Overview of Pediatric Antipyretic Drugs

The temperature of a child is not necessarily proportional to the severity of the illness. If a child has a temperature of 38.8°C but is energetic and does not feel unwell, antipyretic treatment is not necessary. When a child’s temperature exceeds 38.3°C but is depressed and irritable should be treated. A high body temperature of 39 ℃ or more is prone to cause convulsions in children, children under 6 months of age in fever due to rapid changes in the condition of all should be treated promptly. 3 months of infants and young children should be cautious of using drugs to reduce fever, it is desirable to use more physical methods to reduce fever. The effect of drugs to reduce fever is not good or less than two hours after the use of drugs to reduce fever and body temperature over 39 ℃ should also be used physical methods to reduce temperature. Drugs need a certain amount of time to see the effect of fever, in the body temperature suddenly exceeds 40 ℃ should be used immediately when the first physical methods of fever. Acetylsalicylic acid, or aspirin, is an antipyretic and analgesic with a long history of use. Commonly used as a combination of aspirin and phenobarbital, Abenomics tablets for pediatric antipyretics have been well received by the clinic. It is usually used in small doses for short periods of time, which is safer. However, the drug can cause neonatal cyanosis, bleeding from the navel, vomiting blood and blood in the stool and other adverse reactions, and should be prohibited for use in infants and young children. Piracetam (Lepirin) is a product of aspirin combined with lysine, which has reduced toxicity, and can be administered by injection for fast results, and can be used by children over the age of 3. However, the phenomenon of pediatric aspirin-induced Reye’s syndrome has been repeatedly reported. There are few reports of aspirin-induced Rachel’s syndrome in children in China. Most of the cases are related to the long-term history of aspirin use in children to treat rheumatic fever and other diseases. Therefore, with the exception of Kawasaki disease, aspirin is no longer used in children in many countries, and there are no strict requirements for its use in China, but it should be used with caution. Aspirin should especially be avoided as an antipyretic in viral diseases such as chickenpox, when children are more likely to incur Reye’s syndrome. Ibuprofen, or isobutylpropionic acid, reduces fever quickly and steadily, lasting up to 8 hours. The drug is similar to aspirin, but gastrointestinal irritation and other adverse effects are significantly lower than aspirin, and easy to tolerate, is considered safe and reliable antipyretic and analgesic drugs. The dosage of the drug for children may depend on the condition. Generally 5mg per kilogram of body weight per dose, higher than 39 ℃ can be used 10mg, need to be re-administered should be 6 ~ 8 hours apart. Increasing the dose can increase the duration of fever, if necessary, the dose per kilogram of body weight per time up to 40 mg. ibuprofen can be used alone, but also often with a number of other drugs to enhance the efficacy of the combination. The commonly used compounded zinc cloth granules contain zinc gluconate to promote the body’s metabolic vitality, while chlorpheniramine maleate reduces the symptoms of nasal congestion, runny nose and sneezing caused by colds or flu. Acetaminophen is paracetamol, the drug mainly in the central nervous system site on the inhibition of prostaglandin synthesis and produce the effect of regulating body temperature and analgesia, rarely cause gastrointestinal adverse reactions. Because of its fast onset of action, strong effect and safety features, it is a widely recommended and used antipyretic drugs in the world. Children over two months can be preferred to the drug, the dose is 10 ~ 15 mg per kilogram of body weight each time, no more than 4 times a day, for fever generally not more than 3 days. It should be used on medical advice in infants under two months of age. Anacin can cause more serious adverse reactions such as granulocyte deficiency, kidney damage and allergic reactions. The drug is still listed in the pharmacopoeia, but it is indicated for emergency antipyretic use only in cases of acute hyperthermia and severe illness where no other effective antipyretic is available. Oral administration has become less common and is more commonly used for nasal drops. A 20% solution should be used, with 1 to 2 drops per nostril for infants and 2 to 3 drops per nostril for children over two years of age. It is used for infants under 10 months of age and has a precise effect. children over 5 to 6 years of age are usually not administered by nasal drops. children over 6 months of age with high fever may be administered intramuscularly at a dose of 10-20 mg per kilogram of body weight per dose, usually only once, to ensure safety. Adrenocorticotropic hormone Some primary care doctors regard corticosteroid as a “cure-all drug” and use dexamethasone to reduce fever, which is an incorrect medication program. In addition to autoimmune diseases, corticosteroids are mainly used for the emergency treatment of shock, severe infection or inflammation. Corticosteroids used to reduce fever in children tend to mask the condition and can lead to misdiagnosis. These drugs do not have antibacterial or antiviral effects, but have significant immunosuppressive effects, improper use of which can promote the spread of bacterial or viral infections and exacerbate the condition, and may also revive infections that tend to improve. Corticosteroids also aggravate the adverse effects of antipyretic drugs such as acetaminophen. Therefore, the use of dexamethasone and other corticosteroid drugs to reduce fever may lead to a small disease into a big disease of adverse consequences, this method can not be used easily. Causes of fever are many, can be a cold, tonsillitis; may also be pneumonia, measles and meningitis and other serious diseases. Antipyretic drugs can only improve the symptoms, no antibacterial, antiviral ability. Therefore, before using antipyretic drugs should find out the cause of the disease, so as not to affect the diagnosis and delay treatment. There are many varieties of antipyretic drugs, including single-component and compound preparations, but the main active ingredients are the same or similar, so it is not advisable to use several drugs at the same time.