GABA 系統,故較無濫用或依賴性,適合入睡困難型失眠。記憶:名字含「-melteon \u002F melatonin」就走褪黑激素受體;「-orexant」就是 orexin 拮抗;Z 藥與 BZD 都撥 GABA 的弦。理解機轉差異有助評估依賴性、次日殘留鎮靜與跌倒風險。",[25,28,30,32],{"term":26,"count":27},"褪黑激素受體促效劑",2,{"term":18,"count":29},1,{"term":31,"count":29},"視交叉上核睡眠週期",{"term":33,"count":29},"GABA-A 與 orexin 機轉對比",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-113-3-basic-medicine-033","下列藥物中，何者不作為躁鬱症（mania and bipolar disorder）的治療用藥？",33,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-114-2-basic-medicine-029","小腦天幕疝脫（transtentorial herniation），顳葉內側緣被擠壓時，下列何種變化最少見？",29,114,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-115-1-basic-medicine-023","下列何者不屬於體染色體（autosome）數量異常的疾病？",23,115,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-106-2-basic-medicine-041","下列有關缺鐵性貧血（iron deficiency anemia）的診斷條件，何者錯誤？",41,106,{"webId":55,"stem":56,"number":57,"year":58,"session":29},"nurse-108-1-basic-medicine-005","下列何者含副鼻竇？",5,108,{"webId":60,"stem":61,"number":62,"year":63,"session":29},"nurse-109-1-basic-medicine-039","下列何者最不可能引起左心衰竭（left heart failure）？",39,109,"2026-09-04",1788510751763]