Pediatria pre prax 4/2003
Farmakoterapie horečky u dětí
Pharmacotherapy of fever in children Although fever belongs to the most common and prominent symptom of disease, our understanding of effectivenes of antipyretic drugs is far from ideal. The common mechanism of action of antipyretics is blockade of prostaglandin production in hypothalamus. The key enzyme responsible for production of feverous prostaglandins is cyclooxygenase 2 (COX-2). The use of aspirin in the therapy of fever in infancy is limited due to risk of Reye´s syndrome. Paracetamol is well established and safe antipyretic in children despite recent meta-analysis brought conflicting results. Nonsteroidal antiinflammatory drugs (ibuprofen and nimesulide) are newer agents with sufficient evidence of efficacy. Metamizole is forgotten alternative to commonly used antipyretic drugs. Key words: fever, antipyretics, paracetamol, aspirin, ibuprofen, metamizole, nimesulide.
