高普考題庫
109 年 109年公務人員高等考試三級考試暨普通考試

調劑學與臨床藥學

本卷皆為申論題,點「看答案與解析」查看擬答。

申論 1請寫出下列藥品之學名、治療用途、主要副作用、用藥諮詢重點及相關注意事項等:(每小題5分,共25分)㈠Ciproxin㈡Nexium㈢Plaquenil㈣Sinemet㈤Xenical
申論 2請閱讀下述案例報告病程描述並回答下列問題:A 71-year-old woman with paroxysmal atrial fibrillation being treatedwith warfarin 3.75 mg/day presented at the hospital with a 5-day history ofincreasing swelling in her neck, sialorrhoea, and difficulty swallowing. Oneweek earlier, she had been started on fluconazole 200 mg once a day becauseof oral candidiasis. She was afebrile. Physical examination showed a large,soft, dark-red swelling on the floor of her mouth: her tongue was displacedsuperiorly. She had a sublingual haematoma. Laboratory testing showed aC-reactive protein level of 65 mg/L (reference value <5.0 mg/L), a white cellcount of 12.510per L with 83.3% neutrophils, and an internationalnormalised ratio of more than 9.0 (reference range 3.0). Coagulation wasrapidly corrected with prothrombin complex concentrate and intravenousvitamin K, leading to spontaneous resolution of haematoma over the courseof one week while the patient was under close surveillance.㈠列出文中所述及藥品與其用途。(3分)㈡說明該年長女士之病程概要與可能原因。(7分)㈢分析如何解決與監測此案例之臨床狀況,並闡述藥師角色。(10分)
申論 3有關「兒童友善製劑(pediatric-friendly drug formulation)」:(每小題10分,共20分)㈠請舉出三項藥品與其藥理作用機轉,並說明為何可歸類為「兒童友善製劑」。㈡試分析臨床所面臨之困境或挑戰,並提出相對應之改善策略。
申論 4請參考圖例,以中文回答下列問題:㈠此圖意欲闡釋何種藥事作業?請依序列出此藥事作業之各步驟及意義?(7分)㈡藥師主要執業場域有社區藥局與醫療院所;針對前述藥事作業,試比較在不同執業場域,藥師所執行工作內容(職責)之異同。(10分)㈢為確保前述藥事作業在各執業場域達一定水準,國內頒布或制定了那些相關法規、條例、準則或規範,供藥事執業人員遵循或參照?另請分別從執業場所空間設計、硬體設施、作業流程、病人服務等各相關面向思考,列舉與前述藥事作業相關之具體實務事例或細項,並闡述相對應法條內文要求與出處。(10分)㈣試以醫療機構為例,為求前述藥事作業順暢、保障用藥安全,可以建構那些系統性措施,以增進效率與品質、降低人因干擾、避免錯誤?(8分)