Antipyretic – Fever-Reducing Agents Explained
Antipyretic means fever-reducing. Antipyretic agents are used to lower elevated body temperature and improve well-being during fever episodes.
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Antipyretic means fever-reducing. Antipyretic agents are used to lower elevated body temperature and improve well-being during fever episodes.
What does antipyretic mean?
Antipyretic is a medical term derived from the Greek words anti (against) and pyretos (fever). It describes the property of a substance or measure that reduces fever. Substances with antipyretic effects are collectively referred to as antipyretics.
How does fever develop?
Fever is a controlled increase in core body temperature above the normal value of approximately 37 °C. It occurs as a response of the immune system to infections, inflammation, or other triggers. In this process, so-called pyrogens are released – signaling molecules such as prostaglandins that raise the temperature set point in the brain (specifically in the hypothalamus).
Mechanism of action of antipyretic substances
Most antipyretics work by inhibiting the production of prostaglandins, primarily through the inhibition of the enzyme cyclooxygenase (COX). This lowers the elevated temperature set point in the hypothalamus back to normal, prompting the body to release excess heat through sweating and vasodilation.
Common antipyretic agents
- Paracetamol (Acetaminophen): One of the most widely used antipyretics, well tolerated by children and adults. It reduces fever and relieves pain but has minimal anti-inflammatory effect.
- Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID) with antipyretic, analgesic, and anti-inflammatory properties.
- Acetylsalicylic acid (Aspirin): Also has antipyretic and analgesic effects, but is contraindicated in children and adolescents with viral infections due to the risk of Reye syndrome.
- Metamizole (Dipyrone): A potent antipyretic with analgesic properties, available by prescription in some countries.
Application and dosage
Antipyretics are administered orally (as tablets, syrup, or suppositories) or intravenously. Dosage depends on age, body weight, and the specific agent used. Fever below 38.5 °C does not necessarily require medication, as it serves an important immune function. However, treatment is appropriate for higher fever, significant discomfort, or at-risk patients such as infants or elderly individuals.
Side effects and risks
- Paracetamol: Overdose carries a risk of severe liver damage.
- Ibuprofen and Aspirin: May cause gastric irritation, kidney impairment, and increased bleeding risk.
- Metamizole: In rare cases, it can cause a dangerous reduction in white blood cells (agranulocytosis).
When to see a doctor?
Medical attention should be sought promptly in cases of persistently high fever (above 39.5 °C), fever in infants under three months of age, or when accompanying symptoms such as neck stiffness, skin rash, or severe headache occur.
References
- World Health Organization (WHO): Management of fever in children. WHO Guidelines, Geneva.
- Rang H.P., Dale M.M., Ritter J.M., Flower R.J., Henderson G.: Rang and Dale's Pharmacology. 9th Edition, Elsevier, Edinburgh 2019.
- Brune K., Patrignani P.: New insights into the use of currently available non-steroidal anti-inflammatory drugs. Journal of Pain Research, 2015; 8: 105–118.
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