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PloS One 2014Prophylactic antipyretic administration decreases the post-vaccination adverse reactions. Recent study finds that they may also decrease the antibody responses to... (Review)
Review
BACKGROUND
Prophylactic antipyretic administration decreases the post-vaccination adverse reactions. Recent study finds that they may also decrease the antibody responses to several vaccine antigens. This systematic review aimed to assess the evidence for a relationship between prophylactic antipyretic administration, post-vaccination adverse events, and antibody response in children.
METHODS
A systematic search of major databases including MEDLINE and EMBASE was carried out till March 2014. Randomized controlled trials (RCTs) comparing prophylactic antipyretic treatment versus placebo post-vaccination in children ≤ 6 years of age were included. Two reviewers independently applied eligibility criteria, assessed the studies for methodological quality, and extracted data [PROSPERO registration: CRD42014009717].
RESULTS
Of 2579 citations retrieved, a total of 13 RCTs including 5077 children were included in the review. Prophylactic antipyretic administration significantly reduced the febrile reactions (≥ 38.0 °C) after primary and booster vaccinations. Though there were statistically significant differences in the antibody responses between the two groups, the prophylactic PCM group had what would be considered protective levels of antibodies to all of the antigens given after the primary and booster vaccinations. No significant difference in the nasopharyngeal carriage rates (short-term and long-term) of H. influenzae or S. pneumoniae serotypes was found between the prophylactic and no prophylactic PCM group. There was a significant reduction in the local and systemic symptoms after primary, but not booster vaccinations.
CONCLUSIONS
Though prophylactic antipyretic administration leads to relief of the local and systemic symptoms after primary vaccinations, there is a reduction in antibody responses to some vaccine antigens without any effect on the nasopharyngeal carriage rates of S. pneumoniae & H. influenza serotypes. Future trials and surveillance programs should also aim at assessing the effectiveness of programs where prophylactic administration of PCM is given. The timing of administration of antipyretics should be discussed with the parents after explaining the benefits & risks.
Topics: Antibodies; Antipyretics; Child; Humans; Treatment Outcome; Vaccination
PubMed: 25180516
DOI: 10.1371/journal.pone.0106629 -
Life Sciences Jan 2023Acetaminophen is the medication of choice when treating fever because of its limited anti-inflammatory effects. However at overdose it can cause mitochondrial...
AIMS
Acetaminophen is the medication of choice when treating fever because of its limited anti-inflammatory effects. However at overdose it can cause mitochondrial dysfunction and damage, often associated with metabolism to N-acetyl-p-benzoquinone imine (NAPQI). What has never been investigated is whether the inhibition of mitochondrial function, particularly fatty acid uptake and oxidation could be the key to its antipyretic and hypothermic properties.
METHODS
Mitochondrial function and fatty acid oxidation (FAO) was determined by measuring oxygen consumption rate (OCR) in isolated mitochondria and in 3T3-L1 adipocytes using the XFp Analyser. Basal fatty acids and adrenergic stimulated OCR of mitochondria and 3T3-L1 adipocytes were assessed with acetaminophen and compared to NAPQI, etomoxir, and various mitochondrial stress compounds.
KEY FINDINGS
Using the XFp Analyser, acetaminophen (10 mM) decreased FAO by 31 % and 29 % in basal and palmitate stimulated adipocytes. NAPQI (50 μM) caused a 63 % decrease in both basal and palmitate stimulated FAO. Acetaminophen (10 mM) caused a 34 % reduction in basal and adrenergic stimulated OCR. In addition acetaminophen also inhibited complex I and II activity at 5 mM. NAPQI was far more potent at reducing mitochondrial respiratory capacity, maximum respiratory rates and ATP production than acetaminophen.
SIGNIFICANCE
These studies demonstrate the direct inhibition of mitochondrial function by acetaminophen at concentrations which have been shown to reduce fever and hypothermia in mammals. Understanding how antipyretics directly affect mitochondrial function and heat generation could lead to the development of new antipyretics which are not compromised by the anti-inflammatory and toxicity of the current medications.
Topics: Animals; Acetaminophen; Antipyretics; Hypothermia; Benzoquinones; Mitochondria; Adrenergic Agents; Fatty Acids; Palmitates; Mammals
PubMed: 36379307
DOI: 10.1016/j.lfs.2022.121194 -
African Health Sciences Mar 2023leaves and fruits of are used locally in the management of fever in Nigeria. No scientific credence has been lent to this claim.
BACKGROUND
leaves and fruits of are used locally in the management of fever in Nigeria. No scientific credence has been lent to this claim.
OBJECTIVE
To investigate the antipyretic effect and potency of aqueous extracts of leaves and fruits of in albino rats.
METHOD
Brewer's yeast was used to induce pyrexia. Thirty animals were divided into six groups. Group A was orally administered normal saline (103 mg/kg). Group B was served indomethacin (5 mg/kg), while groups C and D received aqueous extract of at 100mg/kg and 200mg/kg, 17 hours post induction of pyrexia. Groups E and F were administered extract of at the same doses. Rectal temperature of the animals was taken at 60-, 90- and 120-minutes post-treatment.
RESULTS
Both and produced significant reduction (p<0.05) in rectal temperature after 120 minutes in the rats compared with animals in the control group. Also, the antipyretic activities of the two extracts at 100mg/kg and 200mg/kg were comparable to 5mg/kg of indomethacin, with apparent dose dependence in the antipyretic activities of both extracts.
CONCLUSION
leaves and fruits of exhibit dose-dependent antipyretic activities.
Topics: Rats; Animals; Antipyretics; Plant Extracts; Capsicum; Morinda; Fruit; Fever; Indomethacin; Plant Leaves
PubMed: 37545963
DOI: 10.4314/ahs.v23i1.23 -
CNS Drug Reviews 2007The combination of numerous classic drugs with nitric oxide donors has led to the development of new compounds with promising therapeutic activities in a great variety... (Review)
Review
The combination of numerous classic drugs with nitric oxide donors has led to the development of new compounds with promising therapeutic activities in a great variety of situations, including cardiovascular and respiratory systems, ocular pressure, inflammation, and pain. One of the first compounds developed was NCX-701 or nitroparacetamol, resulting from the combination of paracetamol, a classic and popular analgesic used in a great number of over-the-counter medications because of its antipyretic and analgesic properties, and a nitrooxybutyroyl moiety, which releases nitric oxide at a low but steady level. Although paracetamol is devoid of most of the gastrointestinal toxicity associated with aspirin-like drugs, this type of compounds was first designed to take advantage of the cytoprotective properties of nitric oxide when released at low concentrations. However, the combination of these molecules also resulted in an unexpected enhancement of the analgesic activity of paracetamol. In fact, NCX-701 has been shown to be effective in acute nociception as well as in neuropathic pain, situations in which paracetamol and other COX inhibitors are devoid of any effect. In addition, NCX-701 is more potent and, in some circumstances, more effective than its parent compound in different models of inflammatory pain. Furthermore, whereas paracetamol lacks any effective antiinflammatory action, NCX-701 might reduce inflammation. All these results taken together imply that the mechanism of action of NCX-701 is different from that of paracetamol, although it is not yet established for either molecule. NCX-701 appears to be a promising compound in the treatment of different types of pain, with a likely better profile of side effects than its parent molecule, paracetamol. Although recent clinical trials provided data consistent with the preclinical profile of NCX-701, further studies are needed to support its clinical use.
Topics: Acetaminophen; Analgesics; Animals; Humans; Nitrates; Pain
PubMed: 17894645
DOI: 10.1111/j.1527-3458.2007.00016.x -
The Annals of Pharmacotherapy Oct 2011Antipyretic therapy is commonly prescribed for patients with infection, but studies of its impact on clinical outcomes have yielded mixed results. No data exist to...
BACKGROUND
Antipyretic therapy is commonly prescribed for patients with infection, but studies of its impact on clinical outcomes have yielded mixed results. No data exist to characterize the use of antipyretic medications in patients with severe sepsis or septic shock.
OBJECTIVE
To identify clinical and demographic factors associated with antipyretic medication administration in severe sepsis and septic shock.
METHODS
This single-center, retrospective, cohort study assessed febrile patients (temperature ≥ 38.3 °C) with gram-negative severe sepsis or septic shock at an 1111-bed academic medical center between January 2002 and February 2008. Patients were excluded if they had liver disease, acute brain injury, or allergy to acetaminophen. Generalized estimating equations were used to estimate the effect of clinical factors on treatment of patients with antipyretic medications.
RESULTS
Although 76% of patients in this febrile cohort (n = 241) were prescribed an antipyretic agent, only 42% received antipyretic therapy; 95% of the doses were acetaminophen. Variables associated with antipyretic treatment were maximum body temperature (OR 2.11, 95% CI 1.53 to 2.89), time after sepsis diagnosis (OR 0.88, 95% CI 0.82 to 0.95), surgery during hospitalization (OR 0.49, 95% CI 0.31 to 0.80), death within 36 hours (OR 0.35, 95% CI 0.15 to 0.85), and mechanical ventilation (OR 0.58, 95% CI 0.34 to 0.98). Severity of illness factors, demographic factors, and patient treatment location did not predict who would receive antipyretic therapy.
CONCLUSIONS
Most febrile episodes in patients with gram-negative severe sepsis or septic shock were not treated with antipyretic medications. Further studies are needed to demonstrate the effect of antipyretics on clinically relevant outcomes in severe sepsis and septic shock.
Topics: Academic Medical Centers; Acetaminophen; Adult; Aged; Antipyretics; Bacteremia; Cohort Studies; Female; Fever; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Missouri; Myocardial Ischemia; Positive-Pressure Respiration; Postoperative Complications; Practice Patterns, Physicians'; Retrospective Studies; Risk Factors; Shock, Septic
PubMed: 21934034
DOI: 10.1345/aph.1Q319 -
The American Journal of the Medical... Apr 2021With mortality rising from the COVID-19 pandemic, we may be overlooking a key aspect of the immunological response. Fever is a cardinal sign of this rampant infection;... (Review)
Review
With mortality rising from the COVID-19 pandemic, we may be overlooking a key aspect of the immunological response. Fever is a cardinal sign of this rampant infection; however, little attention has been paid towards how a fever may work in our favor in overcoming this disease. Three key aspects of patient care - fever, fluid, and food - can be harmonized to overcome COVID-19 infection. Both animal and human studies have demonstrated that fever suppression during viral infections, either through low ambient temperatures or antipyretic use, may increase morbidity and prolong the illness. As fever rises, so do antidiuretic hormone levels, leading to solute-free water retention - making conservative fluid management essential. Finally, fever inhibits gastrointestinal function as energy is reallocated to the immunological response, underscoring the need to work in concert with these physiological changes. An opportunity awaits to investigate this natural barrier to infection, let us not pass it by.
Topics: Antipyretics; COVID-19; Fever; Humans; SARS-CoV-2
PubMed: 33781387
DOI: 10.1016/j.amjms.2021.01.004 -
Asian Pacific Journal of Tropical... Nov 2012To evaluate the analgesic, anti-inflammatory and antipyretic activity of methanolic Tecomaria capensis (T. capensis) leaves extract using different models in rats.
OBJECTIVE
To evaluate the analgesic, anti-inflammatory and antipyretic activity of methanolic Tecomaria capensis (T. capensis) leaves extract using different models in rats.
METHODS
Methanolic T. capensis leaves extract (100, 300, 1000 and 2000 mg/kg body weight) was given to rats orally to observe acute toxicity, and observed for 14 days. Analgesic activity was evaluated using tail immersion and formalin induced paw licking models in rats. Anti-inflammatory activity was evaluated using carrageenan induced paw edema model in rats. Antipyretic activity was evaluated using brewer's yeast induced pyrexia model in rats. Methanolic T. capensis leaves extract were given at dose of 100, 200 and 500 mg/kg p.o.
RESULTS
Results demonstrated that the no mortality was reported even after 14 days. This indicated that the methanol extract was safe up to a single dose of 2 000 mg/kg body weight. Methanolic T. capensis leaves extract (100, 200 and 500 mg/kg p.o.) significantly increased the latency period in the tail immersion test, reduced the licking time in both the neurogenic and inflammatory phases in the formalin test. Methanolic T. capensis leaves extract (100, 200 and 500 mg/kg p.o.) significantly prevented increase in volume of paw edema. Methanolic T. capensis leaves extract at the doses of (100, 200 and 500 mg/kg p.o.) significantly decreased the rectal temperature of the rats.
CONCLUSIONS
This study exhibites that methanolic T. capensis leaves extract possesses analgesic, anti-inflammatory and antipyretic activity which may be mediated by the central and peripheral mechanisms.
Topics: Analgesics; Animals; Anti-Inflammatory Agents; Antipyretics; Behavior, Animal; Bignoniaceae; Disease Models, Animal; Edema; Female; Fever; Male; Pain Management; Pain Measurement; Plant Extracts; Plant Leaves; Rats
PubMed: 23569863
DOI: 10.1016/S2221-1691(12)60245-7 -
MSphere Jan 2024Acetaminophen is a widely used antipyretic and analgesic drug, and its overdose is the leading cause of drug-induced acute liver failure. This study aimed to investigate...
Acetaminophen is a widely used antipyretic and analgesic drug, and its overdose is the leading cause of drug-induced acute liver failure. This study aimed to investigate the effect and mechanism of Shirota (LcS), an extensively used and highly studied probiotic, on acetaminophen-induced acute liver injury. C57BL/6 mice were gavaged with LcS suspension or saline once daily for 7 days before acute liver injury was induced via intraperitoneal injection of 300 mg/kg acetaminophen. The results showed that LcS significantly decreased acetaminophen-induced liver and ileum injury, as demonstrated by reductions in the increases in aspartate aminotransferase, total bile acids, total bilirubin, indirect bilirubin, and hepatic cell necrosis. Moreover, LcS alleviated acetaminophen-induced intestinal mucosal permeability, decreased serum IL-1α and lipopolysaccharide levels, and elevated serum eosinophil chemokine (eotaxin) and hepatic glutathione levels. Furthermore, analysis of the gut microbiota and metabolome showed that LcS reduced the acetaminophen-enriched levels of , , long-chain fatty acids, cholesterol, and sugars in the gut. Additionally, the transcriptomic and proteomic results showed that LcS mitigated the decrease in metabolic and immune pathways as well as glutathione formation during acetaminophen-induced acute liver injury. This is the first study showing that pretreatment with LcS alleviates acetaminophen-enriched acute liver injury, and it provides a reference for the application of LcS.IMPORTANCEAcetaminophen is the most frequently used antipyretic analgesic worldwide. As a result, overdoses easily occur and lead to drug-induced acute liver injury, which quickly progresses to liver failure with a mortality of 60%-80% if not corrected in time. The current emergency treatment for overused acetaminophen needs to be administered within 8 hours to avoid liver injury or even liver failure. Therefore, developing preventive strategies for liver injury during planned acetaminophen medication is particularly important, preferably nonpharmacological methods. Shirota (LcS) is a famous probiotic that has been used for many years. Our study found that LcS significantly alleviated acetaminophen-induced acute liver injury, especially acetaminophen-induced liver injury toward fulminant hepatic failure. Here, we elucidated the function and potential mechanisms of LcS in alleviating acetaminophen-induced acute liver injury, hoping it will provide preventive strategies to people during acetaminophen treatment.
Topics: Humans; Mice; Animals; Acetaminophen; Lacticaseibacillus casei; Antipyretics; Chemical and Drug Induced Liver Injury, Chronic; Proteomics; Mice, Inbred C57BL; Administration, Oral; Liver Failure; Analgesics; Glutathione; Bilirubin
PubMed: 38193757
DOI: 10.1128/msphere.00672-23 -
Journal of Traditional Chinese Medicine... Jun 2023To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine (TCM) on coronavirus disease 2019 (COVID-19) patients.
OBJECTIVE
To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine (TCM) on coronavirus disease 2019 (COVID-19) patients.
METHODS
We retrospectively analyzed 369 patients from January 26th, 2020 to April 15th, 2020, who had been diagnosed with COVID-19. Among 92 eligible cases, 45 cases were identified as treatment group Ⅰ ( 45) and 47 cases were identified as treatment group Ⅱ. Patients in the treatment group Ⅰ were treated with TCM herbal decoction within 5 d after admission. Patients in the treatment group Ⅱ were treated with TCM herbal decoction after the 6th admission day. The onset time of antipyretic effect, the antipyretic time, the time of negative oropharyngeal swab nucleic acid conversion, and the changes of cell count in blood routine test were compared.
RESULTS
The treatment group I showed shorter average antipyretic duration (4 7 d; <0.05), and shorter average time for polymerase chain reaction (PCR) nucleic acid test results to turn negative (7 11 d; <0.05) than the treatment group II. For patients ( 54) with body temperature>38 ℃, patients in the treatment group I had shorter median onset time of antipyretic effect than those in the treatment group II (3 4 d; <0.05). The absolute lymphocyte (LYMPH) count and absolute eosinophil (EOS) count on the 3rd day after admission and the neutrophil/lymphocyte ratio on the 6th day after admission of patients in the treatment group I were notably different from those in the treatment group II at the same time point (0.05). Based on Spearman's rank correlation analysis, the change of body temperature on the 3rd day after admission was positively correlated with the increase of EOS count and the increase of EOS count and LYMPH counts on the 6th day after admission (0.01).
CONCLUSIONS
Early TCM intervention within 5 d after hospital admission shortened the onset time of antipyretic effect and fever duration of COVID-19 patients, reduced the time required for PCR test results to turn negative. Moreover, early TCM intervention also improved the results of inflammatory markers for COVID-19 patients. LYMPH and EOS counts can be used as indicators of TCM antipyretic effect.
Topics: Humans; COVID-19; Medicine, Chinese Traditional; Retrospective Studies; Antipyretics; SARS-CoV-2; Drugs, Chinese Herbal
PubMed: 37147761
DOI: 10.19852/j.cnki.jtcm.20230208.001 -
JAMA May 2021This study describes oral temperatures in a large sample of nonsurgical inpatients without infections to inform evaluation of fever in the hospital.
This study describes oral temperatures in a large sample of nonsurgical inpatients without infections to inform evaluation of fever in the hospital.
Topics: Acetaminophen; Age Factors; Anti-Inflammatory Agents, Non-Steroidal; Antipyretics; Body Temperature; Female; Humans; Inpatients; Male; Mouth; Reference Values; Sex Factors
PubMed: 33974027
DOI: 10.1001/jama.2021.1541