高山症用藥全解：先講最重要的——階梯式上升與「症狀來了就下撤」才是根本，藥物只是補充。接著拆三大藥：acetazolamide（預防 125mg、副作用、磺胺過敏其實多數可用）、dexamethasone（壓症狀不促適應、HACE 8mg→4mg q6h、5-7 天內不需減量）、HAPE 用藥（nifedipine 30mg ER、tadalafil；acetazolamide 不預防 HAPE），以及誰需要預防、孕婦/兒童/G6PD 等特殊族群與撤退時機。

⚠️ 本集由 AI 多來源研究＋對抗式查核（含 WMS 2024 指引全文逐字校對）後、以對談形式製作，為衛教資訊、不構成個別醫療建議；實際用藥與劑量請依最新指引並諮詢醫師。引用來源：

• WMS 2019 臨床指引 — Luks AM et al. Wilderness Environ Med. 2019;30(4S):S3-S18. PMID 31248818
• WMS 2024 Update — Luks AM et al. Wilderness Environ Med. 2024;35(1_suppl):2S-19S. PMID 37833187（全文付費牆，部分經 PMC11855094 appraisal 確認）
• Burtscher J et al. Mil Med Res. 2025;12:48. doi:10.1186/s40779-025-00634-y（PMC12337374，narrative review）
• CDC Yellow Book 2026 — High-Altitude Travel and Altitude Illness（含 Table 3.5.2 兒童劑量）
• Strom BL et al. N Engl J Med. 2003;349:1628-35. PMID 14573734（磺胺交叉過敏 N=969）
• Low EV et al. BMJ 2012. PMID 23081689（meta-analysis，acetazolamide 250 mg/day NNT=6, 95% CI 5-11）
• Basnyat B et al. High Alt Med Biol. 2006;7(1):17-27. PMID 16544963（PACE trial，125 vs 375 mg BD）
• Berger MM et al. J Appl Physiol. 2022. PMID 35511718（acetazolamide 不預防 HAPE，N=13，43% vs 67%，P=0.39）
• Giamello G et al. 2024 acetazolamide review（PMC11672352，禁忌列表）
• Maggiorini M et al. Ann Intern Med. 2006;145:497. PMID 17015867（tadalafil/dexamethasone 預防 HAPE）
• George CE et al. 2025 HAPE 預防 RCT. PMID 39872192（nifedipine 30 mg SR BD 零 HAPE）
• Bates MGD et al. High Alt Med Biol. 2011;12:207. PMID 21962063（sildenafil 50 mg TID）
• Webb DJ et al. Am J Cardiol. 1999;83:21C. PMID 10078539（sildenafil + nitrate 血壓）
• Kloner RA. Am J Cardiol. 1999;84:11N. PMID 10503571（sildenafil + nitrate 絕對禁忌）
• Oelz O, Bartsch P et al. Int J Sports Med. 1992. PMID 1483797（nifedipine 20 mg ER q8h）
• Müller J et al. Front Cardiovasc Med. 2023（PMC10326614，Fontan fitness-to-fly）
• Sandoval（PMID 35405103，2640m 手術存活）；Johnson（PMID 23414794，長期高海拔 Fontan 存活）
• WMS 2024 guidelines appraisal（PMC11855094）
• 高地醫學 reviews：PMC6819752、PMC10332563、PMC12832471
• altitude.org、NHS、TravelHealthPro、Princeton University OA safety guide、LITFL、StatPearls、MedlinePlus（公開二級來源，核對共識性原則）
• AAAAI Ask the Expert（2017 & 2019，磺胺過敏共識）
• 英國 Diamox SmPC（emc product 15349，禁忌列表）
• Stienlauf 2014、Kelly & Hackett 2010（G6PD 爭議文獻）
• MEMORY feedback_cyanotic_chd_diamox_no_evidence.md

美伊關係現況——三個月戰爭後的停火草案。從近期戰爭時間線、核問題與制裁、荷莫茲海峽與全球油價，到最新的外交談判草案，一次講清楚。

⚠️ 本集內容由 AI 多來源研究＋對抗式查核後、以 AI 對談形式製作，僅供參考、不構成專業建議。引用來源（31 筆）如下，歡迎自行查證：

• [2026-05-28] Iran peace deal hinges on Trump approval (MOU draft) — link
• [2026-05-29] Trump's 'room to maneuver' narrows as US-Iran close in on framework deal — link
• [2025-06-14] Iran says nuclear talks with US meaningless as Trump pushes for a deal (6th round cancelled) — link
• [2025-09-27] Impending deadline for UN action on Iran: what the snapback of Iran sanctions could mean — link
• [2026-02-15] 2025–2026 Iranian protests (cross-check) — link
• [2026-05-26] 2026 Iran war (Operation Epic Fury, casualties, blockade, oil) — link
• [2026-04-28] 2026 Minab school attack — link
• [2026-03] Mojtaba Khamenei chosen as successor — link
• [2026-05-04] US intelligence indicates limited new damage to Iran's nuclear program — link
• [2026-03] Grossi: reconstruction 'very possible', you cannot unlearn what you've learned — link
• [2026-05-22] Iran's enriched uranium stockpile: can it be safely transferred? — link
• [2026-05-21] Supreme leader says enriched uranium must stay in Iran — link
• [2026-05-18] Pakistan's mediation faces limits as Iran-US tensions deepen — link
• [2026-02-25] US issues new sanctions as it dials up pressure on Iran (12 vessels) — link
• [2026-05-28] US imposes sanctions on Iranian agency controlling Strait of Hormuz shipping — link
• [2026-05-26] US naval blockade: 108 vessels redirected (CENTCOM) — link
• [2026] Strait of Hormuz closure risks greatest global energy supply shock in decades — link
• [2026-04-13] Von der Leyen statement: EUR 22bn higher fossil fuel bill in 44 days — link
• [2026-05-07] Strait of Hormuz crisis: fertilizer scarcity will affect next harvests (FAO) — link
• [2026-05-22] Congressional report tallies 42 US aircraft lost or damaged in Operation Epic Fury — link
• [2026-03-29] Houthi missile attack on Israel raises Red Sea shipping concerns — link
• [2026-05-26] Israel expands ground operation in south Lebanon; cumulative toll — link
• [2026-05-19] Soufan Center IntelBrief (Kataib Hezbollah commander arrest) — link
• [2026-02-26] 2025–2026 Iran–United States negotiations (Oman/Geneva mediation) — link
• [2026-04-11] US-Iran talks set to begin in Islamabad (Vance-Ghalibaf, 21 hours) — link
• [2026-05-28] GOP lawmakers pressure Trump on Iran (Graham, Wicker) — link
• [2026-05-27] Why a US-Iran deal no longer matters (MOU vs JCPOA, Farsi) — link
• [2026-05-24] Iran International: US obstructing asset unfreezing; $12bn Qatar precondition — link
• [2026-04-09] Iran war ceasefire: Tehran crowds wave flags, state media calls it victory — link
• [2026-05-28] Kalshi: US-Iran nuclear deal prediction market — link
• [2026-03-25] How Trump's Iran war objectives have shifted over time — link