2023-09-11 14:53
下面這張是 WMS 2019 指引的表格 (Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update.PDF)
丹木斯用於兒童的預防劑量和治療劑量都是每次每公斤 2.5mg.
美國FDA對於兒童的定義: 21歲以下都可以算pediatric.
Pediatric subpopulations are further categorized as follows: Neonates - from birth through the first 28 days of life. Infants - 29 days to less than 2 years. Children - 2 years to less than 12 years. Adolescents - aged 12 through 21 (up to but not including the 22nd birthday)
2023-03-12 12:03AM 高海拔旅行和高海拔疾病2024CDC Yellow Book
預防及治療高海拔疾病使用藥物建議丹木斯 Acetazolamide, 如果體重超過 100 公斤, 可考慮將劑量加倍
兒童劑量. 每次每公斤 2.5mg. 12小時吃一次.
預防 AMS, HACE prevention= Oral 125 mg twice a day; 250 mg twice a day if >100 kg.
Pediatrics: 2.5 mg/kg every 12 h
AMS treatment1 Oral 250 mg twice a day. Pediatrics: 2.5 mg/kg every 12 h
至於兒童的定義(from wiki). 英國建議 18歲以下都看兒科. 美國建議 21歲以下都看兒科, 也有些國家建議 25歲前都看兒科.
Table 3-06. Recommended medication dosing to prevent and treat altitude illness
關於HAPE的用藥
Nifedipine 可用於預防HAPE及治療 HAPE.
威而鋼 tadalafil 及 犀利士 sildenafil 目前的醫學研究還不夠多. 僅列為預防性藥物.
沒列入治療選項. 但表格下面還有一段話, 裡面說犀利士也可用於治療 HAPE.
另外. 止痛退燒藥物 ibuprofen 600mg, 每八小時吃一次. 預防AMS效果不會比丹木斯差.
但要注意. 台灣的 ibuprofen 通常是每顆 400mg. 要吃 1.5 顆才會達到研究建議的劑量.
OTHER MEDICATIONS
Phosphodiesterase-5 inhibitors can also selectively lower pulmonary artery pressure, with less effect on systemic blood pressure. Tadalafil, 10 mg twice a day during ascent, can prevent HAPE; it may also have use as a treatment. Gingko biloba, 100–120 mg taken twice a day before ascent, reduced AMS in adults in some trials. It was not effective in other trials, though, possibly due to variation in ingredients (see Chapter 2, Complementary and Integrative Health Approaches). Recent studies have shown ibuprofen 600 mg every 8 hours to be noninferior to acetazolamide in preventing AMS, although ibuprofen does not improve acclimatization or reduce periodic breathing. It is, however, over-the-counter, inexpensive, and well tolerated.
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