ABSTRACT
INTRODUCTION: Global warming is slowly but surely becoming one of the greatest problems of the modern world. Heatwaves with extremely high temperatures and humidity changes are particularly dangerous as they can lead to increased mortality rates and increased side effects of certain medications. The goal of this study was to give a short review of the most critical issues healthcare professionals should be mindful of when it comes to prescription of medicines during high temperature periods. METHODS: A PubMed literature search was conducted in January 2021 in order to identify studies showing stability changes of most prescribed drugs in high temperatures as well as studies demonstrating impact of some drugs on human thermoregulation. RESULTS: A vast majority of the commonly prescribed drugs, including Simvastatin, Levothyroxine, Omeprazole and Atorvastatin aren't susceptible to heat. However, some studies found that Amlodipine and Lansoprazole degrade following heat exposure. A study demonstrated the effects of low relative humidity environment on Levothyroxine tablets. While Levothyroxine remained stable at high temperatures, it significantly degraded with the decrease in humidity. Since all vaccines, both viral and bacterial, are most stable at exactly 2-8 °C, providing adequate storage has turned out to be an immense challenge. In general, killed whole-cell bacterial vaccines, like pertussis vaccine, show a higher degree of stability of potency compared to live attenuated vaccines, such as BCG. However, when tested in high-temperature conditions, BCG vaccine has proven to be more stable than Pertussis vaccine. Also, diphtheria and tetanus toxoids have proven to be most stable during exposure to various conditions. Many medicines can potentially have their side effects enhanced during heatwaves and cause serious health issues. Using the percutaneous form of nitroglycerin could lead to an additional decrease in blood pressure in warm weather. Subdermally injected insulin could create a severe hypoglycemia in diabetic patients. Studies have shown that schizophrenic patients on antipsychotic treatment have much lower heat tolerance, with a higher possibility of developing hyperthermic syndromes such as febrile catatonia or neuroleptic malignant syndrome. CONCLUSION: Heatwave periods are not to be taken lightly and should be approached with utmost caution when prescribing therapy. It is of critical importance to inform and educate vulnerable populations early in the season and promote proper hydration throughout the periods when temperatures exceed local averages.
