Symptom Based Treatment - FEVER

Question 1

Cyclooxygenase inhibitor

Answer 1

Aspirin

325-650 mg PO q4-q6

increases the risk of Reye syndrome in children

Question 2

Inhibition of COX 1 and COX2

Answer 2

NSAIDS

• Ibuprofen 200-400 mg PO
• Naproxen 500 mg PO

Question 3

COX 3 Inhibition (CNS)

Answer 3

Acetaminophen - 325-650 mg PO q4 PRN

do NOT exceed 3250 mg/day (max of 4 g/day)

Question 4

Reduces PGE2 synthesis

Blocks transcription of mRNA of pyrogenic cytokines

Answer 4

Glucocorticoids

• Dexamethasone 0.5 mg/kg (max 10 kg)
• Prednisone 0.5-2 mg/kg/day

reserved for steroid responsive fever of unknown origin (SR-FUO) and periodic fever syndromes

Question 5

(-) IL-1B activity

Answer 5

Anticytokines
*Anakinra

used for patients w/ autoimmune and autoinflammatory diseases (familial Mediteranean fever, periodic fever syndromes)