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RESPONDING TO SYMPTOMS OF
MINOR AILMENTS -1
AMEENA KADAR K A
FIRST SEM M PHARM
PHARMACY PRACTICE
SANJO COLLEGE OF PHARMACEUTICAL STUDIES

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THE FOLLOWING STEPS SHOULD BE TAKEN WHILE
RESPONDING TO A SYMPTOMS:
ᴥ Obtain sufficient information to enable a proper assessment of the situation
to be made.
ᴥ Decide whether the symptoms might be strongly associated with a serious
condition, and in such circumstances refer the patient for immediate medical
advice.
ᴥ When medicines are supplied, make record and advise to consult a doctor if
the symptoms persist beyond the stated time.

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PYREXIA
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 The word Pyrexia is derived from the Greek 'pyretos’ meaning fire.
 Pyrogen is a substance that induces fever. These can be either internal
(endogenous) or external (exogenous).
 Exogenous pyrogens are derived from outside the patient; most of them are
microbial products, microbial toxins, or whole microorganisms.
 Example of an exogenous pyrogen is the lipopolysaccharide produced by all
gram-negative bacteria.
 Pyrogenic products of gram positive organisms include the enterotoxins of
Staphylococcus aureus.
 Endogenous pyrogens are cytokines, molecules that are a part of the innate
immune system.
 They are produced by phagocytic cells. 4

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 Major endogenous pyrogens are interleukin I (α and β), interleukin 6 (IL-6)
and tumor necrosis factor-alpha.
Pyrexia
 Pyrexia is defined as a condition when the body temperature of an
individual rises above the normal range of 36-37 °C (98-100 °F), Fever is
the temporary increase in the body's temperature in response to some
disease or illness.
 The body temperature can be measured by inserting thermometer in
oral cavity, axillary, rectum and tympanic membrane of the body.

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TYPES OF FEVERS
Fever may be classified in to:
 Continuous Fever: If the temperature remains above normal for long
period of time is called as continuous fever. e.g., fever in lobar pneumonia,
typhoid, and urinary tract infection.
 Intermittent Fever: If the type of fever wherein the body temperature
periodically rises and falls. E.g., Malaria.
 Relapsing Fever: Fever type that recurs several days after the temperature
has turned to normal, e.g., infective endocarditis.

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Risk factors for Fever:
 Bronchitis
 Sinusitis
 Rheumatoid arthritis
 Allergic rhinitis (hay fever).
Common Complications of Fever
High-grade fever (>104F) for a prolonged period may give rise to
complications such as:
Seizures
Brain damage
Coma
Death

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SIGNS AND SYMPTOMS OF FEVER
 Shivering
 Anorexia
 Dehydration
 Lethargy
 Poor concentration
 Sleepiness
 Cold
During high fevers, there may be an extreme irritability, confusion,
delirium and convulsions.

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DIAGNOSIS OF FEVER
 The doctors take a detailed history from the patient about the duration of
fever and the associated symptoms such as chills, headache and body
pains.
 Doctors also physically examine the:
 Temperature: To check for the level of temperature rise
 Eyes: To check for any redness or paleness
 Pulse: To test for the heart rate
 Blood pressure: To check for changes in the blood pressure
Based on the history taken from the patient, the doctors recommend a
Complete blood count (CBC), Urine test and a chest X-ray to determine the
exact cause of pyrexia.

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Medications that Increases the Body Temperature
1. Antimicrobials E.g., Isoniazid
2. Anti-arrhythmia Drugs E.g., Procainamide, Quinidine
3. Anti-epileptic Drugs E.g., Phenytoin, Carbamazepine 4. Anti-hypertensive
Drugs, E.g., Alpha-methyldopa
5. Anti-fungal Drugs, E.g., Amphotericin B
6. Ephedrine
7. Sulfa Drugs
8. Interferon
9. Narcotics/Illicit Drugs, E.g., Cocaine, Cannabis

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MANAGEMENT
Non-pharmacological Methods
 Majority people do not require specific treatment to cure the fever.
 In general, people are advised to keep adequately hydrated using oral
rehydration salts and water.
 Tepid sponging is recommended if the body temperature rises to the level
of hyperpyrexia.
Prevention
 Fevers are commonly caused by bacterial/viral infections.
 Good hygiene practices will reduce the risk of developing an infection.
 Infected people should be cared suitably to prevent further spread of the
infection and care giving individuals are also advised to take suitable
precautions.

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During the Course of Fever
 If the fever is mild, drink plenty of fluids and take rest.
 Remove excess clothing or blankets.
 The room should be comfortable, not too hot or cool.
 Try one layer of lightweight clothing, and one lightweight blanket for sleep.
 If the room is hot or stuffy, a fan may help.
 A lukewarm bath or sponge bath may help in cooling someone with fever.
This is especially effective after medication is given.
 Do NOT use cold baths, ice, or alcohol rubs. These cool the skin, but often
make the situation worse by causing shivering, which raises the core body
temperature.

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Home Remedies to Cure the Fever
1. Bed rest
2. If the fever is high, apply cold compresses on the forehead, and sponge the
whole body with tepid water.
3. Fevers caused by gastro-intestinal problems and respiratory infections
respond well to a teaspoonful of turmeric powder added to a glass of hot
milk with sugar to taste.
4. Mint with pepper boiled water
5. Lemon-grass tea, with honey to taste, is a refreshing remedy for fever.
6. In high fever, the application of cool sandalwood paste on the forehead
brings the temperature down just like a cold compress does.

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Pharmacological Management
Medications: The medications should be used at the exact doses as
recommended by the physician as higher doses may damage the liver or kidney.
Antibiotics: These drugs are recommended if the doctor suspects that the fever
is caused by some bacterial infections in the bladder or bowel.
Antiviral drugs: These medicines are used if the doctors diagnose that the
fever is caused by viral infections.
Rest: The patient should take adequate rest.
Fluids: Adequate fluids along with regular supplements should be taken to
prevent dehydration.
Patients admitted with very high fever and weakness are immediately put on
intravenous vitamin supplements or medications to prevent excessive loss of
salts and minerals from the body.

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 Paracetamol
 325 to 650 mg 6th hourly is recommended for individuals aged more
than 12 years.
 For children in the age group of 4-11 years, the recommended dose is
320-500 mg 6 hourly.
 For less than 4 years of age, the recommended dose is 5 ml (16 mg/ml).

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ROLE OF PHARMACIST IN THE MANAGEMENT OF FEVER
 For an immediate relief, pharmacist may dispense suitable dose of
Paracetamol to the patient for 2-3 doses.
 If the fever is still persisting, patient should be advised to consult the doctor
for further evaluation and management.
 Further patients may be advised about the non pharmacological measures to
control the fever related symptoms.
 Some people take the paracetamol regularly for analgesics purpose.
 Such individuals should be advised to seek the medical opinion regarding
their head ache or any other related problems.
 Excess intake of paracetamol in alcoholics may damage the liver. Such
individuals should be cautioned about the paracetamol use.

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MENSTRUAL PAIN

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 Dysmenorrhea is the term used to describe painful periods.
 Dysmenorrhoea is cyclic, lower abdominal or pelvic pain, which may also
radiate to the back and thighs, occurring before or during menstruation, or
both.
 Women who have painful periods may have higher levels of natural chemicals
than normal which cause contractions of the uterus, bowel and blood vessels.
What is normal period pain?
Period pain is ‘normal’ if:
 you have pain one or 2 days before your period, or when your period starts,
and the pain lasts up to 3 days
 the pain improves when you use pain-relief medication.
It’s important to talk to your doctor if your period pain interferes with your daily
life.

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SYMPTOMS OF PERIOD PAIN
Period pain might be:
 Cramping in your pelvic area
 Pain in your stomach, lower back and legs
 Gripping pain
 A constant ache.
-Other symptoms include:
• Headaches
• Feeling sick
• Digestive problems – such as diarrhoea or constipation
• Premenstrual symptoms – such as sore breasts and a swollen abdomen
• Pain for the first 2 or 3 days of your period.

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CAUSES OF PERIOD PAIN
Women who have painful periods may have higher levels of natural chemicals
than normal. These chemicals (prostaglandins) cause contractions of the uterus,
bowel and blood vessels.
TREATMENT OPTIONS FOR PERIOD PAIN
 Pain-relief medication – such as paracetamol
 Anti-inflammatory medication – such as ibuprofen
 Regular exercise, which releases natural chemicals (endorphins) that relieve
pain
 Putting a heat pack or hot water bottle on your abdomen and lower back to
help relax the muscles
 NSAIDs are inhibitors of prostaglandin synthesis, relieve dysmenorrhoea by
decreasing uterine prostaglandin levels, resulting in reduced uterine
contractility.

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 Anticholinergic, antispasmodics relax the uterine smooth muscle.
 The pill – a contraceptive that reduces prostaglandins and pain
 The Mirena™ intrauterine device (IUD) – a contraceptive that releases
progestogen into the uterus to make periods lighter and less painful.
PERIOD PAIN CAUSED BY OTHER CONDITIONS
Endometriosis is a condition where cells similar to those that line the uterus
grow in other areas of your body, especially around your ovaries and behind
your uterus. Some women have mild pain when they have their periods and
others have severe pain during their whole menstrual cycle.
Fibroids are non-cancerous growths found in the muscle layer of the uterus.
Some women with fibroids experience painful periods.
Adenomyosis is a condition where the tissue that normally lines the uterus
grows into the muscle wall of the uterus. This can cause heavy and painful
periods.

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 Community Pharmacy Practice by Ramesh Adepu. Page No.151.
 https://pharmeasy.in/blog/pyrexia-causes-symptoms-diagnosis-treatment-and-
prevention/
 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstruati
on-pain-dysmenorrhoea#about-period-pain
REFERENCES

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