With temperatures expected to exceed 20°C in some parts of the country this week, Public Health England has issued a heatwave plan for England. The document provides advice for health professionals to support vulnerable people before and during a heatwave.
With many drugs theoretically capable of increasing the risk for heat-related illnesses and death, PHE suggests a medication review should be considered.
Particular attention should be given to the following drugs:
- Diuretics, especially loop diuretics
- Any drug that causes diarrhoea or vomiting (colchicines, antibiotics, codeine)
- NSAIDS, sulphonamides, indinavir, cyclosporin
- Those with levels affected by dehydration (lithium, digoxin, antiepileptics, biguanides, statins)
- Neuroleptics, serotoninergic agonists
- All antihypertensives
- Antianginal drug
The main causes of illness and death during a heatwave are respiratory and cardiovascular diseases, along with heat-related conditions such as heatstroke.
During the summer of 2006, a linear relationship was observed between temperature and weekly mortality in England, with an estimated 75 extra deaths per week for each degree increase in temperature.
Clinicians are also reminded of factors that can increase an individual’s risk during a heatwave. These include:
- older age (especially >75 years; living alone, socially isolated or in a care home)
- chronic and severe illness
- inability to adapt behaviour to keep cool e.g. Alzheimer’s disease, disability, infants
- environmental factors and overexposure