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Can certain medications increase the risk of heat stroke?

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When you’re out enjoying a beautiful, warm summer’s day, your medicine is probably the furthest thing on your mind. But as temperatures rise, it’s a good idea to add your prescription checks to your summer safety checklist.

While many of us know the basics of staying safe while having fun in the sun, you may not know that your prescription can harm you. This is because certain medications, both prescription and over-the-counter, can interfere with thermoregulation, which is your body’s natural ability to control internal temperature. In hot and humid weather, you become more susceptible to heat-related illnesses such as dehydration, severe sunburn, heat exhaustion, and heat stroke.

Below, we’ll discuss the signs and symptoms of heat exhaustion and heat stroke, medications that may increase your risk, and what you can do to stay safe through the summer heat.

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Causes of heat exhaustion, heat stroke and other heat related ailments

While our resting body temperatures can vary slightly, the generally accepted average is 98.6 degrees Fahrenheit. As soon as our internal body temperature starts to rise above this level, our brain wants to cool us down. It sends signals to our sweat glands to make us sweat and tells our circulatory system to start pumping blood to the surface of the skin where heat can escape.

Our reaction to heat puts great stress on the body, and we can only sustain it for so long before fatigue sets in. If your body does everything it can to cool down, but its internal temperature is still rising, you run the risk of heat exhaustion and heat stroke.

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What is heat exhaustion?

When your body is tired and depleted of fluids, heat exhaustion occurs. Heat exhaustion usually doesn’t require medical treatment, but it’s still serious because it’s a prelude to heatstroke. If you or a loved one starts experiencing any of the following symptoms, get out of the heat immediately:

  • Muscle cramp
  • Headache
  • Nauseous
  • Fatigue
  • Dizziness or confusion
  • Excessive sweating with cold and damp skin

Find a place in the shade or somewhere with air conditioning, drink a little water, lie down with your feet above your head, and place a cool cloth on your body to lower the temperature.

What is heat stroke?

Heat exhaustion can turn into a heat stroke if you don’t cool off within an hour of first showing the above symptoms. When your body loses control of its internal temperature, it is heat stroke – an emergency that requires immediate medical care. When spending time in the heat, be aware of these symptoms:

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  • Hot and dry skin without sweating
  • Breath fast and shallow
  • Fast heart rate
  • Confusion, irritability or slurred speech
  • Bad balance
  • Loss of consciousness
  • Seizures (in severe cases)
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If you think someone is suffering from heat stroke, call 911 immediately. While you wait for help to arrive, do all you can to lower their body temperature: keep them out of the sun – preferably somewhere with air conditioning – and place ice and a damp cloth on the skin. them, spray them with cold water or put them in a bath full of cold water.

What types of medications can increase the risk of heat exhaustion, heat stroke, and other heat-related illnesses?

Our ability to respond to hot weather is critical to our health, but what happens when this physical response is impaired? The following classes of drugs can alter your natural reaction to sun and heat, putting you at greater risk of developing heat-related illnesses.

Psychiatric medicine

Certain psychiatric drugs can change the function of a part of the brain called the hypothalamus, which controls body temperature and thirst, among other things. As a result, your brain cannot communicate effectively with your body that you are hot or thirsty. This can cause you to sweat too much or too little, and become dehydrated.

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Keep this in mind if you are taking tricyclic antidepressants, antipsychotics, SSRIs, SNRIs, or benzodiazepines.

Antibiotics

Some antibiotics can make your skin more sensitive to sunlight. This is called drug-induced photosensitivity, and it makes you more likely to develop a rash or severe sunburn — the kind that peels and blisters — after sun exposure.

If you are currently taking fluoroquinolones, sulfa antibiotics (including Bactrim) or tetracyclines, be careful when spending time in the sun.

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Topical acne medication

Topical acne treatments help speed up the renewal of the skin’s surface, but it temporarily thins the outer layer of the skin, making us more vulnerable to the sun’s rays. Try to avoid prolonged sun exposure, use sunscreen and wear protective clothing if you regularly apply benzoyl peroxide, retinol or salicylic acid to your skin.

Antihistamines

Antihistamines can stop your cold, but the same response that dries up your nasal passages can dry out the others. This will prevent you from sweating as much as you normally would in the heat, depriving you of your body’s primary defense against heat. Benadryl and Dramamine can both limit your ability to sweat. Newer antihistamines, such as Zyrtec and Claritin, won’t affect you this way.

Heart and blood pressure medication

The heat is hard on your heart. And if you’re taking heart or blood pressure medications, your heart may have to work harder to keep you calm. Beta blockers lower your blood pressure and constrict blood vessels, making it harder for your body to pump blood to the surface of your skin and store it there. And because diuretics remove excess fluid and sodium from your body to increase blood pressure, you may not be able to sweat enough in hot weather.

Stimulants

Stimulants increase your basal body temperature, which is the temperature your body maintains at rest. With a higher resting body temperature, it takes less time and lower outdoor temperatures for your core temperature to rise to dangerous levels.

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This is common with prescription stimulants used to treat ADHD, such as Adderall and Ritalin. The same can happen with illegal stimulants, such as cocaine, ecstasy, and amphetamines.

The effects of dehydration on your medication

Most of us take our medicine with water and doing so actually helps the medicine work the way it should. Water helps the medicine move through your stomach and into your intestines, where it can be absorbed. Dehydration prevents your body from properly absorbing the right amount of medication.

No matter the season, most doctors recommend drinking a full 8-ounce glass of water with your medication.

Exposing drugs to high temperatures

Most pill bottles list a temperature range in which the medication inside can be safely stored, usually between 59-77 degrees Fahrenheit. Exposing prescription or over-the-counter medications to high temperatures and humidity for long periods of time can make them less effective – but won’t do them any harm.

However, special care must be taken when storing potentially life-saving drugs such as nitroglycerin, which need to work at a moment’s notice. Be sure to regularly monitor and replace medications such as nitroglycerin and EpiPens.
To preserve your medication:

  • Don’t leave them in the car
  • Do not store in direct sunlight
  • Don’t keep it in your bathroom

The best place to store medication (unless there are instructions for storing it in the refrigerator) is in a warm, dry place away from direct light.

How to prevent heat exhaustion associated with medication and heat stroke?

There’s a lot to think about when you decide to go out in the heat, especially if you’re taking one of the medications listed above. However, summer security can still be simple. With a few extra precautions, you can enjoy the season:

  • Take frequent breaks in the shade or in an air-conditioned place
  • Drink water continuously throughout the day, even when you don’t feel thirsty
  • Apply sunscreen with an SPF of at least 30 regularly, and avoid the sun in the middle of the day, around 10 am to 4 pm
  • If you go outside during this time, protect yourself from the sun by wearing a wide-brimmed hat, long sleeves and sunscreen.
  • Consult your doctor before trying a new outdoor sport in the summer
  • Don’t change the way you take your medicine without talking to your doctor first

Talk to your doctor about your prescription

Your prescription should work for you and your lifestyle, not the other way around. If you find that your medication is blocking you from some of your favorite summer activities, schedule an appointment with your primary care doctor. They can adjust your dose or help you find alternative medications and treatments.

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