PF1011 Pharmacy Practice I Pain and Analgesia – Part 3 PDF

PF1011: Pharmacy Practice I Pain and Analgesia – Part 3 Dr. Harriet Bennett-Lenane [email protected] Lecture Layout Fever in Children OTC Pain Relief in Pregnancy and Breastfeeding Learning Outcomes By the end of this lecture, you should be able to… Describe what a fever is in lay...

PF1011: Pharmacy Practice I Pain and Analgesia – Part 3 Dr. Harriet Bennett-Lenane [email protected] Lecture Layout Fever in Children OTC Pain Relief in Pregnancy and Breastfeeding Learning Outcomes By the end of this lecture, you should be able to… Describe what a fever is in lay language Discuss the elements contained within the NICE Traffic Light system Differentiate between situations where the child with fever needs to be referred or can be treated by the pharmacist Discuss the treatment options (pharmacological and non-pharmacological) for fever Fever in Children NICE Guidelines “This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care.” - NICE Thermoregulation - Hypothalamus – blood temperature - “Thermostat” Normal human temperature - Considered to be 37°C - Can vary by up to 1°C A pyrogen is a substance that provokes fever. What is a fever? Normal body temperature: 37ᵒC Oral temp: 37±1ᵒC Rectal temp ~0.5ᵒC higher Underarm temp ~0.5ᵒC lower. HSE: A normal temperature is between 36 and 36.8ᵒC. Fever ≥38ᵒC ‘A rise in body temperature above normal.’ In children, any temperature of 38 degrees Celsius or above is considered high (HSE) For adults (HSE): Mild fever (38 to 38.9 degrees Celsius) High fever (39 to 39.9 degrees Celsius) Very high fever (40 degrees Celsius or higher) Low grade or high-grade fever. Fever Fever by-product of host response to infection, Fever is a common and normal physiologic response that results in an increase in the hypothalamic “set point” in response to endogenous and exogenous pyrogens. In contrast, hyperthermia is a rare and pathophysiologic response with failure of normal homeostasis (no change in hypothalamic set point) that results in heat production that exceeds capability to dissipate heat. Emphasize that fever is not an illness but is, a physiologic mechanism that has beneficial effects in fighting infection. Retards growth and reproduction of bacteria and viruses, enhances neutrophil production and T-lymphocyte proliferation, and aids in the body's acute-phase reaction. Degree of fever does not always correlate with the severity of illness. Most fevers are of short duration, are benign, and may actually protect the host. Fever in Children High temperature is common in young children. The temperature usually returns to normal in 3 or 4 days. A temperature above 38 Degrees Celsius is usually a sign of an infection such as a cold. But it can also be due to more serious infections, so it's important to look at all symptoms, is the child alert and responding. Even if they do not have a high temperature, they may still be seriously ill. How to Measure Temperature (NICE) Do not routinely use the oral and rectal routes to measure the body temperature of children aged 0 to 5 years. In infants