Wednesday, November 24, 2010

61 下列有關血清素再吸收阻斷劑fluoxetine與三環類抗憂鬱藥物amitriptyline作用之比較,何者錯誤?
前者較不適用於前列腺肥大的病人
前者較不會產生鎮靜作用(sedative action)
前者較不會產生直立性低血壓(orthostatic hypotension)的副作用
前者較不會產生視覺模糊及口乾等的副作用
A
血清素: SEROTONIN
Fluoxetine (also known by the tradenames Prozac, Sarafem) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.

Amitriptyline (Elavil, Tryptizol, Laroxyl, Sarotex, Lentizol) is a tricyclic antidepressant (TCA).[1] It is the most widely used TCA and has at least equal efficacy against depression as the newer class of SSRIs:
AmitriptylineCommon side effects of using amitriptyline are mostly due to its anticholinergic activity, including: weight gain, dry mouth, changes in appetite, drowsiness, muscle stiffness, nausea, constipation, nervousness, dizziness, blurred vision, urinary retention, insomnia and changes in sexual function.

IN BPH, YOU GIVE ALPHA BLOCKER: Alpha blockers (technically α1-adrenergic receptor antagonists)
================

62 下列有關局部性麻醉劑(local anesthetics)藥理作用之敘述,何者錯誤?
 局部麻醉劑一般為弱酸性物質
局部麻醉劑通常作用在鈉離子管道產生其藥理作用
局部麻醉劑在正常生理的pH值(7.4)為陽離子形式
全身性投與局部麻醉劑時容易發生中樞神經抑制作用
A


63 用於化療法引發之嘔吐拮抗藥物ondansetron主要作用於中樞神經之何種受體?
5-HT2受體 5-HT3受體 Histamine H2受體 Muscarinic M3受體
B
Ondansetron HCl (INN) (pronounced /ɒnˈdænsɛtrɒn/) (developed and first marketed by GlaxoSmithKline asZofran) is a serotonin 5-HT3 receptor antagonist used mainly as an antiemetic to treat nausea and vomiting,




64 下列何種藥物可以有效地預防病人感染Onchocerca volvulus引發蟠尾絲蟲病(onchocerciasis)而造成“river blindness"?
Diethylcarbamazine Bithionol Oxamniquine Ivermectin
D
Simulium yahense) : VECTOR
SIMULA MAG ONCHO ONCHO
RIVER BLINDNESS: YOU USE "EYE"VERMECTIN!!!!!!!!



65 下列何種藥物給予腎臟功能不全與缺乏G-6-P dehydrogenase的病人會造成神經病變及溶血症?
Salicylic acid Nitrofurantoin Metronidazole Methenamine
B
NITROFURANTOIN: . It is usually used in treating urinary tract infection. Like many other drugs, it is often used against E. coli.
Neonates (babies up to the age of one month) have immature enzyme systems in their red blood cells (glutathione instability) and nitrofurantoin must therefore not be used because it can cause haemolytic anaemia. For the same reason, nitrofurantoin should not be given to pregnant women after 38 weeks of pregnancy, or who are about to give birth.
Nitrofurantoin is contraindicated in patients with decreased renal function (CrCl <>






66 下列藥理作用何者與misoprostol之療效無關?
減少胃酸分泌 促進胃黏液分泌 促進子宮收縮 血管收縮
D
Misoprostol is a drug that is used for the prevention of non-steroidal anti-inflammatory drug (NSAID)-inducedgastric ulcers, for early abortion, to treat missed miscarriage, and to induce labor.



67 下列何者不是腎上腺皮質素的副作用?
骨質疏鬆 免疫抑制
肌病變(myopathy) 黑色素沈積
D
腎上腺皮質素:CORTISOL


68 下列制酸劑(antacid)何者具有輕瀉作用?
Mg(OH)2 Al(OH)3 CaCO3 NaHCO3
A


69 Epinephrine作用在腎臟juxtaglomerular apparatus的何種receptor而導致renin的釋放增加?
α1 β1 α2 β2
B

α receptors

α receptors have several functions in common, but also individual effects. Common (or still unspecified) effects include:

[edit]α1 receptor

Alpha1-adrenergic receptors are members of the G protein-coupled receptor superfamily. Upon activation, a heterotrimeric G protein, Gq, activates phospholipase C (PLC). The PLC cleaves phosphatidylinositol 4,5-bisphosphate (PIP2) which in turn causes an increase in inositol triphosphate (IP3) anddiacylglycerol (DAG). The former interacts with calcium channels of endoplasmic and sarcoplasmic reticulum thus changing the calcium content in a cell. This triggers all other effects.

Specific actions of the α1 receptor mainly involve smooth muscle contraction. It causes vasoconstriction in many blood vessels including those of the skin,gastrointestinal system, kidney (renal artery)[6] and brain[7]. Other areas of smooth muscle contraction are:

Further effects include glycogenolysis and gluconeogenesis from adipose tissue[8] and liver, as well as secretion from sweat glands[8] and Na+ reabsorption from kidney.[8]

Antagonists may be used in hypertension.

[edit]α2 receptor

[edit]β receptors

[edit]β1 receptor

Specific actions of the β1 receptor include:

  • Increase cardiac output, by raising heart rate (positive chronotropic effect) and increasing impulse conduction and increasing contraction thus increasing the volume expelled with each beat (increased ejection fraction).
  • Increase Renin secretion from juxtaglomerular cell of kidney.
  • increase ghrelin secretion from the stomach[9]

[edit]β2 receptor

Specific actions of the β2 receptor include the following:

[edit]β3 receptor

Specific actions of the β3 receptor include:

  • Enhancement of lipolysis in adipose tissue. Beta-3 activating drugs could theoretically be used as weight-loss agents, but are limited by the side effect of tremors.


代號:2101
頁次:8-6
70 下列何種藥物會惡化維他命D(vitamin D)過量所引起的高血鈣(hypercalcemia)副作用?
Phenytoin Glucocorticoids Benzothiadiazine Phenobarbital
BONUS

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