Drug-Induced Fever

Aka: Drug-Induced Fever, Drug Induced Fever, Fever Due to Medications, Drug Fever, Drug-Induced Hyperpyrexia

advertisement

II. Types

  1. Hypersensitivity Reaction (associated with Eosinophilia, rash)
  2. Idiosyncratic Reaction
  3. Drug-Induced Hyperthemia Syndromes (Muscle rigidity and fever >40 C)
    1. Malignant Hyperthermia
    2. Neuroleptic Malignant Syndrome
    3. Serotonin Syndrome

III. Signs: Intensive Care Unit Patients

  1. Rigors (53%)
  2. Myalgias (25%)
  3. Leukocytosis (22%)
  4. Eosinophilia (22%)
  5. Rash (18%)
  6. Hypotension (18%)

IV. Causes: Antimicrobial Induced Fever

  1. Amphotericin
  2. Carbapenems
  3. Cephalosporins (common)
  4. Erythromycin
  5. Isoniazid
  6. Minocycline
  7. Penicillins (common)
  8. Nitrofurantoin
  9. Rifampin
  10. Sulfonamides
  11. Vancomycin

V. Causes: Cardiovascular Medication Induced Fever

  1. Atropine
  2. Captopril
  3. Clofibrate
  4. Hydralazine
  5. Hydrochlorothiazide
  6. Methyldopa
  7. Nifedipine
  8. Procainamide (common)
  9. Quinidine (common)
  10. Streptokinase

VI. Causes: Anticonvulsant induced fever

  1. Barbiturates
  2. Carbamazepine (Tegretol)
  3. Phenytoin or Dilantin (common)

VII. Causes: Gastrointestinal Medication induced fever

  1. Cimetidine (Tagemet)
  2. Ranitidine (Zantac)
  3. Phenothiazines

VIII. Causes: Analgesics

  1. Aspirin
  2. Ibuprofen
  3. Sulindac (Clinoril)
  4. Meperidine (Demerol)

IX. Causes: Miscellaneous Medications Inducing Fever

  1. Allopurinol
  2. Heparin

X. Management

  1. Withdraw suspected medication causes
    1. Expect fever to resolve within 2-3 days (up to 7 days) of medication discontinuation
  2. Exclude other sources of fever
    1. See Acquired Fever in Hospitalized Patients
    2. See Persistent Fever Causes

XI. References

  1. Marino (2014) The ICU Book, p. 777-95
  2. Hersch (2014) Am Fam Physician 90(2): 91-6 [PubMed]
  3. Johnson (1996) Infect Dis Clin North Am 10(1): 85-91 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Drug-Induced Fever." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Related Topics in Pharmacology

advertisement