Products
Antipyretics are available in numerous dosage forms. These include, for example, tablets, effervescent tablets, suppositories, juices, and chewable tablets. The name is derived from the technical term pyrexia (fever). The first synthetic agents, such as acetanilide, salicylic acid, and acetylsalicylic acid, were developed in the 19th century.
Structure and properties
Antipyretics do not have a uniform chemical structure. However, groups can be formed within the class (see below).
Effects
Antipyretics have antipyretic (antipyretic) properties. The active ingredients are usually additionally analgesic and some are also anti-inflammatory, which is a key contributor to the effects of the drugs. The effects of antipyretics are based on peripheral inhibition of pyrogenic mediators. Centrally, they inhibit the formation of prostaglandin E2, which is involved in the development of fever. Fever is a physiological, normal and benign response of the body, which often occurs in infectious diseases. Therefore, a mild fever does not need to be treated with medication. Whether fever reduction negatively affects the course of the disease is controversial in the literature. Corresponding cases have been described. Febrile convulsions cannot be prevented by the administration of antipyretics. By the way, fever is not the same as hyperthermia, which can be caused by strong solar radiation. Fever reduction is recommended only at high temperatures, about 38.5 to 39°C and above. Some authors consider it unnecessary even then. The administration of antipyretics can lead to a significant alleviation of the feeling of illness, which is probably mainly due to the additional effects of the agents (see above). Therapy of fever is primarily symptomatic. For example, antibiotics may be indicated for a bacterial infection.
Indications
For symptomatic treatment of fever.
Dosage
According to the professional information. Most drugs must be administered several times daily because of their short half-life. Some NSAIDs are available for which once- or twice-daily administration is sufficient. In children, dosing is based on body weight. The dosing interval, i.e. the time interval between doses, must be observed. Do not overdose! Not all active substances are suitable for children, for example, acetylsalicylic acid is not recommended. We recommend paracetamol. Monotherapy is recommended, i.e., not a combination of several antipyretic substances. However, if a drug has an insufficient effect, a change can of course be made.
Active Substances
Acetanilide:
- Paracetamol
NSAIDs (non-steroidal anti-inflammatory drugs, selection):
- Acetylsalicylic acid
- Diclofenac
- Ibuprofen
- Mefenmic acid
- Naproxen
Pyrazolones:
- Metamizole
Herbal antipyretics:
- Willow bark
Due to better tolerability, paracetamol should be used as the first choice agent in our view.
Contraindications
Precautions depend on the individual agents.
Adverse effects
The most common potential adverse effects of NSAIDs include digestive symptoms and central nervous disturbances. All NSAIDs can cause serious side effects rarely and especially if taken over a long period of time. Paracetamol is considered well tolerated, but must be dosed properly because overdose is dangerous and can damage the liver. Metamizole can rarely cause blood count disorders such as agranulocytosis.