Written by Jacob Liu | Edited by Alexander Alva
Photo by Polina Tankilevitch
Whether from fighting off infections or other ailments, fever is a normal response of the body’s immune system. Fever occurs when the thermoregulatory response in the hypothalamus in the brain sets off to increase the body’s core temperature. This state of raised body temperature, scientifically known as pyrexia, is attributed to fever-inducing substances produced by the body, known as pyrogens [1]. Elevated body temperature serves the body well by increasing the metabolic rate, which enhances immune functionality; increasing white blood cell activity; stimulating antiviral agent production; and activating T cells, all improving the innate ability of the immune system to resolve whatever disease is occurring [2]. However, high body temperature causes brain damage when above 107.6°F and various gastrointestinal, liver, and kidney issues when above 104°F [1]. This has led to a global usage of medications to decrease fever, known as antipyretics, to prevent these adverse effects. However, in treating fever, the usage of antipyretics especially in children has grown beyond cautionary usage to prevent dangerous temperature rises [3]. Instead, antipyretics have been largely used to prevent essential rises in temperature required to trigger the body’s natural immune response, negatively affecting the health of those overusing antipyretics.
From a sick child inconveniencing busy parents to an elderly person with a worrisomely persistent fever, such situations motivate people around the world to take antipyretics in order to decrease fever in hopes of helping alleviate the ailment of a cared one. These antipyretics are commonly found in household medicines, such as acetylsalicylic acid in aspirin, acetaminophen in Tylenol, and other nonsteroidal anti-inflammatory drugs like ibuprofen in Advil [4]. Although the recommended practice for children is to start antipyretics at temperatures higher than 101°F, many caregivers are more concerned with the discomfort of their children and may begin to give antipyretics at temperatures below 100°F, resulting in practices that may continue throughout life unless better informed [5]. Additionally, antipyretics are intended to be administered based on weight of the individual; however, studies have shown that caregivers administer based on height and age, which has led to overdosage and overuse of antipyretics [3]. This trend results in increased recovery times from the original ailment, as well as liver damage due to the chronic exposure to toxic byproducts resulting from the breakdown of antipyretics [6].
Consequently, with the ongoing trend of antipyretic overuse around the world, there must be change before these damaging practices become all too common and harmful. So far, the best method of correcting against this has been the improvement of public health education by physicians, pharmacists, and researchers who bring knowledge of these dangers and excessiveness to the public, such as by parameters of temperature ranges, type of antipyretic, and proper dosage amounts based on body weight. Additionally, many pharmaceutical companies have begun improving medication labels to provide more easily accessible resources on usage and guidelines to prevent such dangers. All in all, we can hope that better education and safe practice of antipyretic usage will help things to cool down in fever treatment around the world.
References:
5. Sullivan, J.E., Farrar, H.C. (2011) Fever and Antipyretic Use in Children. Pediatrics, 127(3):580-587. 6. Ladd, Joseph. “How much is too much? Acetaminophen overuse in the United States.” Pharmacy Today, Elsevier Inc., 1 November 2018, www.pharmacytoday.org/article/S1042-0991(18)31497-X/fulltext#relatedArticles. Accessed 20, October 2022.