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The optimal choice of an analgesic and antipyretic drug in paediatric practice

https://doi.org/10.21518/2079-701X-2019-2-106-112

Abstract

Onset of fever and pain syndrome in children is one of the most frequent reasons parents take their children to a paediatrician. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to relieve such symptoms. The mechanism of action of NSAIDs is to inhibit the activity of the enzyme called cyclooxygenase (COX). Paracetamol, one of the drugs that inhibit COX, exerts its pharmacodynamic effect in the central nervous system, thereby providing antipyretic and analgesic effects, but it is ineffective in stopping inflammation. Such common conditions in children as fever and pain syndrome of mild to medium intensity are among the indications for use of Efferalgan containing paracetamol as an active ingredient. Solution and rectal suppositories are the most commonly used dosage forms of Efferalgan in children, as these dosage forms can be used, when the child reaches 1 and 3 months of age, respectively. The correct dose of paracetamol for a child depends on their weight. It should be remembered that the relief of a fever or pain syndrome is a symptomatic treatment. Therefore, if they appear, you should visit a doctor to identify carefully the possible cause and select the appropriate therapy.

About the Authors

V. N. Drozdov
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Drozdov Vladimir Nikolaevich – Dr. of Sci. (Med.), Professor of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Trubetskaya Street, Moscow, 119991, p. 2



A. A. Bagdasaryan
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Bagdasaryan Alina Arsenovna – Dr. of Sci. (Med.), Resident Physician of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Trubetskaya Street, Moscow, 119991, p. 2



S. Yu. Serebrova
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University); Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products» of the Ministry of Health of the Russian Federation
Russian Federation

Serebrova Svetlana Yurievna – Dr. of Sci. (Med.), Professor of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases, Federal State Autonomous Educational Institution of Higher Education «Sechenov First Moscow State Medical University» of the Ministry of Heath of the Russian Federation (Sechenov University); Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products» of the Ministry of Health of the Russian Federation

8, Trubetskaya Street, Moscow, 119991, p. 2, 127051, Moscow, Petrovsky Bulvar, 8, Bldg. 2 



K. M. Muratov
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Muratov Kirill Mikhailovich – Resident Physician of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Trubetskaya Street, Moscow, 119991, p. 2



A. K. Starodubtsev
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Starodubtsev Alexei Konstantinovich – Dr. of Sci. (Med.), Professor of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Trubetskaya Street, Moscow, 119991, p. 2



D. A. Bondarenko
Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Bondarenko Dmitri Alexandrovich – student of the Chair of Clinical Pharmacology and Propaedeutics of Internal Diseases

8, Trubetskaya Street, Moscow, 119991, p. 2



References

1. Walter E.J., Hanna-Jumma S., Carraretto M., Forni L. The pathophysiological basis and consequences of fever. Critical Care. 2016;20:200. doi: 10.1186/s13054-016-1375-5.

2. Funk C.D. Prostaglandins and leukotrienes: advances in eicosanoid biology. Science. 2001; 294: 1871–1875. doi: 10.1126/science.294.5548.1871.

3. Chandrasekharan N.V., Dai Hu, Roos K.L., Evanson N.K., Tomsik J., Elton T.S., and Simmons D.L. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: Cloning, structure, and expression. Proc Natl Acad Sci U S A. 2002 Oct 15;99(21): 13926–13931. Published online 2002 Sep 19. doi: 10.1073/pnas.162468699.

4. Kumpulainen E., Kokki H., Halonen T., Heikkinen M., Savolainen J., Laisalmi M. Paracetamol (acetaminophen) penetrates readily into the cerebrospinal fluid of children after intravenous administration. Pediatrics. 2007;119:766– 771. doi: 10.1542/peds.2006-3378.

5. Anderson B.J., Holford N.H., Woollard G.A., Chan P.L. Paracetamol plasma and cerebrospinal fluid pharmacokinetics in children. Br J Clin Pharmacol. 1998;46:237–243. doi: 10.1046/j.1365-2125.1998.00780.x.

6. Flower R.J., Vane J.R. Inhibition of prostaglandin synthetase in brain explains the anti-pyretic activity of paracetamol (4-acetamidophenol). Nature. 1972;240:410–411. [PubMed: 4564318].

7. Ministry of Health of the Russian Federation. Acute respiratory infection (ARVI) in children. 2016. (In Russ).

8. Healthcare in Russia. 2015: Rosstat statistics digest. M., 2015. 174 p. (In Russ).

9. The management of fever in children with acute respiratory infection in developing countries. Geneva: World Health Organization, WHO/ ARI/93.30; 1993.

10. Abuzarova G.R., Nevzorova D.V., Kumirova E.V., Savva N.N., Arutyunov G.P., Bagnenko S.F., Danilov Al.B., Danilov AB, Kunyaeva T .A., Nikolaeva N.M., Molchanov I.V., Padalkin V.P., Polyakov V.G., Pchelintsev M.V., Stepanenko S.M. Guidelines for the provision of anaesthesia services to adults and children. Pirogov National Research Medical University. M., 2016. 94 p. (In Russ).

11. Jóźwiak-Bebenista M., Nowak J.Z. Paracetamol: mechanism of action, applications and safety concern. Acta Pol Pharm. 2014 JanFeb;71(1):11-23.

12. Prescott L.F. Paracetamol: past, present, and future. Am J Ther. 2000 Mar;7(2):143-7.

13. Ghanem C.I., Pérez María J., Manautou J.E., and Mottino A.D. Acetaminofen; from liver to brain: new insights into drug pharmacological action and toxicity. Pharmacol Res. 2016 July;109:119– 131. doi:10.1016/j.phrs.2016.02.020.

14. Mitchell J.R., Jollow D.J., Potter W.Z., Gillette J.R., Brodie B.B. Acetaminophen-induced hepatic necrosis. IV. Protective role of glutathione. J Pharmacol Exp Ther. 1973;187:211–217. [PubMed: 4746329] (In Russ)..

15. Hay A.D., Redmond N.M., Costelloe C., Montgomery A.A., Fletcher M., Hollinghurst S., Peters T.J. Paracetamol and ibuprofen for the treatment of fever in children: the PITCH randomised controlled trial. Health Technol Assess. 2009 May;13(27):iii-iv, ix-x, 1-163. doi: 10.3310/hta13270.

16. Kramer M.S., Naimark L.E., Roberts-Bräuer R., McDougall A., Leduc D.G. Risks and benefits of paracetamol antipyresis in young children with fever of presumed viral origin. Lancet. 1991 Mar 9;337(8741):591-4.

17. Southey E.R., Soares-Weiser K., Kleijnen J. Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever. Curr Med Res Opin. 2009 Sep;25(9):2207-22. doi: 10.1185/03007990903116255.

18. Kanabar D.J.. A clinical and safety review of paracetamol and ibuprofen in children. Inflammopharmacology. 2017 Feb 6;25(1):1-9. Published 2017 Jan 6. doi: 10.1007/s10787-016-0302-3.

19. de Martino M., Chiarugi A. Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management. Pain Ther. 2015;4:149-168. doi: 10.1007/s40122-015-0040-z.


Review

For citations:


Drozdov VN, Bagdasaryan AA, Serebrova SY, Muratov KM, Starodubtsev AK, Bondarenko DA. The optimal choice of an analgesic and antipyretic drug in paediatric practice. Meditsinskiy sovet = Medical Council. 2019;(2):106-112. (In Russ.) https://doi.org/10.21518/2079-701X-2019-2-106-112

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