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Definition of fever

Definition

By fever (increased body temperature due to infection) understand protective-adaptive reaction of the organism with an increase in body temperature above 37,2 °C (above 37,8 °C in the rectum). Fever may be caused by viruses, bacteria, fungi, parasites and other agents.

Emit "fever of unknown etiology" of more than 3 weeks with body temperature above 38,3 °C and without physical-local data indicating any pathology (special treatment algorithm for prehospital not required, patients hospitalized in the infectious disease hospitals).

Fever is part of the metabolic, endocrine, neurological and immune changes induced by IL-1, previously known as endogenous pyrogens. IL-1, standing out from the mono-macrophage nuclei under the influence of different antigens, activates the hypothalamus with subsequent formation of excessive heat, heat loss and delay the appearance of fever.

Classification

To raise the temperature of a fever is divided into subfebrile (37,2-37,9 °C), mild febrile (38,0 - 38,9 °C), high, or febrile (39,0-40,0 °C), and hyperthermia (above 40,0 °C). For the duration of fever is short (less than 2 weeks) and long (more than 2 weeks), fever of unknown origin can persist for more than 3 weeks (see above). By type of fever is divided by a constant (daily fluctuations in temperature no more than 1 °C), remittent, remittent, or (more fluctuations of 1 °C, the temperature is not reduced to normal), intermittent, or alternating (the periods of normal and high temperatures during the day) perverted, or reverse (higher temperature in the morning), depleted, or hectic (high body temperature with a sharp decrease and increase), and irregular (no patterns).

The physician team SMP at a fever should determine the degree of severity of the condition, identify the leading syndrome or disease, identification of the indications for hospitalization and, if necessary, to select treatment. Antipyretic drugs online first and antimicrobial action must have a high efficiency, lower the body temperature gradually, they are required to safety, safety of metabolites, a low resistance. Generic should be no worse than standard counterparts. They should be equally effective and safe in both children and adults, and antibiotics should have a form for parenteral administration. These criteria correspond to non-steroidal anti-inflammatory drugs, primarily nurofen (ibuprofen) and paracetamol, as well as broad-spectrum antibiotics: cephalosporins III generation of macrolides, amoxicillin / clavulanate and "respiratory" fluoroquinolones (tavanic).

Antipyretic drugs prescribed to children in pre-hospital first 3 months of life at a temperature above 38 °C for children aged 3 months (previously healthy) - at temperatures above 39,0 °C and / or muscle hunk and / or headaches. Antipyretics prescribed to all children with febrile convulsions in history at a temperature above 38-38,5 °C, as well as severe heart or lung disease at a temperature above 38,5 °C.

Do not assign a regular (exchange rate) receiving antipyretic drug. His repeated doses can be applied only after the new increase in temperature to above the level. Antipyretics is not appointed, along with antibiotics pills because it can mask a lack of treatment effect and delay the change of the antibiotic (exception - heat cramps or disorder).

Children prohibited from use as an antipyretic acetylsalicylic acid (aspirin) in connection with severe toxic effects and the development of Reye syndrome. Also prevented the use of analgin inside as an antipyretic because of the risk of agranulocytosis and persistent hypothermia.

The main antipyretic drugs are paracetamol 10-15 mg / kg daily dose of 60 mg / kg and ibuprofen 5-10 mg / kg daily dose of 20 mg / kg. At these doses, these drugs have the same analgesic effect.

Antibacterials tablets is a ceftriaxone (Rocephin) for 80 mgDkgsut) intramuscular injection, amoxicillin / clavulanate (Amoxiclav) at 30-60 mg / (kgsut) orally or parenterally, the initial dose is half the daily.

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