【評論主題】36.有關warfarin用法的敘述，下列何者正確？(A)需要loading dose(B)須依病人之腎功能調整劑量(C)若warfarin過量時應給與vitamin K並進行透析(D)孕婦可改用lo
【評論內容】
(B) IN☆★（★★★★★★★★★）
...
【評論主題】35.下列那一降血壓藥是屬於angiotensin II-type I型受器阻斷劑？(A)Carvediolol(B)Moexipril(C)Irbesartan(D)Nitrendipine
【評論內容】（A） Carvediolol：β-Bl☆☆☆☆☆（☆）...
【評論主題】68.有關前列腺癌之敘述，下列何者正確？(A)不能因為疾病進展緩慢，就將「觀察」列為一個治療選項(B)睪丸切除或LHRH agonist可用於advanced（stage D2）前列腺癌(C)去勢療法
【評論內容】(A)不能因為疾病進展緩慢，就將「觀察」...
【評論主題】49.下列何者治療憂鬱症之機轉與其他三種藥品不同？(A)duloxetine(B)paroxetine(C)sertraline(D)fluoxetine
【評論內容】
3樓詳解錯了
duloxetine是SNRI
【評論主題】54.有下列何種合併症的病人可以使用exenatide？(A)medullary thyroid carcinoma(B)acute pancreatitis(C)osteoporosis(D)mul
【評論內容】用生理學去解題exenatide：GLP-1 ...
【評論主題】23.有關enoxaparin的敘述，下列何者正確？(A)以連續靜脈輸注給藥(B)腎功能不全者應調整劑量(C)須每6小時監測activated partial thromboplastin time（
【評論內容】
Basic and Clinical Pharmacology 13 E
588 SECTion Vi Drugs Used to Treat Diseases of the Blood, Inflammation, & Gout
Monitoring of Heparin Effect
Close monitoring of the activated partial thromboplastin time
(aPTT or PTT) is necessary in patients receiving UFH. Levels of
UFH may also be determined by protamine titration (therapeutic
levels 0.2–0.4 unit/mL) or anti-Xa units (therapeutic levels 0.3–0.7
unit/mL). Weight-based dosing of the LMW heparins results in pre-
dictable pharmacokinetics and plasma levels in patients with normal
renal funct...
【評論主題】7.有關膽道發炎時的經驗性抗生素治療之敘述，下列何者錯誤？(A)應優先選擇能針對革蘭氏陰性菌如E.coli及K. pneumoniae有作用的廣效性抗生素(B)如有院內感染的可能，應考慮併用對綠膿桿菌
【評論內容】Antimicrobial ☆☆☆☆☆☆☆☆ ☆☆ ...
【評論主題】69.黃太太血液透析多年，近日常感皮膚搔癢，下列何者為可能的原因之一？【題組】70.承上題，為緩解黃太太之皮膚搔癢，下列處置何者最不適當？(A)給與oral antihistamine(B)降低 se
【評論內容】
(A)給與oral antihis☆☆☆☆☆☆
(☆)★★ ...
【評論主題】69.黃太太血液透析多年，近日常感皮膚搔癢，下列何者為可能的原因之一？(A)hypovitaminosis A(B)hyperparathyroidism(C)hypercalcemia(D)reni
【評論內容】Uremic pruritusAuthor:Sidney M Kobrin, MDSection Editor:Jeffrey S Berns, MDDeputy Editor:Shveta Motwani, MD, MMSc, FASNAll topics are updated as new evidence becomes available and our peer review process is complete.Literature review current through: Mar 2021. | This topic last updated: Dec 12, 2019.
RISK FACTORS AND ASSOCIATIONS
No single cause underlying uremic pruritus has been identified. Multiple factors have been associated in observational studies, and supportive therapies that are used to treat uremic pruritus have targeted such factors. (See 'Management' below.)
The following fac...
【評論主題】67.吳先生有末期腎臟病，血鉀10.0 mEq/L，且心電圖出現sine wave。下列何者可拮抗高血鉀之心臟毒性？(A)10% calcium gluconate 10 mL IV(B)sodium
【評論內容】醫院常見降鉀套組Kuzem 1pac☆ ☆☆☆...
【評論主題】57.王先生55歲，因non-Hodgkin lymphoma已接受二次癌症化學治療，回診抱怨口腔與食道吞嚥時刺痛，檢查發現口腔內潰瘍處有白色斑塊；目前用藥包括：prednisolone、pantop
【評論內容】Acid suppressing therapy as a risk factor for Candida esophagitisH W Daniell 1PMID: 25833302 DOI: 10.1111/dote.12354AbstractStudies were reviewed from PubMed for risk factors for the development, recurrence, prevention and therapy of Candida esophagitis, and for mechanisms induced by acid-suppressing therapy potentially influencing these factors. Documented observations included greatly increased Candida populations in the mouth, esophagus, stomach, and upper small intestine induced by acid-suppressing therapy. Among patients without HIV disease, PPI consumers more frequently had developed...
【評論主題】48.當成年病人發生嚴重低血糖導致無意識時，下列處置何者正確？(A)以相當15 g碳水化合物灌食投與(B)給與高蛋白質飲料補充能量(C)glucagon 1 mg皮下注射(D)5% glucose 1
【評論內容】Hypoglycemia in adults with diabetes mellitusAuthor:Philip E Cryer, MDSection Editor:Irl B Hirsch, MDDeputy Editor:Jean E Mulder, MDAll topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Mar 2021. | This topic last updated: Apr 19, 2021.Asymptomatic — For a person with drug-treated diabetes, we suggest defensive actions when self-monitoring reveals a glucose level ≤70 mg/dL (3.9 mmol/L). Defensive options include repeating the measurement within 15 to 60 minutes (depending on the setting), avoiding critical ...
【評論主題】5.若病人對penicillin過敏是屬於IgE-mediated hypersensitivity，則下列何種抗生素不可用來治療group Astreptococci所引起的感染？(A)azithr
【評論內容】
這題其實考得很細緻， ...
【評論主題】【題組】78.承上題，使用此化療藥品時，下列何者可用於預防出血性膀胱炎？(A)mitoxantrone(B)mesna(C)deferoxamine(D)amphotericin B
【評論內容】
1. 出血性膀胱炎(Hemorrhagic cystitis):n代謝物acrolein造成
n(1)Cyclophosphamide
nA.Highndose Cyclophosphamide ( 500~700mg/liter)易產生
nB.High dose Cyclophosphamide會併用mesna，之後再灌500ml的生理食鹽水來增加藥物的排除
nC.如果忘了灌水跟mesna，而發生出血性膀胱炎，那還是只能停藥及灌水
n(2)ifosfamide
nA.不論劑量搭配mesna，...
【評論主題】【題組】78.承上題，使用此化療藥品時，下列何者可用於預防出血性膀胱炎？(A)mitoxantrone(B)mesna(C)deferoxamine(D)amphotericin B
【評論內容】
1. 出血性膀胱炎(Hemorrhagic cystitis):n代謝物acrolein造成
n(1)Cyclophosphamide
nA.Highndose Cyclophosphamide ( 500~700mg/liter)易產生
nB.High dose Cyclophosphamide會併用mesna，之後再灌500ml的生理食鹽水來增加藥物的排除
nC.如果忘了灌水跟mesna，而發生出血性膀胱炎，那還是只能停藥及灌水
n(2)ifosfamide
nA.不論劑量搭配mesna，...
【評論主題】15.陳先生55歲，患有糖尿病及高血壓，其首選之降血壓藥品為：(A)Clonidine(B)Nitroprusside(C)Lisinopril(D)Prazosin
【評論內容】
（A）Clonidine：活化突觸前腎上腺素激性α2 receptor
（B）Nitroprusside：直接的鬆弛小動脈的平滑肌，結果會顯著的降低動脈的壓力
（C）Lisinopril：ACE inhibitor
（D） Prazosin：選擇性α1阻斷劑，改善前列腺肥大症所伴隨之排尿障礙
【評論主題】36.有關warfarin用法的敘述，下列何者正確？(A)需要loading dose(B)須依病人之腎功能調整劑量(C)若warfarin過量時應給與vitamin K並進行透析(D)孕婦可改用lo
【評論內容】
(B) INR值（國際標準凝血時間比）
監測血液中的凝血功能可以透過「PT（prothrombin time）檢驗」，也就是「凝血原酶時間檢測」，但此項檢驗數值可能因儀器與試劑等因素造成差異，經轉換成「INR值（國際標準凝血時間比）」後，受儀器影響較小，能得到較為客觀的數據。
一般來說健康者的INR數值約為0.8－1.2，病人服用Warfarin後，INR應控制於2至4之間，如果抗凝血藥劑量過多(INR4)則會造成提高體內組織出血的機率，如果劑量過少(INR<2)則會造成產生血栓的危險，總之病人服用Warfarin後，應每個月測試一次INR看是否需調整藥量。
https://www.hch.gov.tw/hch/MedicalTeams/HealthEducationDetail.aspx?MNO=C347&ID=6400
【評論主題】35.下列那一降血壓藥是屬於angiotensin II-type I型受器阻斷劑？(A)Carvediolol(B)Moexipril(C)Irbesartan(D)Nitrendipine
【評論內容】
（A） Carvediolol：β-Blocker
（B） Moexipril：ACE inhibitor
（C） Irbesartan：口服的強效選擇性angiotensin II 受體 (AT1 型) 拮抗劑
（D） Nitrendipine：Dihydropyrimidine derivatives，阻止Ca離子進入細胞