Remedies for fever - Causes, symptoms and treatment. MF.

Causes of body temperature increase

Increase in body temperature( fever) is a physiological reaction of the body, which is protective-adaptive in nature. Why does she protect? As is known, the most frequent causes of fever are the causative agents of infectious diseases - bacteria and viruses. They become the starting factors for the formation in white blood cells( leukocytes) of special substances called endogenous pyrogens. Endogenous pyrogens, in turn, act on the thermoregulatory center in a special section of the brain - the hypothalamus, which by means of complex neuroendocrine mechanisms leads to an increase in temperature. The increased temperature has a harmful effect on bacteria and viruses, it increases the immune reactivity of the organism, depresses the reproduction of microbes and speeds up the process of recovery. That is, if you have fever with an infectious disease - this is a sign of an active struggle of your body with an infection.

Rules for reducing the elevated temperature

From the above, it follows that the elevated temperature should not be knocked down often. After all, taking antipyretics does not cure the disease, does not shorten it, but only removes its heavily tolerated symptom and facilitates the condition. Here are the temperatures at which you can take antipyretics:
For adults - 38.5 and above.
For children, pregnant women, people with chronic diseases of the cardiovascular, respiratory and nervous systems and with severe general discomfort - starting at 38.
If after taking the antipyretic agent, the temperature has dropped to normal or close to normal, you do not need to take a seconddose of the drug until the moment it does not rise again.

How do antipyretic drugs work?

All antipyretic agents belong to the groups of non-steroidal anti-inflammatory drugs and analgesics-antipyretics( paracetamol).They have antipyretic, analgesic and anti-inflammatory effects to varying degrees. As you remember, endogenous pyrogenes respond to the temperature increase. So they launch the formation of a physiologically active substance - prostaglandin E, which, in fact, is one of the main "culprits" of fever, it "tunes" the hypothalamus to increase the temperature. Antipyretics stop this process, inhibiting the formation of prostaglandin E, and the temperature goes down within an hour and a half.

Which medicine for temperature to choose?

First of all, the drug must meet the requirements of safety and efficacy. Among these medicines the temperature recommended by WHO, there are only two: paracetamol and ibuprofen. Children should only use them. For adults, other options are possible.

Paracetamol( acetaminophen) .The drug is the first choice in children.
Tablets: 500 mg, 200 mg.
Caulpol suspension 100 ml.
Panadol for children - syrup, suspension 120 mg / 5ml 100ml, suppositories 125 mg.
Panadol extra - tab.soluble.
Efferlangan - suppositories 80 mg, 150 mg, 300 mg, effervescent tablets 500 mg, syrup for children 3 g / 100 ml 90 ml.
Daily intake for adults and children over 12 years old - 4 years.
Take 0.5-1 g at intervals of 4-6 hours. Do not drink alcohol during the intake.
Dosages for children are prescribed based on the weight of the child - a single dose of 15 mg / kg.
A single dose can be given up to 4 times a day in the form of a syrup, suspension, suppositories. Liquid forms of paracetamol can be added to infant formulas or juices. The antipyretic effect develops within 30-60 minutes and lasts 4-6 hours. In the form of candles, the action comes later - in 2-3 hours. It is possible to combine various forms of the drug - for a faster reduction in temperature - a syrup or suspension, then - in the form of candles( after 2-3 hours).
No effect, unlike NSAIDs on the coagulation system, does not irritate the gastrointestinal tract.

Contraindications: renal and hepatic insufficiency, individual intolerance. The main side effect is an adverse effect on the liver( when the recommended doses are exceeded).

Ibuprofen
Tablets 200 mg.
Burana tablets 200 mg, 400 mg.
Migram tablets 400 mg.
Nurofen tablets 200 mg, suspension for children 100 ml, suppositories for children 60 mg.
Nurofen Ultra Capsules 200 mg.
Nurofen Forte Tablets 400 mg.
A single dose for children - 10 mg / kg, can be given no more than 3 times a day.
Adults and children over 12 years of age - 200 mg 3-4 times a day. The maximum daily dose is 1200 mg.
The drug of the second choice, in comparison with paracetamol, has a greater frequency of side effects and a more pronounced analgesic effect, which is why it is preferable in the presence of pain syndrome.

Contraindications: see aspirin.

Special instructions:
Simultaneous or consistent use of paracetamol and ibuprofen in children is not recommended. Ibuprofen should not be used in children with chicken pox( because of the risk of developing streptococcal fasciitis), dehydration.

Other drugs to reduce temperature

Acetylsalicylic acid( aspirin)

It is forbidden for viral infections in children under 12 due to the possible development of Reye's syndrome( toxic damage to the brain and liver), the heaviest condition with a mortality rate above 50%.For the same reason, you can not use candles Cefekon and Cefekon M( contain salicylamide).
Should not be used with proven influenza, increases the risk of bleeding due to increased vascular permeability in this disease.
Application as an antipyretic agent is limited due to the large number of side effects and contraindications associated with irritating effects on the gastrointestinal mucosa and the effect on the blood coagulation system.
It can not be used for peptic ulcer of stomach and duodenum, erosive gastritis, esophagitis and colitis, hypersensitivity to salicylates, hemophilia, hepatic and renal insufficiency, hemorrhagic conditions, "aspirin triad", portal hypertension, during pregnancy and lactation.
Admission: Adults-0.5-3 g per day, divided into 3 doses, after meals.

Analgin( metamizole sodium)

It is forbidden in many countries because of the toxic effect on the hematopoiesis, in children can cause an excessive decrease in temperature( up to 34,5-35).In an extreme case, with the inaccessibility of other, safer drugs, reception is possible in children, but not more than 1-2 tablets and not more than a day.
Adults - 250-500 mg 2-3 times a day, the maximum single dose is 1 g, daily - 3 g.

Nimesulide( nimesil, nise, nimulide, nimica)
Tablets 50 mg, 100 mg.
Contraindicated in children under 12 years of age due to toxic effects on the liver. In adults it can be used as a preparation with a pronounced and quick antipyretic effect with ineffectiveness of other drugs.
Adults - 1 tab.2 times a day, the maximum daily dose is 400 mg.
Children from 12 to 18 years - 50 mg 2 times a day, with a body weight of more than 40 kg - 100 mg 2 times a day.
Contraindications are similar to aspirin, but nimesulide has a less pronounced adverse effect on the gastrointestinal tract and the blood coagulation system.

Antipyretic drugs in combination preparations.

All well-known "cold symptoms" contain paracetamol in various dosages. Of course, it is very convenient, taking one tablet or a packet of such a drug, immediately kill a few rabbits - and reduce the temperature and ease the remaining symptoms of a cold. But here there are limitations. This is especially important in the treatment of children. Taking such a drug, the body receives several pharmacological substances at once, which must be broken down, digested and removed from the body, and with them also various flavors, dyes and preservatives. Moreover, each active substance has its own side effects and the potential risk of allergic reactions. If the main symptom that worries you is fever, it is better to take monocomponent antipyretic drugs and not combine them with combined remedies.

Antipyretics for pregnancy

When pregnant at any time, paracetamol is safe. In spite of the fact that it penetrates into breast milk, it does not have a negative effect on the child, at the recommended daily dosage.

What can not be done with a high fever.

1. You can not warmly dress and wrap yourself in thick blankets. The blanket should be lightweight, made of cotton fabric. Allow the body to give excess heat through the skin.
2. Avoid drafts, but do not create excessively warm and humid air in the room, this also hinders the cooling of the body.
3. Do not drink hot and temperature-raising drinks( tea with raspberries, alcohol, coffee, hot milk with honey) and do not perform warming procedures( hot bath, mustard, steam inhalations, warmers, etc.).
4. Do not use sweet drinks and juices to drink, it is better that it is slightly sweetened cranberry or cowberry mors, mineral water.
5. Do not wipe off alcohol or alcohol-containing liquids in order to lower the temperature. It is strictly forbidden to do this to children.

Non-pharmacological methods to reduce elevated temperature.

It's best to start with them before resorting to taking medication.
Wet cotton towels in cold water, lightly squeeze and apply to the passage of the main arteries: on the forehead, neck, axillary cavities, inguinal region, wrist area.
Wipe the body with a cloth dampened in room temperature water, successively drying.
You can put your feet in cold water, wash your face, upper body with cold water.
Collect a bath of slightly warm water and immerse in it for 20 minutes, after which it should be wiped dry.

The positive effect of taking antipyretic drugs very often induces patients to unreasonably prolonged reception. But antipyretic drugs are unacceptable to take more than 3 days without consulting a doctor, the concept of "treatment" is inappropriate here. It is possible that you have a banal viral infection, in which fever may last longer than this period, but you should not forget about other diseases that have a more serious prognosis, because when you take antipyretic drugs, the clinical picture is distorted, visible well-being is created, andthe doctor can find it difficult to identify the cause of the fever and assess the severity of the condition. This also applies to patients receiving antibiotic treatment, since their effect is assessed, among other things, by reducing the temperature response. If the doctor has prescribed an antibiotic, antipyretic drugs should be abolished.

Physician Therapist SE