Drugs and the heatwave

The following is from the NHS Heatwave advice:

The following drugs are theoretically capable of increasing risk in susceptible individuals. It may be worth careful review of the medication such individuals are taking, and assessing the risks and benefits of any changes to their regime.

MEDICATIONS LIKELY TO PROVOKE OR INCREASE THE SEVERITY OF HEATSTROKE

Those causing dehydration or electrolyte imbalance:

Diuretics, especially loop diuretics
Any drug which causes diarrhoea or vomiting (colchicine,
antibiotics, codeine)

Those likely to reduce renal function

NSAIDS, Sulphonamides, Indinavir, ciclosporin

Those with levels affected by dehydration

Lithium, Digoxin, anti-epileptics, Biguanides, statins

Those which interfere with thermoregulation:

by central action:

Neuroleptics, Serotoninergic agonists

by interfering with sweating:

Anti-cholinergics – Atropine,hyoscine
– tricyclics
– H1 (first generation) anti-histamines
– certain anti-parkinsonian drugs
– certain anti-spasmodics
– neuroleptics
– disopyramide
– anti-migraine agents

Vasoconstrictors

Those reducing cardiac output
– beta blockers
– diuretics

by modifying Basal Metabolic Rate:

Thyroxine

Drugs which exacerbate the effects of heat by reducing arterial pressure

All anti-hypertensives
Anti-anginal drugs

Drugs which alter states of alertness (including those in section 4.4 of the British National Formulary)