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流感季节来临，药店里琳琅满目的感冒药让人眼花缭乱。你是否知道，普通感冒药对真正的流感病毒几乎无效？今天，我们深入解析两款流感“特效药”——奥司他韦与玛巴洛沙韦，并理清它们与普通感冒药的根本区别。 认识真正的抗流感病毒药 处方专属武器 奥司他韦 作用机制 神经氨酸酶抑制剂，阻止病毒在体内传播 用药特点 · 需在症状出现48小时内开始服用 · 每日两次，连续5天，即使症状好转也需完成疗程 · 有胶囊和颗粒剂型，适合不同年龄段患者 适用人群 成人和1岁以上儿童均可使用 注意事项 常见副作用包括恶心、呕吐，与食物同服可减轻 玛巴洛沙韦 作用机制 cap依赖型核酸内切酶抑制剂，阻断病毒复制 革命性优势 · 单次服药即可完成疗程，极大提升依从性 · 起效更快，24小时内症状明显缓解 · 作用在病毒复制更早期阶段 适用人群 目前适用于5岁以上流感患者 注意事项 避免与乳制品、钙强化饮料同服，可能影响药效 关键对比 如何选择 奥司他韦 玛巴洛沙韦 5天，每日2次 单次服药 起效较快 起效更快 适用1岁以上 适用5岁以上 价格相对较低 价格相对较高 它们不是“万能感冒药” 重要提醒 仅对流感有效 这两种药针对流感病毒，对普通感冒病毒、细菌感染无效 处方药严格管理 必须在医生指导下使用，不可自行购买 时机至关重要 越早使用效果越好，超过48小时效果大打折扣 不能替代疫苗 治疗药物≠预防药物，接种疫苗仍是首要防护手段 普通感冒药 缓解症状 不抗病毒 药店常见的感冒药主要分为以下几类，它们只能缓解症状，不能抑制流感病毒： 解热镇痛类 对乙酰氨基酚、布洛芬——针对发热、头痛、肌肉酸痛 鼻塞缓解类 伪麻黄碱——收缩血管减轻鼻塞 抗组胺类 氯苯那敏、苯海拉明——缓解流涕、打喷嚏 止咳祛痰类 右美沙芬、愈创甘油醚——针对咳嗽症状 复方感冒药 上述成分的多种组合（如酚麻美敏、氨酚伪麻美芬等） 危险警示： · 避免同时服用多种含相同成分的感冒药（如同时对乙酰氨基酚过量导致肝损伤） · 儿童用药需特别谨慎，按体重计算剂量 · 某些成分可能影响血压、前列腺或青光眼 科学认知 避免三大误区 ！！！！ 误区一：“流感特效药可以预防流感” 事实：奥司他韦仅在特定情况下用于暴露后预防，且需医生评估，不能作为常规预防手段 误区二：“症状好转就可以停药” 事实：奥司他韦必须完成5天疗程，否则易导致病毒反弹或产生耐药性 误区三：“抗病毒药可以替代所有治疗” 事实：重症流感仍需综合治疗，包括支持治疗、并发症处理等 前沿展望 ！！！！ 流感抗病毒药物研发正朝着“更长治疗窗口、更少耐药性、更方便服用”的方向发展。目前全球多项相关临床研究正在进行中，探索新型作用机制的药物和联合治疗方案。这些研究不仅为患者提供更多治疗选择，也推动着整个医学界对流感的更深入理解。 声明：文中涉及的信息仅供参考，请遵从医生或其他医疗卫生专业人士的意见或指导，所发内容仅供科普宣传，目的在于分享信息。 临/床/招/募 全国多家三甲医院正在开展多项针对肿瘤、慢病的临床研究，如果您想了解更多临床研究信息，您可以拨打热线咨询：400-860-8711，或点击“阅读原文”报名~

Some widely used over-the-counter cold and flu medicines may be exposing patients to unexpectedly high amounts of one ingredient, revealing a lapse in regulations and perhaps raising safety concerns, a company that develops such drugs reported on Wednesday. The company, AFT Pharmaceuticals of New Zealand, said that when the nasal decongestant phenylephrine, or PE, was combined with the pain reliever acetaminophen, levels of PE in the blood were two to four times as high as when the same dose of PE was taken alone. “Effectively, accidentally you are getting a higher dose here,” said Hartley C. Atkinson, chief executive for AFT. He and colleagues reported their finding in a brief correspondence published on Wednesday online in The New England Journal of Medicine website. The letter said the combination increased exposure to PE “beyond levels that were previously deemed to be safe and effective.” Drugs that combine PE and acetaminophen, which is the active ingredient in Tylenol, are common and include certain versions of Robitussin, Theraflu, Mucinex, DayQuil, Tylenol Cold and Flu and other brands. AFT sells a combination product in some markets outside of the United States. The potential adverse side effects from a high dose of PE could include higher blood pressure, elevated heart rate and nervousness. The Food and Drug Administration said it was aware of the finding but suggested it was not a safety concern. It said in a statement that PE was generally recognized as safe, including in combination with acetaminophen. The Consumer Healthcare Products Association, which is based in Washington and represents over-the-counter drug manufacturers, also dismissed any concerns, saying PE had been used safely for decades. Ron Eccles, director of the common cold center at Cardiff University in Britain, who was not involved in the study, said that while he did not think there were serious risks, “Regulatory authorities need to address this issue quickly to reassure the public that these freely available medicines are safe.” Still, the F.D.A. declined several years ago to increase the permitted dose of PE to 25 milligrams from 10 milligrams. Dr. Atkinson of ATF said that 10 milligrams of PE taken in combination with acetaminophen leads to blood levels similar to what would come from taking 25 milligrams of PE by itself. The Consumer Healthcare Products Association, in a 2007 document arguing against the dose increase, said that studies had found that the 25- milligram dose was more frequently associated with increased pulse rate and nervousness than the lower dose. An F.D.A. review concluded, however, that past studies “suggest only negligible effects” at either dose. The use of PE as a nasal decongestant increased markedly several years ago after access to another decongestant, pseudoephedrine, was restricted because it was being used to make methamphetamines. Some experts said the finding of the unexpected interaction of acetaminophen and PE showed that over-the-counter drugs need to be tested more thoroughly before being allowed on the market. “There’s a major public policy issue with respect to how over-the- counter products are regulated,” said Dr. Joshua Sharfstein, secretary of health and mental hygiene in Maryland and a former principal deputy commissioner of the F.D.A. Dr. Sharfstein was involved in 2007 in an effort to prohibit the use of certain cold medicines by infants and young children. Dr. Atkinson said his company discovered this effect in the course of developing a combination of PE, acetaminophen and ibuprofen. It found that levels of PE in the blood of people who took this combination were much higher than expected. Further testing showed that the effect was because of the acetaminophen, not the ibuprofen. He said it appeared that acetaminophen interfered with the breakdown of PE, allowing higher levels to build up in the blood. Still, the data for blood levels of PE shown in The New England Journal of Medicine website was for the triple combination. In its statement, the F.D.A. suggested the finding was irrelevant because the triple combination was not permitted to be sold in the United States. AFT is developing a combination product with half the usual dose of PE. It would benefit commercially if it could establish that the existing dose used in rival products raises safety issues. There is also controversy over whether PE is even effective. Leslie Hendeles, a professor of pharmacy and pediatrics at the University of Florida, said PE had only a minor effect at the dose used. Rather than raising safety concerns, he said, the finding that the effective dose of PE is increased in the combination medicines “would actually render what is an ineffective compound effective.” Source: New York Times, Andrew Pollack, 19 March 2014