奥司他韦究竟是不是甲流神药?能不能预防流感?有什么副作用?浙大儿院权威科普

2023-05-30 儿科医生鲍秀兰 儿科医生鲍秀兰 发表于上海

流感的全称是流行性感冒,是由流感病毒引起的一种急性呼吸道传染病,主要通过呼吸道分泌物的飞沫传播,也可通过口腔、鼻腔、眼睛等黏膜的直接或间接接触传播,潜伏期一般1-4天。

最近,随着甲流小高峰的到来,所谓的甲流特效药奥司他韦数次火上热搜,许多家长纷纷出手囤药。

那么,孩子得了流感到底能用什么药?怎样用药才安全?需要囤药吗?

01 流感可以用什么药?

流感的全称是流行性感冒,是由流感病毒引起的一种急性呼吸道传染病,主要通过呼吸道分泌物的飞沫传播,也可通过口腔、鼻腔、眼睛等黏膜的直接或间接接触传播,潜伏期一般1-4天。

流感一般为急性起病、发热(部分患者可高达39-40℃),伴畏寒、寒战、头痛、肌肉或关节酸痛、极度乏力、食欲减退等全身症状。大多数病程持续一周左右。

与普通感冒不同,流感的发热及全身症状更明显,也需要使用针对性的抗流感病毒药物。

目前使用较多的是奥司他韦的口服剂型(包括颗粒剂和胶囊剂),该药在儿童中用药经验较多、使用方便,对于甲型和乙型流感均有效。一些医院还有静脉用的帕拉米韦和吸入用的扎那米韦。

此外,奥司他韦可能对部分乙型流感的疗效不如甲型流感,这种情况下,如果是12岁以上的乙型流感患儿,可以考虑使用玛巴洛沙韦,在症状出现后的48小时内,只需要口服玛巴洛沙韦片1次,就能起到良好的治疗效果。

02 奥司他韦什么时候用?

奥司他韦是一种特异性的神经氨酸酶抑制剂,可以有效抑制流感病毒从被感染的细胞中释放,减少流感病毒在体内传播,一般在首次出现流感症状的48小时内(理想状态为36小时内)服用奥司他韦,越早用效果越好。

03 奥司他韦该怎么用?

按不同的年龄、体重、用药目的,有不同的剂量推荐,具体可参考下表。

04 奥司他韦可以预防流感吗?

不少家长会问:我家小朋友的学校同桌确诊流感了,那我家小朋友要用奥司他韦预防吗?

答案是可以的。小朋友属于流感的密切接触者,5岁以下的小朋友更是流感的高风险人群,预防时的每次用量和治疗时一样,每天只需要口服一次,疗程是7-10天,具体用量参照上面的表格。

05 奥司他韦有什么不良反应?

总体而言,奥司他韦安全性较好。较常见的不良反应有呕吐和腹泻,不过症状多为一过性,一般在第一次服药时出现,不少患儿可自行缓解。但也有一些孩子不良反应较严重,应当停药并及时就诊。

06 使用奥司他韦,还有哪些要注意的?

1) 奥司他韦是一种处方药,家长不宜自行给孩子服用,应在医生或药师的指导下使用。此外,由于流感为季节性高发,不建议家长囤积奥司他韦,以免造成浪费。如果家中备有奥司他韦,应定期查看药品性状和有效期。

2) 奥司他韦只针对流感病毒,对鼻病毒、腺病毒、呼吸道合胞病毒等易引起普通感冒的病毒无效。

3) 在没有奥司他韦颗粒剂可用的情况下,或是不能吞咽胶囊的儿童,可以打开奥司他韦胶囊获得合适剂量的药物粉末,加少量水搅匀得到口服混悬液,并应在配制后马上服用。

4) 奥司他韦可以与食物同时或分开服用,食物不影响其吸收。

07 流感的其他症状,比如发热、头痛、鼻塞、咳嗽等,有哪些药物可以对症治疗?

1)像发烧、头痛、肌肉酸痛等症状,可以选择对乙酰氨基酚或者布洛芬进行对症治疗。

对乙酰氨基酚:适用于2月龄及以上儿童,每次10-15mg/kg,间隔4-6小时可重复使用,24小时不超过4次。日最大剂量不超过2g。

布洛芬:适用于6月龄及以上儿童,每次5-10mg/kg,间隔6-8小时可重复使用,24小时不超过4次。日最大剂量不超过2.4g。

流感时容易高烧不退,但一般不建议将上面这两种退热药交替使用,因为这会增加药品不良反应发生的风险,或是增加用药差错发生的可能。家长们可以采用温水擦拭等辅助退热的方式。

2)流感的其他症状,比如鼻塞、咳嗽、流涕等,可适当使用一些感冒药进行对症治疗。不过家长们要注意的是,市售感冒药多为复方制剂,一般含有2种或2种以上不同药理作用的成分,因此尽量选择单一成分的药品,并且要注意避免相同或相似成分的感冒药合用。

08 怎样预防流感?

1) 戴好口罩,勤洗手,注意个人卫生,咳嗽或打喷嚏时用纸巾、手肘等遮住口鼻。

2) 避免近距离接触流感患者,流感高发期避免去人群聚集场所。

3) 患者应居家隔离观察、减少外出,不带病上课,接触家庭成员时戴口罩,减少疾病传播。

4) 接种流感疫苗,是预防流感最经济、有效的手段。

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    2023-06-03 来自山东省

    学习了🤓

    0

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    2023-05-31 仁术2023 来自吉林省

    不错,学习了。

    0

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    2023-05-31 Epiphanies 来自河南省

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2140687, encodeId=162b214068e58, content=学习了🤓, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230602/e3141025c69e4ee285ec115657f7bd83/b61b1b078aef4546a3a13cfa8ff58fce.jpg, createdBy=d44d8733557, createdName=醫, createdTime=Sat Jun 03 22:53:37 CST 2023, time=2023-06-03, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2140023, encodeId=680921400237d, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Wed May 31 06:20:27 CST 2023, time=2023-05-31, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2140022, encodeId=7efe214002267, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf358692482, createdName=Epiphanies, createdTime=Wed May 31 06:17:13 CST 2023, time=2023-05-31, status=1, ipAttribution=河南省), GetPortalCommentsPageByObjectIdResponse(id=2139989, encodeId=17f7213998988, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d114843943, createdName=1013100771, createdTime=Tue May 30 22:40:32 CST 2023, time=2023-05-30, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2139986, encodeId=362c213998626, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue May 30 22:28:42 CST 2023, time=2023-05-30, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2139977, encodeId=374421399e781, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Tue May 30 21:34:36 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139949, encodeId=7e63213994986, content=奥司他韦可以预防流感, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65724176436, createdName=13d0179fm99暂无昵称, createdTime=Tue May 30 19:33:40 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139947, encodeId=a926213994e56, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Tue May 30 19:30:43 CST 2023, time=2023-05-30, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2139945, encodeId=c01b2139945c2, content=<a href='/topic/show?id=f6ce106300b3' target=_blank style='color:#2F92EE;'>#普通人逆袭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=106300, encryptionId=f6ce106300b3, topicName=普通人逆袭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3ede8538692, createdName=梅斯话题小助手, createdTime=Tue May 30 19:15:09 CST 2023, time=2023-05-30, status=1, ipAttribution=上海)]
    2023-05-30 1013100771 来自山东省

    谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2140687, encodeId=162b214068e58, content=学习了🤓, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230602/e3141025c69e4ee285ec115657f7bd83/b61b1b078aef4546a3a13cfa8ff58fce.jpg, createdBy=d44d8733557, createdName=醫, createdTime=Sat Jun 03 22:53:37 CST 2023, time=2023-06-03, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2140023, encodeId=680921400237d, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Wed May 31 06:20:27 CST 2023, time=2023-05-31, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2140022, encodeId=7efe214002267, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf358692482, createdName=Epiphanies, createdTime=Wed May 31 06:17:13 CST 2023, time=2023-05-31, status=1, ipAttribution=河南省), GetPortalCommentsPageByObjectIdResponse(id=2139989, encodeId=17f7213998988, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d114843943, createdName=1013100771, createdTime=Tue May 30 22:40:32 CST 2023, time=2023-05-30, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2139986, encodeId=362c213998626, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue May 30 22:28:42 CST 2023, time=2023-05-30, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2139977, encodeId=374421399e781, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Tue May 30 21:34:36 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139949, encodeId=7e63213994986, content=奥司他韦可以预防流感, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65724176436, createdName=13d0179fm99暂无昵称, createdTime=Tue May 30 19:33:40 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139947, encodeId=a926213994e56, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Tue May 30 19:30:43 CST 2023, time=2023-05-30, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2139945, encodeId=c01b2139945c2, content=<a href='/topic/show?id=f6ce106300b3' target=_blank style='color:#2F92EE;'>#普通人逆袭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=106300, encryptionId=f6ce106300b3, topicName=普通人逆袭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3ede8538692, createdName=梅斯话题小助手, createdTime=Tue May 30 19:15:09 CST 2023, time=2023-05-30, status=1, ipAttribution=上海)]
    2023-05-30 1209e435m98(暂无昵称) 来自浙江省

    学习了,谢谢分享

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2140687, encodeId=162b214068e58, content=学习了🤓, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20230602/e3141025c69e4ee285ec115657f7bd83/b61b1b078aef4546a3a13cfa8ff58fce.jpg, createdBy=d44d8733557, createdName=醫, createdTime=Sat Jun 03 22:53:37 CST 2023, time=2023-06-03, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2140023, encodeId=680921400237d, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Wed May 31 06:20:27 CST 2023, time=2023-05-31, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2140022, encodeId=7efe214002267, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf358692482, createdName=Epiphanies, createdTime=Wed May 31 06:17:13 CST 2023, time=2023-05-31, status=1, ipAttribution=河南省), GetPortalCommentsPageByObjectIdResponse(id=2139989, encodeId=17f7213998988, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2d114843943, createdName=1013100771, createdTime=Tue May 30 22:40:32 CST 2023, time=2023-05-30, status=1, ipAttribution=山东省), GetPortalCommentsPageByObjectIdResponse(id=2139986, encodeId=362c213998626, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue May 30 22:28:42 CST 2023, time=2023-05-30, status=1, ipAttribution=浙江省), GetPortalCommentsPageByObjectIdResponse(id=2139977, encodeId=374421399e781, content=认真学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Tue May 30 21:34:36 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139949, encodeId=7e63213994986, content=奥司他韦可以预防流感, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65724176436, createdName=13d0179fm99暂无昵称, createdTime=Tue May 30 19:33:40 CST 2023, time=2023-05-30, status=1, ipAttribution=山西省), GetPortalCommentsPageByObjectIdResponse(id=2139947, encodeId=a926213994e56, content=不错,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=仁术2023, createdTime=Tue May 30 19:30:43 CST 2023, time=2023-05-30, status=1, ipAttribution=吉林省), GetPortalCommentsPageByObjectIdResponse(id=2139945, encodeId=c01b2139945c2, content=<a href='/topic/show?id=f6ce106300b3' target=_blank style='color:#2F92EE;'>#普通人逆袭#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=106300, encryptionId=f6ce106300b3, topicName=普通人逆袭)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3ede8538692, createdName=梅斯话题小助手, createdTime=Tue May 30 19:15:09 CST 2023, time=2023-05-30, status=1, ipAttribution=上海)]
    2023-05-30 医鸣惊人 来自山西省

    认真学习了

    0

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    2023-05-30 13d0179fm99暂无昵称 来自山西省

    奥司他韦可以预防流感

    0

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    2023-05-30 仁术2023 来自吉林省

    不错,学习了。

    0

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    2023-05-30 梅斯话题小助手 来自上海

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研究认为,对于初级保健中的疑似流感人群,在常规护理的基础上,服用奥司他韦可使患者提前1天恢复,而对于年龄较大、病情较重、症状持续时间较长的患者则可提前2-3天

近期发烧、乏力可能是甲流,“特效药”奥司他韦,你用对了吗?

流行性感冒(以下简称:流感)是由流感病毒引起的急性呼吸道疾病,属于丙类传染病。主要临床表现为高热、乏力、头痛、咳嗽、全身肌肉酸痛等。

JAMA子刊:2007-2020年因“流感”住院的儿童使用奥司他韦的趋势和相关影响因素

在这一针对因流感住院儿童的横断面研究中,奥司他韦的使用随着时间的推移而增加,特别是在高危情况的患者中,但存在很大的机构差异。

热销的奥司他韦为何能治疗甲流?

甲型流感态势凶猛,虽然与普通感冒一样也是自限性疾病,但与普通感冒相比病程长,不适感更强,也会有更多的人选择吃药,奥司他韦(Oseltamivir)就是在这个时候被大家更多的关注的。

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单剂量巴洛沙韦在改善高危门诊患者的流感症状方面具有优于安慰剂的疗效,与奥司他韦的疗效相当。巴洛沙韦的安全性和安慰剂的不相上下。

流感又双来了!关于流感你需要知道这些

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