LESSON 11: Antipyretics Flashcards
Body temperature is controlled by the _________
hypothalamus
This is where (1) warmth/cold receptors in the skin and the (2) from the temperature of the blood bathing the regio
Range of 36.5 - 37.5oC (97.7 - 99.5oF)
Rectal temperatures are
generally
0.4oC (0.7oF) higher than oral readings
A fever of >41.5oC (>106.7oF) is called
hyperpyrexia
is characterized by an uncontrolled increase in body temperature that exceeds the body’s ability to lose heat.
Hyperthermia (heat stroke)
T/F: Hypothermia Do not respond to antipyretics
True
a substance causing induction of a febrile response which can be fatal in humans and animals
Pyrogen
are
derived from outside the patient; most are microbial products, microbial toxins, or whole microorganisms (including viruses).
Exogenous pyrogens
the lipopolysaccharide complex associated with the outer membrane of ALL gram-negative bacteria.
bacterial endotoxin
highly biologic or biogenic molecules in humans, produces fever or leukocytosis or even generalized symptoms of varied malaise or weakness
Endotoxins
Reactions to endotoxins lead to
anaphylactic shock and death of patient
Pyrogenic products of gram-positive organisms include the enterotoxins of _______________ and the A and B streptococcal toxins, also called
Staphylococcus aureu; superantigens
is associated with microbiological contamination of parenteral products
Pyrogenicity
Common MOA of NSAIDs
Inhibits cyclooxygenase → inhibits prostaglandin
Examples of NSAIDs
Diclofenac
Phenylbutazone
Ketorolac
Piroxicam
Ketoprofen
Nabumetone
Ibuprofen
Indomethacin
Mefenamic acid
Tenoxicam
Phenylbutazone
ASA
Indomethacin
Sulindac
Naproxen
_______________ → Cyclooxygenase Reaction → ____________________ → Peroxidase reaction → _________________ → Prostaglandins, Prostacyclin, Thromboxanes
Arachidonic acid; Prostaglandin G2; Prostaglandin A2
SELECTIVE COX INHIBITORS
Celecoxib
Etoricoxib
Meloxicam
Valdecoxib & Rofecoxib
Drugs with FDA Black box warning
Selective Cox inhibitors
This decreases incidence of coronary artery thrombosis and myocardial infarction
ASPIRIN
ADE: Reye’s syndrome
ASPIRIN
ASPIRIN has ___________, __________, ____________ effects
Anti-inflammatory, Analgesic, Antipyretic
Toxicity of Aspirin
Salicylism
Treatment of Aspirin Toxicity
Decrease absorption
Enhance excretion
Supportive measures
Aspirin inhibits renal elimination of __________ thus resulting in an _______________
lithium; elevated lithium levels
Aspirin decreases effects of ____________
antigout
Aspirin may casse fluid retention and edema, thus decreasing the effect of
antihypertensives
Aspirin has additive effect on
anticoagulants
Aspirin displaces antidiabetic agents from plasma proteins -> ____________ effects → ___________ agents
increase; hypoglycemia
Aspirin increase risk of
methotrexate
Acetaminophen, APAP (n-acetyl-p-aminophenol)
PARACETAMOL
Paracetamol ADE
Jaundice
possess no significant anti-inflammatory effect
PARACETAMOL
Treatment for toxicity
Acetylcysteine
