Drug fever
When drug fever (also drugs fever ) increased body temperature (is fever ), respectively. This increased body temperature is triggered by the undesirable effects of medication and usually occurs between seven and ten days after the start of therapy. About 10% of inpatients treated with medication are affected by drug fever.
causes
Different mechanisms come into question for the development of drug fever. Examples are:
- Anaphylaxis ( allergic reactions)
- Idiosyncrasy (congenital drug hypersensitivity )
- substance-related effects
- other changes in thermoregulation
Triggering drugs
Almost any medicine can cause allergic reactions . Substance-related drug fever is caused by the pharmacological effect of the drug. Substance-related drug fever is dose-dependent and often occurs with the following substance groups:
- Chemotherapy drugs (such as cytostatics )
- Antibiotics (such as cephalosporins , penicillins , streptomycin , colistin , vancomycin )
- Antifungal drugs (such as amphotericin B )
- Centrally active drugs (such as procarbazine , carbamazepine , phenytoin , methyldopa , halothane , succinylcholine )
- Thyroid hormones ( L-thyroxine )
- Biologics ( infliximab , filgrastim etc.)
- Various others: quinine , nifedipine , procainamide , ranitidine
therapy
Suspicious drugs should be discontinued ex juvantibus . A decrease in temperature suggests a connection, but does not prove anything. Can safely go to when a Reexpositionsversuch is positive. The attempt at re-exposure is not always reasonable or feasible and is always associated with risks. If therapeutic alternatives are available, re-exposure is usually avoided.
Differential diagnoses
If no infectious and / or inflammatory causes of the fever are found (and drugs are taken), drug fever is considered in the differential diagnosis. The fever can often be related to the prescription of new drugs, but all other causes (e.g. tumor fever) that can cause fever should be considered.
See also
Web links
Individual evidence
- ^ PA Tabor: Drug-induced fever . In: Drug Intell Clin Pharm . tape 20 , no. 6 , June 1986, ISSN 0012-6578 , pp. 413-420 , PMID 3522163 (English).
- ^ A b RA Patel, JC Gallagher: Drug fever . In: Pharmacotherapy . tape 30 , no. 1 , January 2010, ISSN 0277-0008 , p. 57-69 , PMID 20030474 (English).
- ^ DH Johnson, BA Cunha: Drug fever . In: Infect Dis Clin North Am . tape 10 , no. 1 . WB Saunders, March 1996, ISSN 0891-5520 , p. 85-91 , PMID 8698996 (English).