Antipyretic

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Coated 200 mg ibuprofen tablets, a commonly used antipyretic

Antipyretics /ænti.paɪˈrɛ.tɪks/; an-tee-pahy-ret-iks; from the Greek anti, against, and pyreticus, pertaining to fever, are drugs or herbs that reduce fever.[1] Antipyretics cause the hypothalamus to override an interleukin-induced increase in temperature. The body then works to lower the temperature, resulting in a reduction in fever.

Most antipyretic medications have other purposes. The most common antipyretics in the United States are ibuprofen and aspirin, which are used primarily as pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDs) are antipyretic, anti-inflammatory, and pain relievers.

There is some debate over the appropriate use of such medications, as fever is part of the body's immune response to infection.[2][3] A study published by the Royal Society claims fever suppression causes at least 1% more influenza cases, resulting in at least 700 extra deaths per year in the United States alone.[4]

Non-pharmacological treatment[edit]

Bathing or sponging with lukewarm or cool water can effectively reduce body temperature in those with heat illness but not usually in those with fever.[5] The use of alcohol baths is not an appropriate cooling method, because there have been reported adverse events associated with systemic absorption of alcohol.[6]

Medications[edit]

Many medications have antipyretic effects and thus are useful for fever but not heat illness, including:

Plants[edit]

Traditional use of higher plants with antipyretic properties is a common worldwide feature of many ethnobotanical cultural systems. In ethnobotany, plants with naturally occurring antipyretic properties are commonly referred to as febrifuges.[7][8]

In children[edit]

The effectiveness of acetaminophen alone as an antipyretic in children is uncertain, with some evidence showing it is no better than physical methods.[9] Therapies involving alternating doses of acetaminophen and ibuprofen have shown greater antipyretic effect than either drug alone.[10] One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone.[11] The decreased use of Aspirin with the converse increased use of Acetaminophen/Paracetamol has been linked to the increase in asthma and other autoimmune disorders by several studies. Physicians recommending Acetaminophen/Paracetamol should use caution and be especially attentive to any genetic or environmental predisposition to asthma or other autoimmune disorders.[12]

References[edit]

  1. ^ "Definition of antipyretic". Merriam-Webster Online Dictionary. Retrieved 2007-12-19. 
  2. ^ "Mayo Clinic". 
  3. ^ "Medline Plus". 
  4. ^ Kupferschmidt, Kai (2014-01-21). "Fight the Flu, Hurt Society?". ScienceNow. 
  5. ^ "UpToDate Inc". 
  6. ^ Sullivan, J. E.; Committee On, H. C.; Sullivan, J. E.; Farrar, H. C. (2011). "Fever and Antipyretic Use in Children". Pediatrics 127 (3): 580–587. doi:10.1542/peds.2010-3852. PMID 21357332.  edit
  7. ^ Schultes, R.E.; Raffauf, R.F. De Plantis Toxicariis e Mundo Novo Tropicale Commentationes. XXXIX. Febrifuges of northwest Amazonia. Harvard Papers in Botany Vol. 5, pp. 52-68. 1994.
  8. ^ Biren N. Shah and Avinash K. Seth Medicinal Plants as a Source of Anti-Pyretic Agents – A Review http://scholarsresearchlibrary.com/aasr-vol2-iss3/AASR-2010-2-3-188-195.pdf
  9. ^ Meremikwu M, Oyo-Ita A (2002). "Paracetamol for treating fever in children". In Meremikwu, Martin M. Cochrane Database Syst Rev (2): CD003676. doi:10.1002/14651858.CD003676. PMID 12076499. "Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive." 
  10. ^ E. Michael Sarrell, MD; Eliahu Wielunsky, MD; Herman Avner Cohen, MD (2006). "Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study". Archives of Pediatrics & Adolescent Medicine 160 (2): 197–202. doi:10.1001/archpedi.160.2.197. PMID 16461878. Retrieved 2010-09-25. 
  11. ^ Kauffman, Ralph; Sawyer, L.A., Scheinbaum, M.L. (1992). "Antipyretic Efficacy of Ibuprofen vs Acetaminophen". Am J Dis Child. 146 (5): 622–625. 
  12. ^ Varner, A. E.; Busse, W. W.; Lemanske, R. F. (1998). "Hypothesis: Decreased Use of Pediatric Aspirin Has Contributed to the Increasing Prevalence of Childhood Asthma". Annals of Allergy, Asthma & Immunology 81 (4): 347–351. doi:10.1016/S1081-1206(10)63127-4. PMID 9809499.  edit