Influence of Drug Use on Morbidity and Mortality in Heatstroke

“…Of the reported drugs associated with hyperthermia in previous literature (psychotropics, anticholinergics, diuretics and cardiovascular agents), no significant differences were found between the patients in the primary and secondary hyperthermia groups. However, irrespective of the primary and secondary hyperthermia subgroups, there were significantly higher users for drugs with anticholinergic properties, antihypertensives and diuretics in the study population aged ≥60 years compared with the study population aged <60 years.…”

Section: What Is New and Conclusionmentioning

confidence: 67%

“…Hyperthermia can cause life‐threatening complications, including rhabdomyolysis and secondary hyperkalaemia, metabolic acidosis, organ failure and disseminated intravascular coagulation . Various drugs, such as antipsychotics, diuretics, cardiovascular agents and drugs with anticholinergic properties, have been associated with impaired thermoregulation and hyperthermia . However, these associations are principally based on the known pharmacological effects of drugs and a handful of studies .…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…Various drugs, such as antipsychotics, diuretics, cardiovascular agents and drugs with anticholinergic properties, have been associated with impaired thermoregulation and hyperthermia . However, these associations are principally based on the known pharmacological effects of drugs and a handful of studies . For instance, drugs can potentially affect thermoregulation by altering the neurotransmitters serotonin, acetylcholine, norepinephrine and dopamine at the hypothalamic‐pituitary adrenal axis …”

Section: What Is Known and Objectivementioning

confidence: 99%

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Drug‐associated hyperthermia: A longitudinal analysis of hospital presentations

2019

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What is known and objective: Hyperthermia occurs when heat accumulation surpasses the body's ability for heat dissipation. Many drugs can affect thermoregulation through mechanisms including altering the neurotransmitters that cause increased heat production or decreased heat loss and may, therefore, be associated with hyperthermia. This study aimed to examine hospitalizations and emergency department (ED) presentations due to hyperthermia and to investigate the potential association with drug therapy. Methods:A retrospective analysis of ED presentations and hospitalizations due to hyperthermia in all four major hospitals in Tasmania, Australia, between July 2010 and December 2018 was performed. Data of patients aged ≥18 years were extracted from the hospital digital medical records and analysed for the prevalence, trends and various potential risk factors for hyperthermia, such as age, environmental temperature and drug therapy. Results:This study included 224 patients. The data illustrated a trend with time, albeit not statistically significant, towards increasing hospital presentations due to hyperthermia. Antiepileptics (P = .03) and furosemide (P = .04) were the most frequently used drugs in patients with primary hyperthermia. The high use of levothyroxine in the study population (6.7%) stood out compared with the estimated national average (2.1%). Various drug classes associated with hyperthermia were used significantly more in the age group ≥60 years, suggesting polypharmacy in the elderly as a contributing factor for hyperthermia. What is new and conclusion:This study reports a possible association of some drugs, particularly diuretics (furosemide), antiepileptics and levothyroxine, with hyperthermia. Healthcare professionals should be aware of the increasing prevalence of hyperthermia and the possible involvement of drugs. K E Y W O R D S antiepileptics, drug-associated, elderly, furosemide, hyperthermia, levothyroxine, thermoregulation | 487 BONGERS Et al. 39. Kim TH, Kim KW, Ahn HY, et al. Effect of seasonal changes on the transition between subclinical hypothyroid and euthyroid status. Additional supporting information may be found online in the Supporting Information section. How to cite this article: Bongers KS, Salahudeen MS, Peterson GM. Drug-associated hyperthermia: A longitudinal analysis of hospital presentations. J Clin Pharm Ther.

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“…Lastly, medications such as stimulants frequently prescribed for ADHD or medications with anticholinergic properties (secondary to decreased sweating) can predispose children to heat intolerance. 12…”

Section: Environmental Factorsmentioning

confidence: 99%