title: Medicines can affect thermoregulation and accentuate the risk of dehydration and heat-related illness during hot weather.
abstract: 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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: K
authors.initials: K
authors.lastname: Westaway
authors.affiliation: Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
authors.forename: O
authors.initials: O
authors.lastname: Frank
authors.affiliation: Medicines Information NPS MedicineWise, Surry Hills, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Husband
authors.affiliation: Department of Pharmacy, Royal Adelaide Hospital and Glenside Campus, Adelaide, SA, Australia.
authors.forename: A
authors.initials: A
authors.lastname: McClure
authors.affiliation: Department of Veterans' Affairs, Veterans' Medicines Advice and Therapeutics Education Services (Veterans' MATES) Clinical Reference Group, Adelaide, SA, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Shute
authors.affiliation: Southern Adelaide-Fleurieu-Kangaroo Island Medicare Local Limited, Adelaide, SA, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Edwards
authors.affiliation: Australian Medicines Handbook Pty Ltd, Adelaide, SA, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Curtis
authors.affiliation: Drug and Therapeutics Information Service, Repatriation General Hospital, Adelaide, SA, Australia.|Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, University of South Australia, Adelaide, SA, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Rowett
mesh_terms: D000368:Aged; D001833:Body Temperature Regulation / Q000187:drug effects; D003681:Dehydration / Q000209:etiology / Q000517:prevention & control*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D018882:Heat Stress Disorders / Q000209:etiology / Q000517:prevention & control*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D014887:Weather
keywords: angiotensin-converting enzyme inhibitor; anticholinergic agents; antidepressants; dehydration; hot weather; medicines