Understanding Fever and OTC Treatments

15 Questions

What is the defined body temperature for fever?

100º F (37.8º C)

Which term is used to describe a malfunctioning of the normal thermoregulatory process at the hypothalamic level?

Hyperthermia

What is the body temperature range associated with hyperpyrexia?

>106º F (>41.1º C)

What regulates the rise in body temperature in response to a pyrogen?

Hypothalamus

What does hyperpyrexia indicate?

Body temperature higher than 104º F

Which condition might require medical attention and is associated with fever?

HIV

What is the recommended antipyretic for pregnancy and breastfeeding?

Acetaminophen

Which antipyretic is contraindicated in children under 6 months and those with chickenpox or influenza-like symptoms?

Aspirin

What is the potential adverse effect of Ibuprofen?

Increased blood pressure

What should be carefully considered to improve adherence and outcomes of non-prescription analgesics and antipyretics?

Following dosing instructions carefully

Which of the following can induce hyperthermia as a side effect?

Chloramphenicol

How should core temperature be measured consistently throughout an illness?

Using the same thermometer and site

What is the recommended temperature measurement site for children over 3 years of age?

Oral

What complications are associated with fever?

Dehydration, change in mental status, seizures

What is the diagnosis of fever based on?

Temperature above the normal range

Study Notes

Fever is caused by the activation of immune cells, leading to an increase in body temperature. This can be due to exogenous pyrogens released by macrophages and lymphocytes, or endogenous pyrogens like interleukins, interferons, and tumor necrosis factor.
Clinical presentation of fever includes symptoms such as headache, diaphoresis, generalized malaise, chills, tachycardia, arthralgia, myalgia, irritability, anorexia, and elevated body temperature.
Medications can induce hyperthermia as a side effect, including antimicrobials such as aminoglycosides, amphotericin B, cephalosporins, clindamycin, chloramphenicol, imipenem, isoniazid, linezolid, macrolides, mebendazole, vancomycin, antineoplastics like bleomycin, chlorambucil, cytarabine, daunorubicin, hydroxyurea, LAsparaginase, 6-Mercaptopurine, procarbazine, streptozocin, cardiovascular drugs such as epinephrine, hydralazine, methyldopa, nifedipine, procainamide, quinidine, streptokinase, CNS agents like amphetamines, barbiturates, benztropine, carbamazepine, haloperidol, lithium, nomifensine, phenytoin, phenothiazines, serotonin-noradrenaline reuptake inhibitors, tricyclic antidepressants, sumatriptan, thioridazine, trifluoperazine, topiramate, zonisamide, monoamine oxidase inhibitors, and other agents like allopurinol, atropine, azathioprine, cimetidine, corticosteroids, folate, inhaled anesthetics, interferon, iodides, metoclopramide, propylthiouracil, prostaglandin E2, salicylates, tolmetin, etc.
To accurately detect fever, a thermometer must be used to measure the core temperature, which can be estimated using various sites such as rectal, oral, axillary, tympanic, or temporal.
Core temperature should be measured consistently using the same thermometer and site throughout an illness, as readings may vary up to 2.5°F (1.4°C) depending on the site and individual body temperature.
Diagnosis of fever is based on a temperature above the normal range, which varies by measurement site and age. For example, a rectal temperature above 100.4°F (38.0°C), an oral temperature above 99.5°F (37.5°C), or an axillary temperature above 99°F (37.2°C) may indicate fever.
Recommended temperature measurement sites by age include rectal for infants under 3 months, rectal, oral, or temporal for children aged 3-36 months, and oral, tympanic, or temporal for children over 3 years of age.
Complications of fever include dehydration, change in mental status, seizures, and febrile seizures in infants or children without an intracranial infection, metabolic disturbance, or other defined cause.
Treatment of fever includes self-management with antipyretics, nondrug measures, medical referral, and prescription of antipyretic agents based on patient factors and preferences. Exclusion criteria for self-management include age under 3 months with rectal temperature above 100.1°F (38°C), age over 3 months with rectal temperature above 104°F (40°C), symptoms that are not self-limiting, increased risk of hyperthermia, impaired oxygen utilization, or impaired immune function.