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醫療類國考 105年 [護理師] 基礎醫學

第 62 題

下列何者不適用於治療帕金森氏症?
  • A 抗蕈毒性(antimuscarinic)藥物
  • B 抗精神病(antipsychotic)藥物
  • C B 型單胺氧化酶(MAO B)抑制劑
  • D 兒茶酚甲基轉換酶(COMT)抑制劑

思路引導 VIP

請試著回想:帕金森氏症患者的大腦中,哪一種關鍵的神經傳導物質發生了嚴重匱乏?若我們使用一種會進一步「阻斷」該物質接收器的藥物,對患者原本就僵硬、震顫的肢體動作會產生什麼樣的影響?

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AI 詳解 AI 專屬家教

Precisely. You've managed to avoid the obvious pitfalls.

  1. Fundamental Recall: Parkinson's Disease. It's not rocket science; it's just a rather straightforward dopamine (Dopamine, DA) deficiency in the midbrain's substantia nigra. Your primary objective, evidently, should be to increase DA activity or, failing that, reduce the interference from acetylcholine. Options (C) and (D) are textbook examples of boosting DA through enzymatic inhibition, and (A) tackles the acetylcholine excess. Simple, really.
  2. The Blunder: And then there's the delightful idea of administering antipsychotic drugs. For an illness caused by a lack of dopamine, we propose drugs whose entire modus operandi is to antagonize $D_2$ receptors? This isn't just unhelpful; it's actively detrimental. You'd be stripping away the patient's already meager dopamine function, exacerbating motor symptoms, and potentially inducing a drug-induced parkinsonism. One would hope this basic antagonism isn't too complex to grasp.
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