Antipyretics

OBJEKT
IF
• Menerangkan definisi dan
tindakan ubat ‘anti-pyretic.
• Menerangkan kesan
sampingan ubat.
• Menyatakan contoh, dos dan
cara pemberian ubat.
• Menyatakan indikasi dan
kontraindikasi ubat.
• Menyatakan nasihat yang
relevan semasa penggunaan/
pemberian ubat.
 Antipyretics

• Ubat yang digunakan untuk

menurunkan suhu badan yang
tinggi atau mengurangkan
demam.
 Tindakan
• Act on hypothalamic heat-
regulating center to cause
– vasodilation & sweating (helps
dissipate heat)
-
Perencatan sintesis prostaglan
din (reduces body temperature)
 General Indication

• Digunakan untuk
menurunkan suhu
badan.
 Jenis-jenis Antipyretics

A. Salicylates
B. Non-Salicylates
C. NSAIDs (Non Steroidal Anti-
Inflammatory Drugs)
Salicylates
 Tindakan

• Menghalang penghasilan
prostaglandin dengan
bertindak ke atas pusat
kawalan suhu
(thermoregulatory center) di
hypothalamus.
• Pengurangan prostaglandin
akan menurunkan suhu
badan.
• Prostaglandin:
– A group of naturally occuring
fatty acids that act within the
body to:
• Regulate acid secretion in
stomach
• Regulate body temperature
• Regulate platelet aggregation
• Control inflammation
 Contoh ubat

• Acetylsalicylic Acid
(Aspirin)
1. Acetylsalicylic Acid
(Aspirin)

Category: C
 Indication

• Antipyretics
• Analgesics
• Anti-inflammatory
• Anti-platelet
 Dose
• Adult:
• 300-900mg tiq/qid (divided
dose)
• Max: 4g/day
• Peads:
• Not recommended for child
< 12 yrs
 Kesan Sampingan
• Irritation (lapisan mucosa
gaster)
• Epigastric distress
• GI bleeding
• Increase bleeding time
• Allergic reactions
 Contraindication

• Allergic to Aspirin
• Bleeding ulcers
• Hemorrhagic status
• Child < 12 yrs
 Cautious

• Impaired renal function

• Pregnancy
• G6PD deficiency
 Interactions

• Activated charcoal
– Kurangkan penyerapan
salicylates
• Antacids
– Kurangkan kesan salicylates
• Carbonic anhydrase
inhibitors
– Tingkatkan kesan sampingan
salicylates
• Heparin
– Tingkatkan risiko pendarahan
• NSAIDs
– Tingkatkan serum NSAIDs
Non-Salicylates
 Tindakan

• Menyebabkan ‘vasodilation’
dan perpeluhan dengan
bertindak secara langsung ke
atas ‘Thermo-regulating
center’ di hypothalamus.
• Vasodilation dan perpeluhan
akan meningkatkan
kehilangan haba dari badan
dan mengurangkan suhu
badan.
 Contoh ubat

• Paracetamol/
Acetaminophen (Panadol)
 1. Paracetamol/
Acetaminophen (Panadol)
Category: C

Indication
• Antipyretics
• Analgesics
 Dose

• Adult:
• 500-1000mg tiq/qid PO
• Max: 4g/day
• Peads:
• 1 yr: 60-120mg tid-qid PO
• 1-5 yr: 120-240mg tid-qid PO
• 6-12 yr: 240-480mg tid-qid PO
• Max: 4 doses/day
 Kesan Sampingan
• Hepatotoxicity
• Jaundice
• Hemolytic anemia
• Urticaria (allergic)
• Pancytopenia (blood <)
• Note: Adverse reactions are rare when
used as directed
 Contraindication

• Allergic to Paracetamol
 Cautious

• Impaired hepatic & renal

function
• Pregnancy
• Lactation
• Chronic alcoholism
 Interactions
• Anti-coagulants
• Alcohol
• Aspirin
• Chloramphenicol
• Phenobarbitone
 NSAIDs
(Non Steroidal
Anti-Inflammatory
Drugs)
 Tindakan Umum

• Menghalang penghasilan
prostaglandin.
• Pengurangkan dalam
prostaglandin akan
mengurangkan suhu badan.
 Contoh ubat

• diclofenac sodium
(Voltaren)
• ibuprofen (Brufen)
• mefanamic Acid (Ponstan)
1. Diclofenac sodium
(Voltaren)

Category: A
 Indication
• Antipyretics
• Analgesics
• Anti-inflammatory
 Dose (75mg/3ml inj)

• 75mg/d IM (max for 2 days)

• Severe case: 75mg bd (max
for 2 days)
1. Ibuprofen (Brufen)
Category: B

Indication
• Antipyretics
• Analgesics
• NSAIDs
 Dose
• Adult:
• 200-400mg tiq PO
• Max: 2-4g/day
• Peads > 7 yrs:
• 20mg/kg/day (divided dose)
• Not recommended for child <
7 yrs
 Kesan Sampingan
• Headache
• Dizziness
• GI disturbances
– (Nausea, Gastric/duodenal ulcer,
GI bleeding)
• Allergic reactions
– (Rashes, angioedema,
bronchospasm)
 Contraindication

• Allergic to ibuprofen
• GI bleeding
• Pregnancy
• Lactation
• Peptic ulcer
 Cautious
• Impaired renal or hepatic
function
2. Mefenamic Acid
(Ponstan)
Category: B

Indication
• Antipyretics
• Analgesics
• NSAIDs
 Dose
• Adult:
• 250-500mg tiq PO (after meal)

• Peads:
• > 6 mths: 6.5mg/kg tid-qid PO
(limited to 7 consecutive
days)
• After meal
 Kesan Sampingan
• Dizziness
• Tiredness
• Nausea
• Diarrhea
• Constipation
• Bleeding
 Contraindication
• Allergic to Ponstan
 Cautious
• Impaired renal or hepatic
function
• GI bleeding
• Pregnancy
• Lactation
• Peptic ulcer
• Hypertension
 Interactions
• Anti-coagulants, lithium
– Risiko pendarahan
• Diuretics, anti-hypertensives
– Kesan diuretics &
antihypertensives berkurang
• Paracetamol (long-term)
– Renal impairment
 Soalan
1. Berikan definisi ubat
antipyretics?
2. Senaraikan jenis-jenis
antipyretics & terangkan cara
tindakannya?
3. Senaraikan contoh ubat
antipyretics?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat anti-pyretics?