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=35, 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=37, 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=32, 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=53, 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=35, 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=41, 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=37, 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=37, 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=29, 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=35, 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=37, 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=32, 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=53, 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=35, 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=41, 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=37, 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=37, 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=29, 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=35, 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=37, 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=32, 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=53, 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=35, 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=41, 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=37, 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=37, 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=29, 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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