pain and fever. - what is an analgesic? it relieves pain by providing symptomatic treatment for pain and fever but does not treat the cause. pain happens because of stimulation of sensory nerves (specialized nerve endings) which result in distress or agony. the cause of pain is mechanical which is heat or cold, neurotransmitter release and inflammatory mediators and decreased threshold at nerve endings to sources of pain. endorphins are our protective mechansim (reflexive withdrawal) they are natural hormones in our body that inhibits pain perception, one type of endorphin enkephalins stimulate morphine action, they can also increase with exercise, acupuncture, meditation, sex, music, laughter and uv light. there are 3 types of pain: referred which is when the pain is projected to a distant part of the body and the origin is usually deep visceral. superficial pain orignates from skin receptors, mucus membranes or connective tissues near the surface of our skin, it's characterized as a shapr, pricking, burning or throbbing sensation that is usually localized to the area of damage such as a cut or scrape. deep visceral pain comes from our internal organs like the heart, lungs, gi tract and bladder due to inflammation or obstruction, it is often felt as a dull, squeezing, aching ot poorly localized and deep sensation. it is hard for us to pinpoint the exact location of pain. fever - our body temperature is regulated by homeostasis means. our hypothalamus balances heat production and heat loss by causing peripheral vasodilation which is when our skin feels hot. pyrogens change the hypothalamic 'set point' so the body regulates to a higher temperature. a pyrogen is any agent that causes a fever, it can be produced in the body as a response to infection or inflammation, a drug-induced fever may result from stimulation of pyrogen production or be a manifestation of a drug allergy/hypersensitivity. a fever is our body's warning signal that we have an illness or other problems. fever is also called pyrexia! a low grade fever is between 37.3 to 38.0 C, moderate grade is between 38.1 to 39.0 C, high grade is between 39.1 to 41 C and hyperthermia is greater than 41C. febrile seizures in infants happens when the fever is too much for the brain to handle. we use thermometers to measure fevers, armpit is for newborns and young children, mouth is for children > 5 years and adults, ear is the least reliable and used in children < 2 years and adults and rectal is fr newborns and young children and is the most accurate.
drugs for pain and fever - acetaminophen (Tylenol) is a non-opioid analgesic and antipyretic but has no effect on inflammation making it not a NSAID, there are fewer drug interactions and side effects with acetaminophen and its safe for pediatric use which is best dosed by weight and considered safe in pregnancy. - NSAIDs: nonsteroidal anti-inflammatory drugs like ASA, ibuprofen, naproxen and diclofenac. higher-strength formulations of ibuprofen and naproxen are prescription only. NSAIDs have many drug/disease interactions such like blood pressure and heart medications, anticoagulants/antiplatelets and varying degree of GI issues such as ulcers. acetylsalicylic acid/ASA (Aspirin) comes as oral tablets in many different strengths such as 325mg which is regular strength, 81mg which is coated low dose for antiplatelet effect, there is also entrophen and novasen, coated asipirin 325mg or daily low dose 81mg. there are also suppositories 150mg for pediatric and 650mg for adults. - ibuprofen (Motrin, Advil and Apo-Ibuprofen) they come as tablets, liquids and caplets. comes in 200mg, 300mg and 400mg and 600mg which is prescription only. they are safe in children which is dosed best by weight. - naproxen (Aleve) which has a longer duration of action than ibuprofen they last up to 12 hours, no OTC (over the counter) childrens formulations, packaged for 12 years and up and can be used for under 2 years old but requires a prescription. combination products - ASA combinations: Alka-Seltzer which is ASA + citric acid and sodium bicarbonate (effervescent), Anacin which is ASA and caffeine, Roaxisal: ASA and methocarbamol (+/- codeine) and 222's which is ASA + caffeine and codeine. next there is acetaminophen combinations: Excedrin/Tylenol ultra relief which is acetaminophen and caffeine, Tylenol night time which is acetaminophen and diphenhydramine, Tylenol #1 which is acetaminophen + codeine and caffeine, Robaxacet: acetaminophen + methocarbamol (+/- codeine), Mersyndol: acetaminophen + codeine + doxylamine succinate then there is Midol which is acetaminophen + caffeine and pyrilamine. then there is ibuprofen combinations contain Robax platinum: ibuprofen and methocarbamol, Combogesic which is ibuprofen and acetaminophen and Advil nighttime which is ibuprofen and diphenhydramine. analgesics may be combined with decongestants it may also be combined with cough suppressants and antihistamines for cold symptom relief. the last NSAID is diclofenac diethylamine (Voltaren) which is a topical formulation. it comes as original and joint pain which is 1.16% and extra strength which is 2.12%, it is used for mild arthritic pain and should not be taken with an oral NSAID, it's meant for local relief but is absorbed systemically. the extra strength is double the strength of the original and lasts up to 12 hours. there is also salicylates topicals: methylsalicylate and trolaminesalicylate. NSAIDs should be avoided beyond 20 weeks in pregnancy, use during this time can result in low amniotic fluid and may impair lung maturation and increased bleeding/hemorrhage in the baby.
common cold - which is a viral infection affecting the mucous membranes of the upper respiratory tract, it is also referred to as rhinoviruses which invade nasal epithelial cells causing damage and triggering inflammation. the inflammation causes congestion, cough and a runny nose; illness resolves with immune defense. cold viruses spread mainly through hand to hand contact and respiratory droplets from coughing and sneezing. blocked sinus drainage can lead to sinusitis or bronchitis with worsened symptoms and fever after initial cold. infants and older adults are more at risk due to their weaker immunity and increased risk of prolonged illness.
drugs for the common cold - antitussives for cough relief like codeine and dextromethorphan, they supress coughs duh. codeine also has analgesic effects is unsafe for children under six. expectorants thin mucus to ease productive coughs (wet cough) and decongestants reduce nasal swelling but must be used carefully to avoid rebound effects. analgesics relieve pain and fever like mentioned before and first-gen antihistamines reduce sneezing but may cause sedation. an example of an expectorant is guaifenesin (Mucinex, Robitussin, Benylin-DM-D-E, Benylin first defense, Sudafed) now for decongestants we have pseudoephedrine and phenylephrine (oral) and xylometazoline (Otrivin), oxymetazoline (Dristan) which are topicals. antihistamines include chlorpheniramine and doxylamine.
allergic reactions - sensitization process: during first exposure the immune system produces IgE antibodies that prepare for allergic response. mast cell activation: on re-exposure, allergens bind IgE on mast cells triggering the release of inflammatory chemicals. allergic symptoms: inflammatory mediators cause symptoms like itching, sneezing, swelling and mucus production. allergic rhinits: affects the nasal mucosa and is triggered by outdoor pollen or indoor allergens like dust mites. urticara(hives): it causes itchy, raised welts on the skin and is a common allergic skin reaction. asthma reaction: it's a severe allergic reaction causing bronchial constriction and breathing difficulty. anaphylaxis emergency: it's a rapid, life-threatning systemic allergic reaction. allergen contact: antigenic proteins contact nasal mucosa and are processed by protective enzymes during first exposure. IgE antibody production: immune system produces IgE antibodies specific to the allergen, marking sensitization initiation. mast cell sensitization: IgE binds mast cells in skin and mucosa, priming them to release inflammatory mediators upon re-exposure. mast cell activation: allergens bind to IgE on mast cells which trigger degranulation and chemical mediator release. role of histamine: they cause vasodilation (widening of blood vessels caused by the relaxation of smooth muscle cells in vessel walls which increases blood flow and reducing blood pressure), increased permeability, muscle contraction and mucus secretion. inflammation mediators: prostaglandins and leukotrienes promote inflammation, bronchoconstriction and increased mucus production. immune response drivers: cytokines and interleukins recruit inflammatory cells and sustain allergic inflammation over time. bradykinins increase vascular permeability which contributes to allergy symptoms.
drugs for allergies - cromolyn sodium acts as a mast-cell stabilizer providing preventive relief by blocking inflammatory mediator release. antihistamines block H1 receptors. there are first gen antihistamines and second-gen, first-gens cause sedation so second-gens are preferred for daytime use. topical nasal steroids reduce inflammation and help chronic nasal congestion but avoid use during bacterial infections. common first-gens are diphenhydramine (Benadryl), chlorpheniramine, tripolidine and doxylamine which are used in cold and nighttime relief products. they are often combined decongestants, analgesics or cough suppressants for multi-symptom relief.(Benadryl, chlor-tripolon, sinutab, tylenol cold, actifed and nyquil. second-gens are loratadine, cetirizine, desloratadine and fexofenadine. (claritin, chlor-tripolon, allegra, reactine and aerius). nasal lubricants moisturize dry nasal passages and soothe irritation by using polyethylene and polypropylene glycol. isotonic balance is important to prevent additional mucosal dryness and maintain nasal comfort. cromolyn stabilizes mast cells which prevent the mediator release and provides non-steroidal allergy relief. (Secaris gel, Rhinaris gel and Cromolyn nasal solution). nasal steroids reduce inflammation and swelling and they effectively control persistent allergic rhinits with consistent use. (Flonase, Nasacort and Nasonex)