Why does the temperature rise
From an immunological point of view, an increase in body temperature is a protective reaction of the immune system aimed at eliminating the damaging factor and accelerating recovery1. Numerous studies have found that during periods of increased heat production in the body, the synthesis of specific chaperone proteins (the so-called “heat shock proteins”), which take an active part in the formation of the immune response, is activated.
In addition, under the influence of moderate fever, there is an increased production of interferon (a protein substance that blocks the proliferation of pathogenic viruses)1,3. With the development of an infectious-inflammatory process, the higher the thermometer rises, the more actively interferon is synthesized, which alone fights the infection. As a rule, its amount reaches maximum values 48–72 hours after the temperature rises.
Finally, an increase in temperature is a response to the negative effects of pathogens and their toxins1,2. For many infectious agents, in the presence of fever, the ability to reproduce is reduced, and for some of them, an increase in temperature to 38–39 degrees becomes fatal.
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When to lower a child's temperature
Taking into account all of the above, the conclusion suggests itself that hyperthermia, which accompanies most infectious and inflammatory diseases, is in fact a protective reaction of the body and indicates a properly functioning immune system. And in this situation, the use of antipyretic drugs that reduce high fever can be justified by a number of factors, such as:
- rapid increase in temperature in young children;
- the presence of a high risk of developing seizures (convulsions in children from 6 months to 5 years at a temperature of 38–39 °C is one of the possible complications of hyperthermia);
- temperature increases to critical levels (39–41 °C);
- development of dehydration (when hyperthermia is accompanied by severe vomiting and/or diarrhea);
- pallor, chills, cold extremities, confusion;
- the child has a hard time with increasing temperature1,2,3.
Experts recommend the use of antipyretics at high
temperatures in children: up to 2 months - from 38 °C, at older ages - from 38.5 °C1,2,3.
Of course, each child experiences hyperthermia individually1,3. And if one baby with a temperature of 38–39 degrees does not feel much discomfort, then another at 37–37.5 °C may develop a semi-fainting state. Therefore, in this situation, parents should focus not on the thermometer readings, but on the general condition of the baby and the doctor’s recommendations.
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Literature
- Yewale VN, Dharmapalan D. Promoting appropriate use of drugs in children // Int J Pediatr. 2012; 2012: 906570. Epub 2012 May 8.
- Allan GM, Ivers N., Shevchuk Y. T reatment of pediatric fever: Are acetaminophen and ibuprofen equivalent? // Can Fam Physician. 2010, Aug; 56(8):773.
- Sullivan JE, Farrar HC Fever and antipyretic use in children // Pediatrics. 2011, Mar; 127(3):580–587.
- Zakharova I.N., Zaplatnikov A.L., Tvorogova T.M., Machneva E.B. Pediatricians – about febrile conditions in children: what you need to know and be able to do. Text of a scientific article in the specialty “Fundamental Medicine”/216.
- Baranov A.A., Tatochenko V.K., Bakradze M.D. Feverish syndromes in children. Recommendations for diagnosis and treatment. M., 2011.
Dosage forms of antipyretic drugs for children
The modern pharmacological industry offers customers a large list of safe antipyretics for children (antipyretics). This list includes suppositories, suspensions, powders, syrups and tablets1,7. Moreover, each of the dosage forms has its own advantages and disadvantages.
Candles
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Antipyretic drugs for children, produced in the form of rectal suppositories, can be used from the first months of a child’s life7. Their use at a very early age is more comfortable and less problematic than taking oral forms. Also, children's antipyretic suppositories are preferable if an increase in body temperature is accompanied by vomiting or there is a predisposition to the development of food allergic reactions1,2,3.
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At the same time, antipyretic suppositories for children, in addition to their advantages, also have disadvantages. Potentially, they can provoke irritation of the mucous membrane of the anal canal. In addition, rectal suppositories in rare cases can cause the development of such negative side reactions as abdominal pain, nausea, and stool disorders.
Suspensions
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Antipyretic drugs for children, available in the form of suspensions, make it possible to simultaneously use insoluble and soluble components1,2.
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The main disadvantages of this pharmacological form: instability (sufficiently rapid sedimentation of suspended particles, which does not allow precise dosing of the medicine), the presence of flavorings that can cause allergies, and a short shelf life.
Powders
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Children's antipyretics, produced in the form of powders for preparing a hot drink, can consist of one, two or more components and simultaneously provide antipyretic, analgesic and anti-inflammatory effects. This dosage form, manufactured on equipment designed for the finest grinding, has a larger area of contact with body tissues and, as a result, has a more pronounced pharmacological effect. Children's antipyretic in powder form is easy to dose, it is relatively easy to prepare and is easy to transport.
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In some cases, the powder product may acquire foreign odors, become damp when exposed to moisture, and deteriorate when exposed to light.
Syrups
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Antipyretic syrups for children are water-based medications. They contain an active antipyretic component, sucrose and excipients. They have a fairly pleasant taste, are easy to dose and, due to their dissolved state, begin to act almost immediately1,2.
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Children take antipyretic drugs in the form of syrups with much greater pleasure than tablets. However, due to the high content of sugar and flavorings, these products can provoke the development of an allergic reaction, and the thickness and cloying sweetness can cause nausea and vomiting in a child.
Pills
+ Antipyretic tablets for children are a dosage form for oral administration, obtained by pressing or molding from a mixture of active and auxiliary substances. As a rule, they contain the same active ingredients as antipyretic drugs for adults, only in a lower dosage. The advantages of tablet forms include dosing accuracy, portability, ease of transportation, long shelf life, and prolonged action2.
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Antipyretics for children in the form of tablets are not suitable for all ages, which should be taken into account when choosing a drug. In addition, many children refuse to “drink bad-tasting medicine”; some develop a gag reflex, and if there is severe vomiting, taking pills is impossible.
Based on all of the above, the conclusion suggests itself: the question of which antipyretic is best for a child cannot be answered unequivocally. Any dosage form intended to stabilize temperature indicators must be used taking into account the age restrictions specified in the instructions and in strictly recommended doses. A preliminary consultation with a doctor is required.
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Temperature candles for children
Candles can be used to treat adults and children. Components that promote healing are absorbed through the intestinal mucosa, enter the bloodstream and spread throughout the body, providing an antipyretic effect. The process bypasses the upper gastrointestinal tract without causing irritation. Their main difference from capsules and tablets is that the components necessary for treatment enter the body faster, and accordingly, recovery will occur sooner.
Temperature candles for children:
- Efferalgan. Their active substance is paracetamol, which blocks the center of pain and thermoregulation. Suppositories are used for elevated body temperature, acute respiratory viral infections, influenza, infectious diseases and reactions to vaccines. They can also act as an anesthetic for dental, headache, muscle and other types of pain.
- Panadol. Experts classify these suppositories as analgesics. Their use can reduce pain and lower body temperature. You should not use more than 4 suppositories per day. Without consulting a doctor, treatment should last no longer than 3 days.
- Cefcon D. This drug attracts with its affordable price - 50 rubles per pack. The main active ingredient is paracetamol of varying dosages. The effect of use will be felt after 30 minutes. Also great for lowering fever in babies and newborns.
Review of antipyretic drugs for children with different active ingredients
The list of antipyretics for children includes various groups of drugs that block the production of substances that enhance the body's thermal response. The active ingredients approved for use in pediatric practice are paracetamol, nimesulide, and ibuprofen.
Paracetamol
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Today, paracetamol is one of the most well-known antipyretic drugs used to relieve the unpleasant symptoms of a cold. Produced in a variety of dosage forms (effervescent and chewable tablets, capsules, syrups, rectal suppositories, powders and solutions for injections), in addition to its ability to lower temperature, it acts as a mild analgesic and anti-inflammatory. Unlike other antipyretics, paracetamol-based drugs do not affect normal body temperature. They are quickly absorbed into the blood, in therapeutic doses do not disrupt metabolic processes in the body, and practically do not give side effects from the gastrointestinal tract1,2,3,5.
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Despite the fact that paracetamol-based antipyretic for children is considered one of the safest, in some cases its use can cause the development of allergic reactions. However, in the presence of severe inflammation, paracetamol, due to its weak anti-inflammatory effect, does not have the desired therapeutic effect. With caution - infants up to 3 months.
According to the recommendations of the World Health Organization (WHO), a single dose of paracetamol required to eliminate the symptoms of flu and colds should be up to 1000 mg for children and up to 2000 mg for adults1,3.
Nimesulide
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Nimesulide, which belongs to the group of nonsteroidal anti-inflammatory drugs, has a high safety profile, does not irritate the mucous membrane of the digestive tract, has a pronounced analgesic, antiallergic4 and antibradycardinic (restores heart rhythm) effect, and is characterized by fairly high tolerability4.
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Experts insist that using nimesulide as an analgesic and antipyretic is permissible only if paracetamol is ineffective, strictly as prescribed and under the supervision of a doctor. Also, when taking the drug, you need to take into account that standard doses of nimesulide in some cases can cause a sharp decrease in temperature (by 3 degrees within an hour). Therefore, it is better to start using it with half the dosage, and only then, if necessary and according to the doctor’s indications, increase it. The list of contraindications to nimesulide includes children under 12 years of age due to the aggressive effect of the drug on the liver.
Ibuprofen
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Ibuprofen is a non-steroidal anti-inflammatory antipyretic for children, which also has an analgesic and pronounced anti-inflammatory effect. Preparations containing ibuprofen as an active component improve blood microcirculation, inhibit platelet aggregation, reduce fever and the intensity of inflammation1,2,3.
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This anti-inflammatory and antipyretic for children is recommended to be used no more than once every 6-8 hours and only if paracetamol-containing drugs do not provide the required therapeutic effect. Ibuprofen is contraindicated in infants under 3 months. According to indications, it is possible to use a suspension from 3 months, drops from 2 years, coated tablets from 6 years, extended-release capsules from 12 years. Ibuprofen-based medications can cause side effects, which you should be aware of before starting use.
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FAQ
At what temperature should antipyretics be given?
Pediatricians do not recommend lowering the temperature if it is below 38 - 38.5 ° C, and the baby’s condition does not suffer. If, against the background of fever, there is body aches, headache, pallor and coldness of the extremities, then it makes sense to give the child an antipyretic, regardless of the temperature level. If convulsions occur, you should definitely call an ambulance.
How often can you give your child antipyretics?
Ibuprofen-based antipyretics are used at intervals of ~4-6 hours; for paracetamol, the period between doses is about 12 hours. Duration of admission - no more than 3 days.
What should I do if my child vomits after taking it?
If a child vomits immediately after taking an antipyretic orally, this may be either a reaction to the taste of the drug or vomiting due to fever. In such cases, candles can be used. If the temperature does not decrease after suppositories, and vomiting continues, you need to call a doctor.
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Criteria for choosing drugs for children
So, what antipyretics should you give your child?
- The main criteria for choosing antipyretics approved for use in pediatric practice are safety and effectiveness1.
- When choosing one or another dosage form of an effective antipyretic for children, it is imperative to take into account the single and daily doses, which are determined taking into account the age of the small patient and his body weight7.
- When purchasing several types of drugs, you need to pay attention to the active ingredients. The same component included in various medications can lead to an overdose, a sharp drop in temperature and other negative consequences.
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Rules for taking antipyretics
- Without exception, all types of antipyretics for children are drugs with symptomatic action1. They do not cure colds and flu, but only reduce fever. Therefore, the efforts of parents should be aimed primarily at eliminating the causes that provoked the development of the disease.
- It is strictly not recommended to give antipyretics to the patient on a routine basis (several times a day, by the hour)1. They should be used only when necessary: if the child has a high fever or does not tolerate high temperatures.
- The duration of use of antipyretic drugs for children without consultation with the attending physician should not exceed 3 days. If during this time the child’s condition does not improve, it is necessary to urgently seek help from a specialist. A fever that does not go away for a long time may indicate a secondary bacterial infection that requires specific treatment.
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Troychatka from temperature for children
At elevated temperatures, doctors prescribe medications that relieve painful symptoms. Triad is considered one of the most effective remedies for the disease. This is a preparation of three natural herbs.
The troika for fever helps to cope with acute respiratory viral infections and influenza. This remedy can be used when a child has an elevated temperature due to an inflammatory process, seasonal cold or flu.
An example of such a miracle cure is Troychatka from Evalar. This is a specially developed herbal complex of extracts of three herbs with an antiparasitic effect. This drug does not cause allergies in the baby, as it consists of natural ingredients - extracts and flowers of tansy, wormwood and clove buds.
All of the above medical drugs can be purchased, as well as order the manufacture of drugs in the Gubernskiye Pharmacies network at a reasonable price. Place an order in our online store or call 2911-555.
RINZASIP® for children – a multi-component remedy for alleviating the symptoms of ARVI and influenza
To reduce the severity of negative symptoms of the infectious-inflammatory process and the subsequent progression of colds, a complex drug RINZASIP® was created for children from 6 years of age6. This product, produced in the form of a powder for preparing a raspberry hot drink*, contains 3 active ingredients: paracetamol (280 mg), ascorbic acid (100 mg) and pheniramine (10 mg)6.
Paracetamol has a good antipyretic and analgesic effect, pheniramine has antiallergic properties, relieves swelling and hyperemia of the mucous membrane, helps eliminate nasal congestion, and vitamin C (ascorbic acid) regulates redox processes, supports immunity and increases the body's resistance to infection6.
The powders, packaged in sachets, have a pleasant taste. RINZASIP® for children can be given to a child from 6 years of age to normalize the condition of colds, toothaches, headaches, and rhinitis of allergic origin6. Taking a complex drug at the earliest stages of colds and flu helps prevent their development and alleviates the condition of the little patient.
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Is homeopathy necessary?
In pediatric practice, homeopathy has the right to exist because of its safety, first of all. But there is another undeniable advantage of this group of drugs. Homeopathic medicines do not a priori lower the temperature, but activate the body’s defenses. After taking two or three correctly selected doses, the temperature goes away. Of course, you need to consult your doctor, since each drug has its own characteristics. Here are some examples:
- Aconite stops fever at an early stage of its development, if the temperature rises sharply, the disease progresses intensively, the drug simultaneously relieves anxiety and restlessness;
- Belladonna is necessary at a temperature that is accompanied by delirium, redness of the face, cold feet - sore throat, otitis media;
- Ferrum phosphoricum is used at the very beginning of the disease, when it is clear that there is inflammation, but there are still no symptoms to clarify the localization of the process, the temperature creeps up slowly, the face is either pale or with red spots, the baby behaves restlessly: with purulent sore throat, such a drug is not will help;
- Pulsatilla is a fever medicine for capricious children; the main property of the medicine is the ability to calm children, relieving stress hyperthermia.
Taking homeopathic medicines is special. It is better to give one grain at a time, which needs to be absorbed. Up to 3 years, the medicine is dissolved in water (a couple of granules per glass of water). The first 3 doses are taken every couple of hours, after improvement - less often. If fever returns after discontinuation of the drug, treatment should be continued.
If there is no result from taking three doses, the drug is changed. If the temperature does not fall below 39°C or remains at low-grade levels for more than 5 days, you must call a doctor. This is especially true for newborns. Antipyretic therapy should be carried out against the background of treatment of the underlying pathology that caused the fever.
