Choice of antipyretic drugs for children

At present, there are many antipyretic drugs for children, such as ibuprofen, acetaminophen, indomethacin, nimesulide, aminopyrine, etc. They are all similar drugs and belong to non-steroidal anti-inflammatory drugs. The main side effects are gastrointestinal irritation such as nausea, vomiting, abdominal pain, bloating, diarrhea, etc. Severe cases may cause granulocytopenia, liver and kidney damage, etc. The treatment of fever is mainly aimed at the cause of the disease, and it is necessary to drink more water and physically cool down. If the fever is above 38.5, antipyretic drugs can be used for treatment.

Acetaminophen is the first choice for children over 3 months of age and adults.

The maximum daily dose of acetaminophen for children is 15 mg per kilogram of body weight, once every 4 hours, up to 4 times a day. For example, if the baby weighs 10 kg, the maximum dose that can be given each time is 150 mg. If the concentration of acetaminophen in your hand is 100 mg per ml of drops, then the volume of 150 mg converted into medicine is 1.5 ml, that is, a 10 kg baby can take a maximum dose of 1.5 ml each time. Any dose below this dose is safe, but it cannot exceed. The recommended daily dose of acetaminophen for adults is 500 mg or 650 mg each time, once every 4 to 6 hours, up to 4 times a day, with a single maximum dose of 1000 mg and a maximum daily dose of 4000 mg. Acetaminophen can be used by pregnant and breastfeeding women, and will not harm the fetus or affect the breastfeeding baby. In addition to liquid dosage forms, acetaminophen also has another dosage form: the dosage form that can be administered through the anus, that is, suppositories. In foreign countries, anal administration is actually very common, but due to cultural reasons in our country, most Chinese people find it difficult to accept this method of medication. But in some cases, such as when feeding the baby, the baby will vomit, or the baby has a high fever at night and you don’t want to wake the baby up, it will be much more convenient to use anal suppositories.

Ibuprofen is suitable for children over 6 months and adults.

Patients with favism, i.e. hereditary glucose-6-phosphate dehydrogenase (G6PD) deficiency, should avoid using acetaminophen to reduce fever, but ibuprofen can be used. Patients who do not respond to acetaminophen for reducing fever may also consider using ibuprofen to reduce fever. Well-known drugs with ibuprofen as the only active ingredient include Motrin and Fenbid. The maximum daily dose of ibuprofen for children is 10 mg per kilogram of body weight, once every 6 hours, up to 4 times a day. The conventional dose for adults is 200-400 mg each time, once every 6-8 hours, up to 4 times a day, and the maximum daily dose is 2400 mg. It is safe to use as long as it does not exceed the maximum dose. Ibuprofen has a strong antipyretic effect, and it will cause the body to sweat a lot during the antipyretic process. Therefore, ibuprofen is not suitable for patients with dehydration symptoms. At the same time, ibuprofen is excreted through the kidneys, and patients with poor kidney function should also use it with caution. Ibuprofen's adverse reactions also include the possibility of inducing asthma, and babies with asthma should use it with caution. This drug is safe when used at recommended doses, but overdose can easily cause kidney damage.

What should I do if my child has a persistent high fever?

The minimum time interval between acetaminophen administration is 4 hours. If the fever has not subsided after two hours of taking the maximum dose of acetaminophen, ibuprofen can only be used alternately, because the minimum time interval between the two drugs is two hours. When used alternately, the maximum number of times each drug can be used per day remains unchanged.

Don't easily switch between different types of antipyretic medicines for your child.

When you only need to take two or three antipyretics a day to reduce the fever, I recommend choosing a single antipyretic, because each additional drug doubles the risk of taking the wrong drug. Therefore, when a fever can be controlled with one antipyretic, do not use two drugs alternately. In addition, drink more water when taking medicine to reduce fever, speeding up the excretion process is conducive to taking away the heat in the body. At the same time, while taking medicine to reduce the temperature, you also need to cooperate with physical cooling, such as taking a warm bath or wiping the whole body with a warm and wet towel, but do not use alcohol to wipe, especially for children, as alcohol can easily penetrate the tender skin of children and cause alcohol poisoning.

Note:

When a child has a fever, the first thing to do is to measure the temperature. If the temperature is below 38.5 degrees, physical cooling can be performed. You can give the child a warm bath or apply a cold towel to the forehead. If the temperature exceeds 38.5 degrees, you need to take antipyretics under the guidance of a doctor.

Be sure to give your child plenty of water, measure body temperature at all times, and don't dress your child too much to avoid overheating which accelerates the rise in body temperature.

Popular Science Pharmacist: Wang Hongjie

Workplace: Henan Province Pingyu County Maternal and Child Health Hospital