Fever Flashcards
What are some normal temperature readings?
Rectum: 37.5C
Mouth: 37C
Armpit: 36.5C
Ear: 37.5C
What are some symptoms of a fever?
Temperature rises above its normal range usually accompanied by sweating, chills, headache, and body aches
What is the optimal location to measure in kids depending on age?
Age <2
1st choice: rectum
2nd choice: armpit
Ear – not recommended
Not as accurate
Age 2 to 5
1st choice: rectum
2nd choice: ear, armpit
Age >5
1st choice: mouth
2nd choice: ear, armpit
Rectal is best for kids under 5, but not mandatory
Are digital ear thermometers recommended for newborns?
No, parents are not able to get accurate readings because their technique isn’t the best
Do pharmacists check temperatures?
No, but we should know how to administer them in the case someone asks us how to use
How to educate parents on checking their kid’s rectal temperature?
Show them a medsask video, much easier to show than to tell.
How to take ear temperatures for newborns and toddlers?
Newborns: pull earlobe down
Toddlers: pull earlobe up
How should a fever be treated by a pharmacist?
younger than 3 months: refer to physician
3mo-2y: No need to treat if fever is below 39, but treat if fever is above 39.
older than 2 years: No need to treat if fever is below 39, but treat if fever is above 39
A good rule of thumb for referrals is the following:
if fever lasts…
1 day for 1 year-old
2 days for 2 year-old
3 days for 3-year-old
Then refer to a doctor
When should we treat a fever in kids?
Pediatricians recomend that we only give medications to kids that appear sick enough.
What can I do if my child has a fever?
Non drug option: remove layers and reduce heat
drug option: ibuprofen or tylenol
What is children’s dosing for acetaminophen?
10-15 mg/kg every 4 to 6 hours to a max of 75 mg/kg/day. That comes to 5 doses per day and that is far from overdose
Does age matter more than weight when it comes to children’s acetaminophen dosing?
No, weight trumps age.
Does acetaminophen have any side effects?
Nausea and heartburn are potential side effect in a small percentage of people. Hepatotoxicity is a result of overdoses, but not at intended dosages
Does acetaminophen do something for colds?
No, does nothing for the main symptoms of colds
Tell me about Ibuprofen
Ibuprofen has fast onset and delivers up to 8 hours of relief. Ibuprofen is an NSAID and it reduces pain and fever. It is no better or worse for fevers than acetaminophen
What is children’s dosing for Ibuprofen?
For children over 6 months, 5-10 mg/kg every 6 to 8 hours up to max dose of 40 mg/kg/day
For children under 6 months, drop down to 5 mg/kg every 8 hours
For children under 3 months, refer to a doctor
What are nuissance symptoms?
These are symptoms that manifest themselves at higher doses and duration of use that isn’t found when treating fevers
Does ibuprofen have less side effects than acetaminophen at OTC doses?
No, they are have similar reported adverse effects. Ibuprofen has an advantage in fewer number of doses vs acetaminophen
Is Naproxen used for fevers in Canada?
No
Are acetaminophen and ibuprofen essentially interchangeable?
Yes, go ahead and decide on price, kid prefers one flavour over another
What is fever phobia?
Unrealistic and exaggerated misconceptions of parents whose children have a fever. Concerns about fever-induced seizures are unfounded
Can you alternate/simulataneously use ibuprofen and acetaminophen?
It isn’t wrong to use both, but scheduling can become tricky to synch. Usually not done as it is overkill
What is the maximum daily adult dose for acetaminophen?
4g (4000mg)
If monotherapy with ibuprofen or acetaminophen fails, what is a pharmacists greatest concern.
We should worry more about what is causing the fever rather than drug safety. Great time to refer to a physician.
