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Fever and
Antipyretic Usein Children
Janice E. Sullivan, M.D.Professor of PediatricsUniversity of Louisville
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Prepared for your next patient.
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drugs that are not #ithin the drugs$ approved indications, MeadJohnson does not promote the use of any drug for indicationsoutside the %&A'approved product label.
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OVERVIEW
%ever
Antipyresis
Therapeutic goals
Safety Summary
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FEVER
(ne of most common clinical symptoms managedby pediatricians and other )*Ps
o +nscheduled physician visits
oTelephone calls
*auses heightened anxiety in parents andcaregivers
Pediatricians and nurses are the primary resourcefor information on fever management for parents
and caregivers
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FEVER
%ever rectal temperature - /.0 * 12020 %3o "nfants 4 months of age /0* 1200.50 %3
6ormal physiologic response
o 7esults in an increase in the hypothalamic 8setpoint9
7esponse to endogenous and exogenous pyrogens
Most fevers are of short duration and are benign
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FEVER
:enets of fevero Protective role in the immune system
"nhibition of gro#th and replication of microorganisms
Aids in bodys acute phase reaction
;nhanced immunologic function of #bcs lymphocyte response to mitogens
bactericidal activity of neutrophils
production of interferon
Promotion of monocyte maturation into macrophages
Promotion of lymphocyte activation and antibodyproduction
&ecreased availability of free iron for bacterialreplication
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FEVER AND ILLNESS
Antipyretics may prolong course of illnesso Adults #ith rhinovirus shed the virus longer
o *hildren #ith varicella have delayed time forlesions to crust 1about 2 day3
o *hildren #ith malaria ta vs >? hours3
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FEVER !O"IA#
Term coined in early 2?/0s by :& Schmitt, M.&. Primary fears
o :rain damage
o *oma
o Sei@ures
o :lindness
o &eath
(ther contributorsoTechnology
o Pharmaceuticals
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AN$I%RESIS
Many parents aim for 8normal9 temperatureo &aycare, school #or< can drive this
Antipyresis therapy &(;S 6(T
o 7educe morbidity or mortality from a febrileillness
o &ecrease the recurrence of febrile sei@ures
Antipyresis &(;S
o
7elieve discomforto &ecrease insensible Buid loss
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AR&U'EN$S A&AINS$ AN$I%RESIS
%ever is not an illness Most fevers are short'lived and benign
%ever may protect the host
&egree of fever does not correlate #ith severityof illness
fever may obscure diagnostic or prognosticsigns
6o evidence that children #ith fever are at ris