Heat Wave, Old Age, and Medication - Things to Consider
Many of us are currently enjoying the heat wave, but for the elderly, high temperatures may pose great health-related risks.
Extreme temperatures can trigger various heat-related illnesses, and people aged 65 and older are at an increased risk. Older people are more vulnerable to dehydration due to age-related changes, for instance decreased total body water and reduced sensation of thirst. The likelihood of dehydration is also exacerbated by many medications commonly used by elderly. Insufficient fluid intake may lead to increased drug effects or even renal failure.
It might be challenging to determine the origins of a symptom, whether it is caused by an illness or medication - or by a combination of extreme heat and medication. Therefore, extra caution should now be exercised with the following medications:
- Medications, with narrow therapeutic index (e.g. digoxin)
- Some blood pressure lowering medications (ACE inhibitors, and angiotensin II receptor blockers) and antipsychotics, which may cause a reduced sensation of thirst, leading to dehydration. With blood pressure medication, there may also be an increased risk for hypotension. Thus, regular monitoring of blood pressure is useful.
- Anticholinergics (e.g. some urinary incontinence medications, muscle relaxants, and antihistamines), which may prevent sweating and lead to hyperthermia (i.e. overheating)
- Diuretics, which increase urination, and thus, the risk of dehydration
- Beta blockers, which slow down the heart rate and reduce blood circulation, potentially disrupting thermoregulation
When it comes to maintaining sodium balance, key high-risk medicines are diuretics and various antidepressants. Non-steroidal anti-inflammatory drugs, also available OTC, should be used with caution during extreme temperatures, especially with impaired kidney function. The use of anti-inflammatory drugs combined with dehydration, low blood pressure, and/or a specific blood pressure medication can lead to an acute kidney failure.
Let’s keep an eye on our and our loved ones’ well-being and encourage each other to drink enough fluids during this heat wave!
PhD in Pharmacy
Source: sic! 2/2014