Medications can magnify heat dangers: Special warnings given for older people
By J.C. ZOGHBY, Staff Reporter, Mobile Register, Jul. 22, 1995.
Section:  1B, 6B

   The extreme summertime heat can pose potential health problems
to most anyone, but its danger can be magnified for those on certain
types of medication.

   Lou Hansen's daily dose of pills controls her diabetes and stabilizes
her asthma, but the combination of pills impedes her body's natural
cooling system.

   I don't get in the heat any more than I have to,'' said Ms. Hensen,
67. I drink a lot of water, being a diabetic, and people really
do need to drink a lot of water or this weather will affect them something
terrible.''

   For Mobilians, sweat rags are a seasonal necessity during the
high-temperature, high-humidity dog days of July.

   But as unsightly as it may seem, sweat is actually the body's
natural way of maintaining the correct internal temperature.

   Some medications commonly prescribed to treat diabetes, high
blood pressure, sinus congestion or depression can impair the
body's ability to deal with the intense summer heat through a retention
of fluids or a constriction of the blood vessels.

   Infants and senior citizens are usually the first heat casualties,
because they lack an adequate internal thermometer. In the case
of seniors, medications can exacerbate the problem.

   Old people don't tolerate dehydration near as well,'' said
Dr. Stephen Davis, an internist at Providence Hospital. They'll
have lots of throwing up, vomiting, having diarrhea. And with an
old 90-year-old person, you'll have problems with their temperature
regulation mechanism. Not to mention that they might have lung
disease or heart disease.''

   Davis said the combination of an underlying disorder  such as
diabetes, high blood pressure or a heart condition  and its corrective
medicine can turn sun exposure into an exercise in dehydration.

   The thing you worry about with the heat is the underlying disorders,''
Davis said. If you're a diabetic and you get dehydrated, then
your sugar goes up, and kidney function gets worse.''

   Dr. Michael Culpepper, director of nephrology and hypertension
at the University of South Alabama, said diuretics prescribed
to eliminate excess salt and water can be dangerous in the summertime
when sweating depletes these stores.

   Heat and high blood pressure present a dangerous combination:
A patient tempted to supplement dietary sodium may already be on
a salt-restricted diet.

   In the elderly folks this heat problem is complicated by
diuretic medications,'' said Dr. Michael Sternberg, assistant
director of emergency medicine at USA. They're usually related
to hypertension medication and you need isotonic fluids'' to replenish
the lost minerals.

   In addition to sodium loss, sweating also depletes the body's
potassium stores  a mineral found in bananas and athletic sports
drinks, such as Gatorade or 10K, Culpepper said.

   Beta blockers used to regulate high blood pressure don't allow
the small blood vessels in the skin to dilate. A restriction of blood
flow to the skin impedes sweat production and causes the body temperature
to rise, he said.

   Culpepper said antihistamines reduce sinus congestion by
blocking the function of the autonomic nerves. But, because this
group of nerves stimulates the sweat glands, a side effect is reduced
sweat production.

   Cassandra Ewing, director of Springhill Memorial Hospital's
Fitness Center, said it's best to stay indoors in a cooled room during
the hottest hours of the day. And, in the case of senior citizens
on beta blockers they need to talk to their doctors ... definitely
if they're going to be outside.''

    GRAPHIC:  HOT MEDICATIONS

This article reproduced with special permission from the Mobile Register.

This searchable database is from 1992 to present.  To suggest articles for inclusion, please send e-mail to gholbert@jaguar1.usouthal.edu or call (251) 460-7044.

More stories from the Mobile Register are available at Alabama Live.

To make comments, suggestions, or get more information, send e-mail to medlib@jaguar1.usouthal.edu or call (334) 414-8210.

URL:  http://southmed.usouthal.edu/library/news/22jul95.html
Last update: 1/3/01