Drug-related heatstroke

Clark, William G.; Lipton, J. M.

doi:10.1016/0163-7258(84)90040-8

Cited by 38 publications

(21 citation statements)

References 264 publications

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“…10 The highest reported core body temperature in a patient who survived was 46.5°C (115.7°F), 11 associated with a history and clinical course consistent with acute Meth overdose. 11 Current therapeutic approaches include cardiovascular stabilization, tranquilization and external cooling of psy-chostimulant-poisoned patients.…”

Section: Introductionmentioning

confidence: 95%

“…One study examining 250 cases of drug-related heatstroke reported that nearly 50% of the patients had a maximal recorded body temperature of 40–41°C and a 69% survival rate, 10 about 25% had a temperature of 41.1–42.1°C with a 53% survival rate, and the remaining had temperatures >42.1°C with a survival rate of only 30%. 10 The highest reported core body temperature in a patient who survived was 46.5°C (115.7°F), 11 associated with a history and clinical course consistent with acute Meth overdose.…”

Section: Introductionmentioning

confidence: 99%

“…It is known that activation of particular dopamine receptors in the central nervous system (CNS) mediates, at least partially, drug-induced hyperthermia, 3,13 suggesting that dopamine-blocking neuroleptic drugs may be helpful. 3,10,13 However, the role of peripheral thermogenic sites has thus far being under-appreciated. The correlation between increased core body temperature and high motor activity has led to the hypothesis that muscle activity is a source of heat in drug abuse.…”

Section: Introductionmentioning

confidence: 99%

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Reactive oxygen species scavenger N-acetyl cysteine reduces methamphetamine-induced hyperthermia without affecting motor activity in mice

et al. 2014

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Hyperthermia is a potentially lethal side effect of Methamphetamine (Meth) abuse, which involves the participation of peripheral thermogenic sites such as the Brown Adipose Tissue (BAT). In a previous study we found that the anti-oxidant N-acetyl cysteine (NAC) can prevent the high increase in temperature in a mouse model of Meth-hyperthermia. Here, we have further explored the ability of NAC to modulate Meth-induced hyperthermia in correlation with changes in BAT. We found that NAC treatment in controls causes hypothermia, and, when administered prior or upon the onset of Meth-induced hyperthermia, can ameliorate the temperature increase and preserve mitochondrial numbers and integrity, without affecting locomotor activity. This was different from Dantrolene, which decreased motor activity without affecting temperature. The effects of NAC were seen in spite of its inability to recover the decrease of mitochondrial superoxide induced in BAT by Meth. In addition, NAC did not prevent the Meth-induced decrease of BAT glutathione. Treatment with S-adenosyl-L-methionine, which improves glutathione activity, had an effect in ameliorating Meth-induced hyperthermia, but also modulated motor activity. This suggests a role for the remaining glutathione for controlling temperature. However, the mechanism by which NAC operates is independent of glutathione levels in BAT and specific to temperature. Our results show that, in spite of the absence of a clear mechanism of action, NAC is a pharmacological tool to examine the dissociation between Meth-induced hyperthermia and motor activity, and a drug of potential utility in treating the hyperthermia associated with Meth-abuse.

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Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reactive oxygen species scavenger N-acetyl cysteine reduces methamphetamine-induced hyperthermia without affecting motor activity in mice

et al. 2014

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“…43 Older people tend to be more reliant on various medications such as diuretics, tranquillisers and sedatives, and heart and blood pressure drugs which may impede diaphoresis. Studies conducted by Clark and Lipton, 44 Beggs, 45 Klein-Schwartz and Oderda, 46 Epstein et al, 47 and Vanakovski and Seppala 48 have examined the relationship between pharmacokinetics, physiological changes, and heat exposure in the elderly. KleinSchwartz and Oderda note that various "physiological changes in the elderly may influence" absorption, excretion, metabolism, and distribution.…”

Section: Heat Stress and Thermal Impactsmentioning

confidence: 99%

Global warming and Australian public health: reasons to be concerned

Saniotis¹,

Bi²

2009

Aust. Health Review

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Studies in global warming and climate change indicate that human populations will be deleteriously affected in the future. Studies forecast that Australia will experience increasing heat waves and droughts. Heat stress caused by frequent heat waves will have a marked effect on older Australians due to physiological and pharmacological factors. In this paper we present an overview of some of the foreseeable issues which older Australians will face from a public health perspective.

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“…For example, amitriptyline, a serotonin reuptake inhibitor, is commonly prescribed. Unfortunately, some antidepressants have been implicated in drug-related heatstroke [3,4]. The balance of norepinephrine and serotonin in the preoptic-anterior hypothalamus controls the body temperature set point and may be responsible for short-and long-term thermoregulatory adaptive modifications of the shivering threshold [5].…”

mentioning

confidence: 99%

Postherpetic neuralgia as a risk factor for classic heatstroke

Sekiyama

Sumida

Hayashida

et al. 2003

Journal of Anesthesia

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On one of the first hot days of summer (ambient temperature 33°C, relative humidity 78%) in late July, the patient took mianserin and slept as normal, without air-conditioning. Early the next morning, she was taken to the emergency room with an axillary temperature of 40.0°C, as a result of exposure to high ambient temperatures throughout the night. The patient vomited on the way to the hospital, and, on arrival, was found to be dehydrated and confused with the following clinical signs: a rectal temperature of 40.0°C; heart rate, 105/ min; blood pressure, 90/50 mmHg; and Glasgow Coma Scale, 13. From these clinical manifestations, her condition was diagnosed as classic heatstroke. She received external cooling and infusions of Ringer's lactate solution, and, by afternoon, her body temperature had normalized and she was conscious. Results of laboratory tests were normal except for slight hypokalemia and hypoglycemia. On the third day, she was able to walk unattended. On the tenth day, she was discharged from this hospital without sequelae. DiscussionPHN patients may have risk factors that result in an increased susceptibility to classic heatstroke. The majority of PHN patients are elderly [2], and their ability to regulate body temperature is less efficient than in younger people [1]. Numerous PHN patients also receive neuroactive agents, such as antidepressant drugs for pain relief. For example, amitriptyline, a serotonin reuptake inhibitor, is commonly prescribed. Unfortunately, some antidepressants have been implicated in drug-related heatstroke [3,4]. The balance of norepinephrine and serotonin in the preoptic-anterior hypothalamus controls the body temperature set point and may be responsible for short-and long-term thermoregulatory adaptive modifications of the shivering threshold [5]. Amitriptyline and mianserin can affect

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Drug-related heatstroke

Cited by 38 publications

References 264 publications

Reactive oxygen species scavenger N-acetyl cysteine reduces methamphetamine-induced hyperthermia without affecting motor activity in mice

Reactive oxygen species scavenger N-acetyl cysteine reduces methamphetamine-induced hyperthermia without affecting motor activity in mice

Global warming and Australian public health: reasons to be concerned

Postherpetic neuralgia as a risk factor for classic heatstroke

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