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The heat is on

By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

In 1984, Glenn Frey recorded The Heat is On for the soundtrack to Beverly Hills Cop.  The single hit #2 on the Billboard Hot 100 in March 1985.  The song was written by Harold Faltermeyer and Keith Forsey for Glenn Frey.  This single was the highest charting solo by any member of the band known as The Eagles. 

The Eagles formed in Los Angeles in 1971 at the encouragement of Linda Ronstadt.  When Linda went out on tour, many members of The Eagles were in her band.  She recognized their talent and encouraged them to become a band.  The interesting details are part of the 2019 documentary about her life and her music.  If you have never seen Linda Ronstadt: The Sound of My Voice, it is worth the time if you are a rock and roll fan.  

The Heat is On popped into my head as we are experiencing a heat wave with consistent temperatures in the upper 90s.  There are so many factors to consider about medications when the heat of the day is on.  

One factor is how you store your medications. Make sure medications are not left in a hot car, truck, tractor, or camper.  Drugs can lose potency when exposed to excess heat for a period of time or they could be chemically changed to a different substance.  On average, the temperature on the inside of a car will be about 35-40 degrees warmer than the outside temperature.  At 90 degrees Fahrenheit, your medications could be exposed to temperatures exceeding 120 degrees.  Ideally, most medications should be stored in a cool, dry space with a temperature range of 59 to 70 degrees Fahrenheit.  

In addition to properly storing your medications, it is essential to understand the interaction between heat and medication within the body.  Medications can create dangerous situations when the heat is on!  

Medications can increase your sensitivity to the heat, which can increase your risk of heat stroke or heat exhaustion.  Drug can decrease your body’s ability to sweat and naturally help cool the skin.  Other medications can increase your risk of becoming dehydrated or increase your body temperature even without a hot day. These effects are different then medications that increase your risk for sunburn.

Drugs with anticholinergic properties can decrease your ability to sweat, which include many common medications for mental health. Always be cautious with hot temperatures if you are taking antidepressant or antipsychotic medications.  Common allergy drugs such as diphenhydramine (Benadryl) can decrease sweating.  Watch out for combination cough and cold products, which can often contain an antihistamine or a decongestant.  The antihistamine can decrease the ability to sweat, while decongestants such as pseudoephedrine or phenylephrine can increase the body’s temperature. Some drugs used to manage Parkinson’s disease, overactive bladder, or motion sickness can have anticholinergic properties. Ask your pharmacist for advice!

Some medications are prescribed to help the body eliminate excess water (diuretics) for heart failure or managing blood pressure, while others have this as a side effect.  Caffeine and alcohol are two drugs with the ability to increase water excretion and can make one prone to dehydration.  Some of the newer agents to treat diabetes, as well as heart failure stimulate the body to eliminate water and dehydration can occur even without excess heat.  These newer agents as a class are called SGLT-2 inhibitors and have proven to be vital additions to manage these conditions.  Some examples of SGLT-2 inhibitors include canagliflozin (Invokana®), dapagliflozin (Farxiga®) and empagliflozin (Jardiance®).  Maintain adequate fluid intake when taking these medications especially with hot weather.  

Some drugs stop the body’s ability to cool down by decreasing blood flow to the skin making it harder for the body to rid of excess heat.  Beta-blockers are a class of drugs used to manage blood pressure, heart failure, and other heart conditions.  These drugs limit blood flow to the skin.  Other medications with the ability to cause blood vessels to constrict will have this effect on the body as well.  

Stimulant medications can increase body temperature without excessive heat, but can exaggerate the response when it is hot outside.  Medications used to manage attention deficit disorder or narcolepsy have stimulant properties as well as the decongestants mentioned previously.  Use caution especially in children who take these medications when playing outside in the heat.  Let coaches, teachers, or camp counselors know about these medications if children’s activities will include outside recreation. 

If you see signs of heat exhaustion or heat stroke, seek professional medical help immediately.  Signs can include headache, dizziness, nausea and vomiting, muscle cramps, weakness, fever, lack of sweating, confusion, or seizures.  

Other medications increase the risk of sunburn and include ibuprofen (Motrin, Advil), naproxen (Aleve), sulfa antibiotics, tetracycline-related antibiotics, fluoroquinolone antibiotics, as well as many acne medications both over the counter and prescription therapy.  

If the heat is on, talk to your pharmacist about your medication and best advice for a sunscreen product.  

ONU HealthWise is offering COVID-19 including boosters Monday through Friday from 10 AM to 5 PM. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna and Pfizer COVID-19 vaccines. Call the pharmacy to get more information. 

ONU HealthWise Pharmacy