Taking antipsychotics, diuretics, and anticholinergic medications poses the highest risk in the current weather conditions. Primarily, elevated temperatures affect antibiotics, hormonal medications, and those based on bacterial cultures. We explore how medications alter our adaptability to high temperatures and review our summer medicine cabinet: what to keep and what to toss?
How Heat Affects Medication: A Scientific Explanation
can significantly impact the effectiveness of familiar medications and intensify their side effects. This is due to the fact that high temperatures alter metabolism and the sensitivity of receptors to drugs. The body’s water-salt balance and the rate of distribution and elimination of medications also change. The influence of heat on drug efficacy is scientifically grounded: heat accelerates or slows down the activity of enzymes that control the breakdown and elimination of active substances in medications. This leads to either a decrease or increase in the levels of therapeutic agents in the bloodstream, resulting in altered effectiveness and an increased risk of side effects.
An example of how affects medications is their distribution in body tissues. Changes in blood flow or the permeability of cell membranes can lead to the accumulation of drugs where they may cause unwanted effects, while not reaching the intended site of action in sufficient quantities. Certain need to bind to specific receptors to be effective, and heat alters their sensitivity and responsiveness, modifying the action of the drugs or amplifying their side effects. Additionally, heat increases sweating, which can lead to dehydration and disrupt the water-salt balance. This affects the action of medications that are eliminated by the kidneys or regulate metabolism.
Because heat increases the load on the cardiovascular system, individuals with heart issues may experience worsening conditions, particularly an increase in in hypertensive patients. The specifics of taking blood pressure medications require them to be taken regularly at the same recommended time. It is unacceptable to stop taking heart medications during the summer on one’s own accord, even if blood pressure normalizes, as this can lead to a sudden spike. Similarly, one should not independently change the prescribed dosage or timing of medications: it is essential to pay attention to changes in the effects of therapeutic agents in the heat and adjust intake with a doctor.
Which Medications Should Be Avoided in the Heat
Vulnerable categories of medications include antipsychotics, diuretics, and anticholinergic agents. The latter, in particular, impair thermoregulation and suppress sweating, which in hot weather can lead to of the body and heat stroke (aspirin, acetaminophen, and non-steroidal anti-inflammatory drugs are not recommended for treating heat stroke).
Antipsychotics and High Temperatures
Antipsychotics affect the hypothalamus—the part of the brain that regulates body temperature. This can hinder the body’s normal cooling process during heat, increasing the likelihood of heat stroke and other severe conditions resulting from disrupted thermoregulation and lowered blood pressure. Side effects of antipsychotics in the heat include tremors and muscle spasms (known as extrapyramidal symptoms).
Antipsychotics also impact hydration: they reduce the sensation of thirst, ultimately leading to dangerous dehydration in the heat. Combined with dehydration, the lowered blood pressure caused by antipsychotics can result in dizziness, loss of consciousness, and related complications, potentially leading to accidents. Taking antipsychotics in the heat worsens overall health, leading to weakness, headaches, nausea, and vomiting.
The Dangers of Diuretics in the Heat
Diuretics increase the risk of dehydration and disrupt electrolyte balance. In a hot microclimate, the body already loses fluid through active sweating, and diuretics, by eliminating fluid from the body, further exacerbate dehydration, which can lead to significant fluid loss. This is especially dangerous for older adults, who may not feel thirst as acutely and adapt more slowly to heat.
Along with fluid, diuretics also flush electrolytes from the body: , potassium, sodium. A deficiency of these minerals can cause heart rhythm disturbances and muscle cramps. By overloading the kidneys, diuretics can lead to a sharp drop in blood pressure and dizziness. Diuretics can disrupt metabolism and consequently cause unwanted effects—such as skin reactions.
Side Effects of Medications in the Heat
A hot summer can turn beneficial and safe medications into harmful and dangerous ones. Such medications include those used to treat bronchial asthma, allergies, depression, and hypertension. Beta-blockers or ACE inhibitors (angiotensin-converting enzyme inhibitors), which are used to treat hypertension, increase the risk of fainting in the heat due to a sudden drop in blood pressure.
A side effect of with selective serotonin reuptake inhibitors is increased sweating, which raises the risk of dehydration in the heat. Over-the-counter allergy and bronchial asthma medications, as well as drugs for the comprehensive treatment of Parkinson’s disease, can lead to overheating and heat stroke by reducing sweating: the risk lies in disrupting the body’s natural cooling mechanism.
Characteristic effects include:
- Pain relievers and sedatives make hot weather feel more bearable, reducing awareness of the heat;
- Antidepressants (antipsychotic medications) reduce sweating;
- Thyroxine and sympathomimetics stimulate sweating;
- Beta-blockers and antianginal medications reduce heart contractility;
- Dehydration caused by diuretics slows the elimination of drugs and toxins due to reduced blood flow in the liver and kidneys, causing fluctuations in heart rate;
- Fluid retention antagonists (morphine), laxatives (lactulose), or those that induce vomiting or diarrhea (colchicine) can lead to electrolyte imbalance;
- Non-steroidal anti-inflammatory drugs, sulfonamides, and indinavir can suppress kidney function.
Switching to new medications during the summer in an attempt to avoid unwanted side effects is not the best idea, as the risk of adverse reactions increases during the adaptation period to a new drug. To mitigate the negative impact of heat on the body, it is essential to ensure adequate water intake and avoid excessive physical activity and overheating.
Top Medications That Spoil in the Heat
It is crucial to store medications in a dry, dark, and cool place (preferably or necessarily in the refrigerator, but not in the freezer). Some medications are sensitive to high temperatures and spoil under improper conditions. These include medications that degrade due to heat, change their chemical composition, become unstable, and lose their effectiveness: insulin; certain vaccines and serums; antibiotics; hormonal medications; solutions for injections or infusions; ointments and suppositories. While the usual temperature for storing medications in the heat should not exceed +25°C, insulin must be stored in the at strictly controlled temperatures between 2–8°C.
Medications that are “picky” about storage conditions (light, humidity, temperature) include blood thinners, nitroglycerin (the temperature for these medications should not exceed +25°C), glycoside-based medications, and medical fats. It is essential to provide medications with storage conditions according to the instructions, and solutions should be used promptly after preparation. Medications that have changed color, smell, or consistency should not be used. It is forbidden to leave medications in conditions of high humidity and direct sunlight.
This answers the question of whether medications can be kept in the sun and whether they spoil in the heat. It is unwise to keep a home medicine cabinet in the bathroom, kitchen, or on a windowsill, and a summer medicine cabinet in the car should also be protected from sunlight and overheating. It should be stored in the cabin: in the glove compartment or door pocket, but not on the dashboard or in the trunk. When exiting a vehicle in the heat, the medicine cabinet should be taken to a cool place, as the vehicle can heat up to 70°C—at this temperature, medications become unusable. In an airplane, the medicine cabinet should be kept in carry-on luggage, as the temperature in the cargo hold is not controlled.
Summer Medicine Cabinet: What to Keep and What to Toss
Once a chemical reaction has occurred, it is impossible to restore a spoiled medication. However, throwing medications in the trash or pouring them down the drain is not permissible, as they are hazardous to people and animals and pollute the environment. What should you do if medications have overheated? In large cities, spoiled and expired medications can be returned to pharmacies for disposal (such services are available in Kyiv and Lviv, for example). If there are no special collection points in your area, medications should be tightly packed in a container to prevent access. It is important to pay attention to disposal instructions: guidelines may be included on the packaging.
When reviewing the contents of your medicine cabinet in the summer, you should discard: medications that have been stored at high temperatures; opened bottles and ampoules; expired medications; medications stored in damp places; vaccines, hormones, and ampoules with sediment; pills that have changed color; tablets without blisters; unknown medications. What you can keep in your summer and travel medicine cabinet, if necessary, includes essentials: antihistamines; heart drops; eye drops; pain and fever relievers; medications for motion sickness, nausea, and diarrhea; insect repellents; sunscreen; and wound care supplies (all of which should be updated).
Medications with damaged primary packaging should not be stored. Each medication must indicate its name, expiration date, dosage instructions, and administration guidelines. For storing medications, choose a waterproof plastic container. Medications with a recommended storage temperature of 10–15°C should be kept on a side shelf of the refrigerator—in a closed container or plastic bag to protect them from moisture. A review of the home medicine cabinet should be conducted every six months. When updating its contents, necessary medications should only be purchased from that adhere to the temperature control for storing medications in the heat.
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