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J Clin Pharm Ther. 2015 Aug;40(4):363-7. doi: 10.1111/jcpt.12294. Epub 2015 Jun 13.

Medicines can affect thermoregulation and accentuate the risk of dehydration and heat-related illness during hot weather.

Author information

1
Veterans' MATES Program, Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
2
Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
3
Medicines Information NPS MedicineWise, Surry Hills, NSW, Australia.
4
Department of Pharmacy, Royal Adelaide Hospital and Glenside Campus, Adelaide, SA, Australia.
5
Department of Veterans' Affairs, Veterans' Medicines Advice and Therapeutics Education Services (Veterans' MATES) Clinical Reference Group, Adelaide, SA, Australia.
6
Southern Adelaide-Fleurieu-Kangaroo Island Medicare Local Limited, Adelaide, SA, Australia.
7
Australian Medicines Handbook Pty Ltd, Adelaide, SA, Australia.
8
Drug and Therapeutics Information Service, Repatriation General Hospital, Adelaide, SA, Australia.
9
Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, Adelaide, SA, Australia.

Abstract

WHAT IS KNOWN AND OBJECTIVE:

Hot days are increasingly common and are often associated with increased morbidity and mortality, especially in the elderly. Most heat-related illness and heat-related deaths are preventable.

COMMENT:

Medicines may accentuate the risk of dehydration and heat-related illness, especially in elderly people taking multiple medicines, through the following mechanisms: diuresis and electrolyte imbalance, sedation and cognitive impairment, changed thermoregulation, reduced thirst recognition, reduced sweat production, and hypotension and reduced cardiac output.

WHAT IS NEW AND CONCLUSION:

Commonly used medicines that may significantly increase the risk include diuretics, especially when combined with an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), anticholinergics and psychotropics. Initiation of individualized preventive measures prior to the start of the hot weather season, which includes a review of the patient and their medicines to identify thermoregulatory issues, may reduce the risk of heat-related illness or death.

KEYWORDS:

angiotensin-converting enzyme inhibitor; anticholinergic agents; antidepressants; dehydration; hot weather; medicines

PMID:
26073686
DOI:
10.1111/jcpt.12294
[Indexed for MEDLINE]

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