Antipyretics: Mechanisms of action and clinical use in fever suppression

David M. Aronoff*, Eric G. Neilson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

175 Scopus citations

Abstract

Fever is a complex physiologic response triggered by infectious or aseptic stimuli. Elevations in body temperature occur when concentrations of prostaglandin E2 (PGE2) increase within certain areas of the brain. These elevations alter the firing rate of neurons that control thermoregulation in the hypothalamus. Although fever benefits the nonspecific immune response to invading microorganisms, it is also viewed as a source of discomfort and is commonly suppressed with antipyretic medication. Antipyretics such as aspirin have been widely used since the late 19th century, but the mechanisms by which they relieve fever have only been characterized in the last few decades. It is now clear that most antipyretics work by inhibiting the enzyme cyclooxygenase and reducing the levels of PGE2 within the hypothalamus. Recently, other mechanisms of action for antipyretic drugs have been suggested, including their ability to reduce proinflammatory mediators, enhance anti-inflammatory signals at sites of injury, or boost antipyretic messages within the brain. Although the complex biologic actions of antipyretic agents are better understood, the indications for their clinical use are less clear. They may not be indicated for all febrile conditions because some paradoxically contribute to patient discomfort, interfere with accurately assessing patients receiving antimicrobials, or predispose patients to adverse effects from other medications. The development of more selective fever-relieving agents and their prudent use with attention to possible untoward consequences are important to the future quality of clinical medicine.

Original languageEnglish (US)
Pages (from-to)304-315
Number of pages12
JournalAmerican Journal of Medicine
Volume111
Issue number4
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Antipyretics: Mechanisms of action and clinical use in fever suppression'. Together they form a unique fingerprint.

Cite this