NSAIDS have antipyretic activity and can be used to treat fever.   Fever is caused by elevated levels of prostaglandin E2 , which alters the firing rate of neurons within the hypothalamus that control thermoregulation.   Antipyretics work by inhibiting the enzyme COX, which causes the general inhibition of prostanoid biosynthesis ( PGE2 ) within the hypothalamus .   PGE2 signals to the hypothalamus to increase the body's thermal set point.   Ibuprofen has been shown more effective as an antipyretic than paracetamol (acetaminophen).   Arachidonic acid is the precursor substrate for cyclooxygenase leading to the production of prostaglandins F, D & E.
If I ever forget to change one of me patches, that’s horrible. It’s the worst feeling ever forgetting to change a patch. Why’s that? Because it’s the same kind of medication what they give heroin addicts so it’s, if you forget to change it you get bad withdrawal symptoms so I’ll start itching all over, feeling hot and cold, headaches, unable to sleep and that’s just forgetting to change one day. So it’s horrible. Wow. What kind of patches are these, sorry, what’s the name of it? It’s buprenorphine. It’s like a morphine based. You mentioned the withdrawals there. You didn’t mention pain. Is pain something which gradually comes back as opposed to maybe in one day does the patch leave you in a lot of pain? No, if, well, really I don’t notice the pain if I’ve forgot to change the patch because the withdrawals are that bad, I just can’t think about anything to be honest and it’s sent me into hospital a couple of times where I’ve forgot to change it and I’ve had a bad reaction just from forgetting to change it for one day. When you were hospitalised, what were you suffering from then? At the same time, I’d just started a new medication because I’d reacted wrong, badly to that and because I’d forgot to change the patch, they both reacted badly together and it sent me kind of crazy and my friends started getting worried about me so mum took me into hospital and I ended up going three days without sleep. So they had to give me something to just knock me out of it. Okay. Do you mind just saying what you meant when you say you went a bit crazy? Well, I started I actually started hallucinating because I’d had an allergic reaction at the same time as withdrawal symptoms so I’d actually gone over to my friend’s house and I just asked her if I were a butterfly and it kind of freaked her out so that’s why they says, “We’d better get you to hospital.” Do you remember much about what happened? Yeah, I remember it all. It were, I’d started twitching really badly and the doctor at A and E could see that something were happening and that and at first they said, “Oh, you’ve got to try and get some sleep.” “Oh, I can’t. I’ve been trying for three days.” So then they gave me some diazepam to knock me out and then after I’d actually got some sleep, the patches eventually started kicking in and I started feeling better after a couple of days.
NSAIDs have anti-inflammatory (reduce inflammation), analgesic (relieve pain) and antipyretic (lower temperature) effects. Although different NSAIDs have different structures, they all work by blocking cyclooxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation. Most NSAIDs inhibit both enzymes, although a few are available that mainly inhibit COX-2. The pain-relieving and anti-inflammatory effects of NSAIDs are mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.