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Pain Relievers (Analgesics)
and
Fever Reducers (Antipyretics)

Pain is the most common reason for people to seek medical advice, and medicines for pain are the most frequently purchased over-the-counter (OTC) medications. Fever is one of the most common reasons for people to seek medical advice for their children, and one in five emergency room visits for children is due to fever. Since OTC medicines that are effective in treating pain also are effective at reducing fever, they will be considered together.

What classifications of pain are there?

Pain can be classified as acute, chronic non-malignant, or chronic malignant. Headaches, the most common cause of pain, can be considered a separate class of pain.

Acute pain usually is due to mechanical or thermal (usually heat) injuries. Examples of mechanical injuries include soreness of muscles due to overuse or strain (and sometimes to viral infections), tears of the ligaments, broken bones, bruises, and cuts. These types of acute pain usually respond well to OTC medications for pain. Muscle soreness also may respond well to heat and massage.

Chronic non-malignant pain is a type of pain associated with progressive, debilitating diseases such as arthritis. OTC medications for pain usually are effective for this type of pain. However, because of the chronic nature of the pain, their use often leads to excessive use of the medications and frequent side effects. The pain of arthritis also may respond well to heat.

Chronic malignant pain is pain associated with advanced, progressive diseases (often fatal) such as cancer, multiple sclerosis, AIDS, and terminal kidney disease. OTC medications for pain may be useful for the management of chronic malignant pain. However, stronger prescription medications usually are necessary.

What types of headaches are there?

Headaches--most common reason that analgesic medications are taken-- can be classified into three types: muscle contraction, migraine or vascular, and sinus.

A muscle contraction headache, the most common type, results from the continuous tightening of the muscles in the upper back, neck, or scalp. This type of headache often is described as a tight, pressing, or throbbing sensation of the head. It can be brought on by emotional stress and anxiety ("tension headaches"). Acute muscle contraction headaches generally respond well to OTC analgesics, but chronic muscle contraction headaches often require physical therapy or relaxation techniques.

Migraine or vascular headaches are due to dilation (expansion) of blood vessels in the head. Although many patients use the expression "migraine" to describe any particularly painful headache, many of these are actually muscle contraction headaches. OTC medications for pain may be quite effective for treating migraine headaches. However, prescription medications that are specifically formulated for treating or preventing migraines often are necessary.

A sinus headache is caused by an infection or blockage of one or more sinuses in the head. The pain often is limited to the area around the eyes or the forehead where the major sinuses are located. The pain may occur upon awakening, and may decrease in intensity after the person has been standing or sitting up for a while. In addition to analgesics, OTC decongestants can be effective by helping to drain the sinus.

What is a fever and what is it's causes?

Most fevers are transient (lasting only a few hours or a few days) and are not dangerous, but they may cause a great deal of discomfort. A rectal temperature of greater than 101.8 degrees F (38.8 degrees C), an oral temperature of more than 100 degrees F (37.8 degrees C), or an armpit temperature of greater than 99 degrees F (37.2 degrees C) is considered abnormal. Fevers usually are due to infections, either viral or bacterial, but they also can be due to cancers, injury to tissue (for example, heart attacks), hyperthyroidism, other illnesses in which there is inflammation, and dehydration. Additionally, over 40 different drugs have been reported to cause "drug fever."

Harmful effects of fever (for example, dehydration, changes in consciousness, seizures, or coma) are most likely to occur at temperatures above 106 degrees. Lower fevers are dangerous in persons with heart disease, since fever increases the work of the heart because the pumping of blood must increase. Seizures occur in 2 to 4% of all children between the ages of 6 months and 5 years (usually before age 3) with high fevers though these seizures generally last no more than 15 minutes. Children who experience febrile seizures have a higher risk of developing epilepsy later in life.

What are the different classes of pain relievers and fever reducers?

The three classes of OTC analgesic/antipyretic medications are:






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Last Editorial Review: 9/21/1999 8:31:00 PM





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