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At least 19 recordsLinked to original sources
PubMed2005

[Study on the antipyretic, analgesic effects of qingkailing freeze-dried powder for injection and its antipyretic mechanism].

OBJECTIVE: To investigate the antipyretic, analgesic effects of Qingkailing Freeze-Dried Powder for Injection (QI) and its mechanism of the antipyretic effect. METHODS: The rabbit model of 2, 4-dinitrophenol-induced fever and the rat model of endotoxin-induced fever were established and the body temperatures were observed. Radioimmunoassay was adopted to detect the levels of IL-1beta and cAMP in the hypothalamus of rats. The analgesic effects were tested by hot-plate and writhing reaction method. RESULTS: QI showed marked antipyretic effects on the 2,4-dinitrophenol-induced fever and the endotoxin-induced fever. At the same time, QI remarkably decreased the contents of IL-beta and cAMP in the hypothalamus. QI also remarkably reduced the frequency of acetic acid-induced writhing and delaied the time of licking rear feet. CONCLUSION: QI has antipyretic, analgesic effects. Its mechanism of the antipyretic effects on rats may be inhibiting the production of IL-1beta and accordingly decreasing cAMP in the hypothalamus.

2,4-Dinitrophenol↗
PubMed1993

[Evaluation of the antipyretic action of psychotropic drugs and their effect on the antipyretic effect of acupuncture therapy].

The effect of psychotropic agents on antipyretic effect of acupuncture was studied in rabbits with experimental fever. Haloperidol in the dosage 0.5 mg/kg and benactyzine in the dosage 0.1 mg/kg, that reduced the fever response in rabbits and amitriptyline which induced no significant changes in the fever, led to enhancement of antipyretic effect of acupuncture. Haloperidol and benactyzine in the dose 1 mg/kg, that dropped the temperature by a single administration, and diazepam, which didn't influence upon the fever, reduced the intensity and duration of the antipyretic effect of acupuncture.

Acupuncture Therapy↗
PubMed1975

Further studies on self-administration of antipyretic analgesics and combination of antipyretic analgesics with codeine in rhesus monkeys.

The possible reinforcing effect of acetylsalicylic acid (ASA) was studied in a group of rhesus monkeys that had no history of self-administration of drugs. Rates of lever pressing were compared under conditions in which each lever-pressing response resulted in an infusion of saline, an infusion of saline plus delivery of a food pellet or an infusion of ASA (0.4, 1.0, 2.5 OR 5.0 MG/KG /infusion). Responding was engendered and maintained by the delivery of food pellets but not by infusions of saline alone nor by ASA; however, responding was subsequently engendered and maintained in these monkeys by codeine (0.05 mg/kg/infusion). In another group of monkeys that had been trained to respond under a 10-response fixed-ratio schedule of i.v. infusions of codeine, the possible reinforcing effects of aminophenazone, phenylbutazone and of combinations of each of these drugs with codeine were studied. Aminophenazone and phenylbutazone (0.4-5.0 mg/kg/infusion) did not maintain responding previously engendered by codeine. Mixtures of aminophenazone and phenylbutazone with codeine decreased the number of codeine self-administrations. Thus, codeine intake was reduced when aminophenazone and phenylbutazone were added to codeine in the solution to be self-administered. These experiments suggest that antipyretic analgesics are not effective in reinforcing behavior in the rhesus monkey.

Aminopyrine↗
PubMed2004

Effect of recent antipyretic use on measured fever in the pediatric emergency department.

OBJECTIVES: To determine the prevalence of recent antipyretic use among febrile infants at a pediatric emergency department (ED) and to test the hypothesis that recent antipyretic use is associated with lower measured temperatures in the ED. METHODS: We prospectively enrolled infants younger than 366 days at a pediatric ED. Eligible subjects had a history of fever prior to arrival at the ED or had a measured temperature of 38 degrees C or higher at the ED. Research assistants collected detailed information about recent use of antipyretic drugs. Peak measured temperature prior to arrival at the ED (temperature maximum [Tmax]), measured temperature at the ED, defervescence from Tmax to measured ED temperature, and rates of diagnostic testing were compared between subjects who had or had not been treated with antipyretic medication within the past 6 hours. RESULTS: We enrolled 474 infants. Infants treated with an antipyretic medication (n = 187) had a significantly higher Tmax and a significantly higher measured ED temperature than untreated subjects (n = 287) (P<.001). Treated and untreated subjects did not differ in the amount of defervescence from Tmax to measured ED temperature (P = .41) unless treated subjects included only those who reportedly received therapeutic doses of antipyretic medication within 1 to 5 hours prior to arrival at the ED (P = .02). CONCLUSIONS: Although many febrile infants seen in the pediatric ED have recently received antipyretics, only a few have received a therapeutic dose between 1 and 5 hours prior to arrival. Among febrile infants seen in the ED, recent antipyretic use is associated both with a higher reported Tmax and with higher measured temperatures at the ED. Patients treated with a therapeutic antipyretic dose 1 to 5 hours prior to arrival experience more defervescence from their Tmax than untreated subjects.

Age Factors↗
PubMed1990

Antipyretic orders in a university hospital.

PURPOSE: Antipyretics are prescribed for many hospitalized patients, but details concerning prescribing practices are not known. This study was designed to determine the incidence and format of antipyretic orders in a university-based tertiary-care center, and to ascertain whether orders are correlated with patient characteristics or hospital services. PATIENTS AND METHODS: The records of 300 randomly selected patients on the medicine, general surgery, neurosurgery, and obstetrics and gynecology services, and of 75 patients admitted with pneumonia and fever were retrospectively reviewed using a standardized data form. RESULTS: Orders for acetaminophen prn (as needed), without further explanation, were interpreted by the nursing staff as antipyretic orders; 78% of patients with such an order and fever received acetaminophen during the febrile episode. If orders of this type were included, 153 (51%) of the randomly selected patients received an antipyretic order. Gender, age, duration of hospitalization, intensive care unit residence, fever, and presence of a condition worsened by fever were not significant independent predictors of antipyretic prescription, but documented infection and hospitalization on the medicine and neurosurgery services were, with adjusted odds ratios of 2.5 (95% confidence interval [CI] 1.3 to 5.0), 9.4 (95% CI 3.6 to 25), and 14 (95% CI 5.0 to 41), respectively. Of patients who received an antipyretic order, 70% had an admission order for antipyretics; 26%, an order prompted by fever; and 79%, an order while afebrile. In 86%, the order was written prn without further explanation. Around-the-clock dosing, automatic stop orders, and acknowledgement and justification of orders were rare. CONCLUSION: Antipyretic orders are routine and correlate more strongly with hospital service than with individual patient characteristics. They are umprecisely written and generally leave decisions about antipyretic administration to the complete discretion of the nursing staff.

Acetaminophen↗
PubMed2006

Determinants of antipyretic misuse in children up to 5 years of age: a cross-sectional study.

BACKGROUND: Fever in children is a common and usually benign symptom. It is known that antipyretic treatment is ineffective in the prevention of simple febrile seizures. Caregivers' administration of antipyretic medications to children has been reported, but data concerning the formulations used, actual doses administered, and effects of ethnicity and socioeconomic status on administration practices are incomplete. OBJECTIVE: The aim of this study was to identify the factors affecting antipyretic administration (higher-than-recommended doses in particular) by caregivers to their febrile children in 2 differing cultural-ethnic backgrounds. METHODS: This cross-sectional survey study, conducted from January to March 2002, was part of a larger, ongoing survey study of the differences in care givers' knowledge, beliefs, and attitudes concerning children's fever in the 2 major cultural-ethnic groups in the Negev District in Israel: Jews and Bedouin Moslems. It was conducted at the Pediatric Emergency Department (PED), Soroka Medical Center, Beer-Sheva, Israel. A structured questionnaire was administered to Jewish and Bedouin Moslem parents or usual caregivers of young (age, 0-60 months) children attending the PED due to fever. Each child's weight was obtained from the PED medical record. After completion of the interview, the reported antipyretic dose per kilogram of body weight was calculated. Less-than-recommended dose was defined as <9 mg/kg for acetaminophen and <4.5 mg/kg for ibuprofen. Higher-than-recommended dose was defined as >16.5 mg/kg for acetaminophen and >11 mg/kg for ibuprofen. RESULTS: The caregivers of a total of 201 children (mean [SD] age, 20 [17] months; mean [SD] weight, 10.4 [4.0] kg) were included in the study. The study included 101 Jewish and 100 Bedouin Moslem caregivers. The proportion of people surveyed who were parents was 98%; grandmothers, 2%. Differences existed between the 2 cultural-ethnic groups in the source of knowledge regarding antipyretic use in children (a significantly larger proportion of Jewish caregivers received their knowledge concerning antipyretic use from package inserts compared with Bedouin caregivers [25.7% vs 6.0%; P < 0.001], and a significantly lower proportion of Jewish caregivers used "other" sources [15.8% vs 39.0%; P < 0.001]). Most (65.2%) caregivers indicated that they administered antipyretics for no or minimal elevations in body temperature (<-38 degrees C); 52.7% administered individual acetaminophen doses within 10% of the recommended dose, 34.8 % administered a higher-than-recommended dose, and 21.4% repeated the dose at intervals of <or=3 hours. More Bedouin than Jewish caregivers exposed their children to higher-than-recommended antipyretic doses (48.0% vs 21.8%; P < 0.001). After adjusting for maternal education and work-for-income status, child's age, child's order in the family, and number of children in the family, a significant and independent inverse relationship was found between child's weight and higher-than-recommended acetaminophen doses, in which for each additional kilogram of body weight, a 30% decrease in the proportion of children administered higher-than-recommended doses was found (odds ratio [OR], 0.7 for each additional kg; 95% CI, 0.59-0.89; P = 0.002). In addition, a significant and independent relationship was found between the formulation of acetaminophen and the administration of higher-than-recommended doses (OR, 4.9; 95% CI, 2.32-10.23; P < 0.001), with rectal suppositories related to the administration of higher-than-recommended dose by 4.9-fold. CONCLUSIONS: The results of this survey concerning antipyretic treatment of children by their Jewish and Bedouin Moslem caregivers suggest that lighter body weight and the use of acetaminophen rectal suppositories were associated with the administration of higher-than-recommended doses of acetaminophen. Recommended doses of acetaminophen must be based not on the age but on the weight of the child.

Acetaminophen↗
PubMed2002

Symptomatic intravenous antipyretic therapy: efficacy of metamizol, diclofenac, and propacetamol.

Fever is a common symptom in cancer patients. The most frequent causes of fever are infections, malignancy itself, various medications, transfusions, and allergy. Although it is necessary to treat the cause of fever, if possible, symptomatic fever management is also important. Surprisingly, little attention is paid to this topic in the medical literature, despite the fact that it is a very frequent problem. In order to support symptomatic fever therapy, we wanted to study the patients' discomfort accompanying fever and the beneficial effects of the symptomatic fever management. To the best of our knowledge, there is an absence of studies in this area, despite the fever discomfort can be an important reason for the antipyretic treatment, mainly in cancer patients. In this non-randomized open label pilot study, three intravenous antipyretics were tested in five groups of patients: diclofenac (75 mg, brief intravenous [IV] infusion) vs. metamizol (2500 mg or 1000 mg, brief IV infusion) vs. propacetamol (2000 mg or 1000 mg, slow IV injection or brief IV infusion). The study included 254 febrile episodes mainly in hemato-oncological patients with axillary temperature at least 38 degrees C. The main study endpoints were: changes in axillary temperature, improvement in patient comfort, and number and nature of adverse events. To support justification for symptomatic fever management in febrile patients, we asked the first 45 study subjects to fill in a questionnaire concerning their opinions about fever, fever-associated discomfort, and relief upon antipyretic therapy. All study medications had a significant antipyretic effect. However, metamizol at the dose 2500 mg was considered as the most effective, while propacetamol at the dose 1000 mg showed the lowest antipyretic efficacy. Concerning tolerability and adverse events, there were significant differences among the treatment groups. Diclofenac and metamizol (both 2500 mg and 1000 mg) were tolerated at best. All tested antipyretics significantly improved comfort in febrile patients. Overall, 87% of patients declared improvement in their comfort after administration of antipyretics. Based on the results of the present study, the choice of the antipyretic drug should depend on the clinical status of patient, contraindications, and potential adverse events and risks of the selected agent. It is advisable to use proparacetamol at the higher dosage and to administer it as a brief IV infusion in order to avoid injection-related adverse events. The symptomatic antipyretic treatment in febrile cancer patients is supported by patients themselves and has a significant role in the complex supportive care. Discomfort of patients during fever episodes may be greater than previously thought.

Acetaminophen↗
PubMed2006

Antipyretics and delirious behavior during febrile illness.

BACKGROUND: The purpose of the present paper was to study the use of antipyretics in children with delirium associated with fever in order to clarify their possible adverse effects. METHODS: The use of antipyretics was investigated in 26 children with delirious behavior associated with fever. Temporal relation between delirious behavior and the use of antipyretics was recognized in six children. RESULTS: In four children, delirious behavior was observed soon after administration of antipyretics. The antipyretics used were acetaminophen in two children, mephenamate in one, and diclofenac in one. In the other two children, delirious behavior was observed when body temperature began to fall 1-2 h after administration of antipyretics. The antipyretics used were acetaminophen in one child and mephenamate in one. CONCLUSION: A temporal relationship between antipyretics and delirious behavior was observed in some patients with febrile delirium. This suggests that antipyretics can be a trigger of delirium.

Acetaminophen↗
PubMed2001

[Use of alternating antipyretics in the treatment of fever in Spain].

OBJECTIVE: To assess the frequency of the use of alternating antipyretics among Spanish pediatricians and to analyze the factors that determine this practice. METHODS: An anonymous survey of practicing pediatricians was conducted. Data on the use of antipyretics were collected. Factors related to alternating antipyretics were assessed by using multivariate correlation analyses. RESULTS: Three hundred twenty-four questionnaires were reviewed. The mean age of participants was 46.4 18.6 years (29-68 years). Of the responding pediatricians, 22.5 % worked in hospitals, 87.5 % in health centres and 24.7 % in in private practice. A total of 68.8 % of pediatricians (95 % CI: 63.4-73.8 %) alternated antipyretics. The combination of ibuprofen and acetaminophen was recommended by 96.9 %. The use of alternating antipyretics was positively associated with male sex (OR: 0.535; 95 % CI: 0.296-0.967; p 0.038), with few years' experience (OR: 0.952; 95 % CI: 0.922-0.984, p 0.005), with considering ibuprofen the drug of choice (OR: 2.324; 95 % CI: 1.235-4.372; p 0.009) and with the doctor's recommendation that the antipyretic be readministered in the event of slight increases in temperature (OR: 0.529; 95 % CI: 0.310-0.901; p 0.019). CONCLUSIONS: Despite the lack of scientific evidence to justify the practice, the use of alternating antipyretics is common in the treatment of febrile children. Predictive factors of this practice among pediatricians are male sex, having relatively little experience, considering ibuprofen as the drug of choice and recommending the administration of new doses of antipyretic to control mild fever.

Acetaminophen↗
PubMed1989

Antipyretic effect of central alpha-MSH summates with that of acetaminophen or ibuprofen.

The neuropeptide alpha-melanocyte stimulating hormone has potent antipyretic properties when given centrally or systemically. Little is known about the mechanism of the antipyretic action and virtually nothing is known about interactions among the antipyretic effects of alpha-MSH and commonly used antipyretic agents. Randomized studies in which alpha-MSH, acetaminophen or ibuprofen, or a combination of alpha-MSH and antipyretic drug, were given IV to rabbits made febrile by endogenous pyrogen, indicate that the antipyretic effect of the peptide is summative with those of the drugs. alpha-MSH has been shown to have a wide safety margin in earlier research and the results suggest that combinations of peptide and antipyretic drugs might be safer and have fewer side effects than larger quantities of the drugs alone.

Acetaminophen↗
PubMed1998

Antipyretic activity of cinnamyl derivatives and related compounds in influenza virus-infected mice.

Kakkon-to is composed of seven medicinal herbs and exhibited novel antipyretic activity by suppressing interleukin-1alpha production responsive to interferon in a murine intranasal influenza virus infection model. Using this model, antipyretic compounds with such novel biological activities were characterized from the herbs. The organic solvent-extractable fractions of Cinnamomum cassia among the herbs showed antipyretic activity. We selected six antipyretic compounds from 48 cinnamyl derivatives and related compounds that may be mainly involved in the fractions. Their antipyretic activity was significantly correlated with interleukin-1alpha regulatory activity. Four of them suppressed interleukin-1alpha production to a basal level and showed different mode of antipyretic action from that of aspirin in interleukin-1alpha-injected mice. Structure-bioactivity relationship of the four suggested that an ester bond played an important role for both antipyretic and interleukin-1alpha regulatory activities. These compounds may be useful in analyzing interleukin-1alpha-producing cells in fever production and the mechanism of defervescence by suppressing interferon-induced interleukin-1alpha production.

Analgesics, Non-Narcotic↗
PubMed2000

Endogenous antipyretics.

Fever is the hallmark of the stereotyped host response to microbial infection, although it is just one of a number of high-risk strategies employed by the infected host to clear itself of invading pathogens. The febrile response is accompanied by activation of multiple endogenous antipyretic systems that serve to suppress its magnitude or duration. These include neuroactive substances of neural and humoral origin, some of which (e.g., glucocorticoids, melanocortins, and IL-10) have broad-ranging anti-inflammatory actions. Glucocorticoids, vasopressin, and melanocortins appear to exert their antipyretic effects by acting on receptors within the brain, but beyond this the mechanisms involved are unknown. It is hypothesized, but not proven, that endogenous antipyretic systems protect the host against the destructive consequences of unchecked fever. Importantly, pharmacological blockade of the actions of endogenous antipyretic systems increases fevers of even low to moderate intensity. Therefore, in addition to protecting against catastrophic consequences of high fever, endogenous antipyretic systems seem to play a fundamental physiological role in determining the normal course of fever. Elucidating the neural and biochemical mechanisms involved in suppression of fever by physiological antipyretic systems will yield a rich benefit, both by advancing the basic understanding of host defense strategies, and by permitting the design of novel antipyretic and anti-inflammatory strategies for therapeutic intervention in human disease.

Adrenocorticotropic Hormone↗
PubMed1998

Reevaluation of antipyretics in children with enteric fever.

BACKGROUND: The Committee on Infectious Diseases of the American Academy of Pediatrics recommends withholding antipyretic administration to patients with enteric fever because of the risk of shock developing as a consequence. OBJECTIVE: To evaluate the effects of antipyretics on blood pressure in children with enteric fever. METHODS: A retrospective review of medical records of patients admitted to Texas Children's Hospital from January, 1977, to October, 1997, with a diagnosis of enteric fever. All febrile episodes were evaluated for the use of antipyretics and evidence of hypotension or cardiovascular decompensation associated with them. RESULTS: Twenty-nine patients with enteric fever were identified. Salmonella typhi caused 23 of these infections. Antipyretics were used in all but one patient. We did not find any association between the use of antipyretics and the development of hypotension. One patient developed shock and adult respiratory distress syndrome >36 h after start of antibiotic therapy and unrelated to fever or antipyretic use. Two patients had evidence of dehydration. No other complications occurred. CONCLUSIONS: We did not find any complications associated with the use of acetaminophen or ibuprofen in children with enteric fever. The effects of antipyretics in enteric fever should be further studied.

Acetaminophen↗
PubMed1998

Benefits and risks of antipyretic therapy.

Physicians have used various forms of antipyretic therapy since antiquity to lower the temperature of febrile patients. Nevertheless, it has yet to be determined whether the benefits of antipyretic therapy outweigh its risks. It is not known, for example, if core temperatures encountered during the febrile state ever reach levels that are intrinsically noxious (and therefore merit antipyretic intervention) or when, if ever, fever's metabolic costs exceed its physiologic benefits, or if the benefits of symptomatic relief afforded by antipyretic drugs consistently exceed their toxicologic cost. Whereas preliminary experimental and clinical observations suggest that antipyretic therapy has the potential to increase the duration and/or severity of certain infections, such data are as yet too fragmentary to draw firm conclusions regarding their validity. Finally, although clinicians have long suspected that bacteremia and other severe infections might induce fevers that are less responsive to antipyretic therapy than are those associated with self-limited infections, this concept has not held up under scientific scrutiny. Thus, despite over 2.5 millennia of clinical experience, important questions regarding the risks and benefits of antipyretic therapy remain to be answered.

Analgesics, Non-Narcotic↗
PubMed1978

[Antipyretic activity of SL-573 (II) (author's transl)].

Antipyretic activity of SL-573 was not influenced by age and sex difference in rats. The combined effect of other drugs on antipyretic activity of SL-573 was examined, using several drugs which might be clinically applicable. Cefazolin sodium, ampicillin sodium, codeine phosphate, hydrochlorothiazide and haloperidol did not show any significant effect on antipyretic activity of SL-573. Diazepam itself showed antipyretic activity, and its combined use with SL-573 resulted in an additive effect. SL-573 also showed antipyretic activity in mice with fever induced by yeast, as was seen in rats. SL-573 diminished the hyperthermic response to bacterial endotoxin and leucocytic pyrogen in rats, but not to 2, 4-dinitrophenol. Additionally, SL-573 did not inhibit the bacterial endotoxin-induced production of leucocytic pyrogen and its release in saline medium. SL-573, therefore, is considered to be a centrally acting antipyretic. Intraventricular injection of prostaglandin E2 and arachidonic acid induced a hyperthermia in mice. SL-573 clearly inhibited arachidonic acid-induced hyperthermia, but not prostaglandin E2-induced hyperthermia. Since SL-573 is known to inhibit prostaglandin biosynthesis from arachidonic acid, the prostaglandin biosynthesis inhibition may be one of the main mechanisms of antipyretic action of SL-573.

Age Factors↗
PubMed1985

Dexamethasone fails to produce antipyretic and analgesic actions in experimental animals.

In order to explore the role of phospholipase A2 inhibition in the mechanisms of the action of glucocorticoids, it was investigated whether the steroid exhibits the analgesic and antipyretic actions as well as cyclo-oxygenase inhibitors such as indomethacin or not. Dexamethasone has been reported to produce the anti-inflammatory action with a lag time of at least 1 h at doses of up to 0.1 mg/kg in mice and rats. However, dexamethasone when given 4 h beforehand had no significant analgesic activity even at doses of 1 and 10 mg/kg i.v. in the acetic acid writhing test in rats. In mice, the significant reduction in writhes counts was seen when dexamethasone (1 and 10 mg/kg i.v.) was given 15 min or 4 h before phenylquinone injection; i.e. the activity had not the lag time. On the other hand, dexamethasone showed a strong antipyretic activity against both the fevers caused by LPS and yeast in rats. In the yeast-febrile rats, the antipyretic activity had a lag time of about 1 h, and was dose-related at doses as low as 0.03 to 0.3 mg/kg i.v.; the steroid markedly reduced the increased PGE2 content in the cerebrospinal fluid. The antipyretic activity after local injection into the cerebroventricle or the yeast pouch was stronger than that after systemic injection into the tail vein, although so large a difference in the activity between the dosage routes was not seen, suggesting that the site of the antipyretic action is in both the brain and periphery. The antipyretic activity of dexamethasone (10 mg/kg i.v.) was not seen in rabbits with fever caused by LPS.(ABSTRACT TRUNCATED AT 250 WORDS)

Analgesics↗