退烧药选择要小心

发布者:Artepharm 发布时间:2017-03-01浏览量:849 字体大小:【】【】【

    小儿退烧药的合理选择一直是儿科医生研究的重要课题。记者从不久前召开的国际儿科大会上了解到,目前临床应用的小儿退烧药主要有阿司匹林、安乃近、对乙酰氨基酚、布洛芬和其他一些非甾体抗炎药。它们均有一定的不良反应。在会上,各国医师对如何正确而合理地用药进行了广泛的交流,记者将交流中关于药品不良反应部分整理如下,以期引起使用者注意。
  
    阿司匹林:“头痛感冒发烧,阿司匹林一包。”不了解药品可能带来的不良反应,按这句顺口溜为小儿用药,就可能会出问题。自20世纪70年代引起用药儿童出现瑞氏综合征后,医生们对这一老牌药物的用药安全更加注意了。1975~1985年,瑞氏综合征在北美高发,1980年达到了高峰,其致死率约为30%。因此从1986年起,在所有儿童用阿司匹林的包装上已提出警告。该综合征的主要表现有肝功能损害、黄疸、中枢神经系统症状和肾损害。据悉,此综合征在我国并不多见。此外,阿司匹林还会引起胃肠道刺激、延长出血时间、过敏反应等。在过敏反应中,以哮喘较为常见。

  安乃近:由于其明显的不良反应,这些年安乃近用得少了。1977年该药已从美国市场上撤出,目前,27个国家已禁用或限用安乃近。

  对乙酰氨基酚:该药有明显的剂量依赖性,即随剂量上升而疗效上升。过量应用此药会引起肝脏损害。对乙酰氨基酚没有其他解热镇痛药常见的胃肠道反应、血小板功能影响、粒细胞减少等,也无肾毒性,故安全性高,目前在全球广泛使用。

  布洛芬:该药也是较为安全的药物,对胃肠刺激和血小板影响不大。但在脱水、血容量低和心输出量低的状态下偶见可逆的肾损伤。过量服用可能有中枢神经系统抑制、癫痫发作等。

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