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Drug-associated heat stroke.

Mauricio Martinez1, Lisa Devenport, Jullette Saussy

  • 1Section of Emergency Medicine, Louisiana State University Medical Center, New Orleans, USA.

Southern Medical Journal
|August 23, 2002
PubMed
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During a New Orleans heat wave, 8 patients suffered heat stroke, with 75% linked to hyperthermia-inducing medications like cocaine. This highlights a critical, often overlooked, factor in heat illness management.

Area of Science:

  • Environmental Health
  • Clinical Medicine
  • Toxicology

Background:

  • Heat stroke is a severe heat illness, often exacerbated by environmental conditions.
  • The role of medications in contributing to heat stroke is not widely reported.
  • High ambient temperatures and heat index values can precipitate heat-related illnesses.

Purpose of the Study:

  • To investigate the occurrence of heat stroke during a heat wave in New Orleans.
  • To identify potential contributing factors, particularly medications, in heat stroke cases.
  • To determine the mortality rate and clinical outcomes associated with heat stroke in this cohort.

Main Methods:

  • Retrospective case series of patients admitted with heat stroke during a 14-day heat wave.
  • Review of patient medical records, including medication history and toxicology screens.

Related Experiment Videos

  • Analysis of ambient temperature and heat index data during the study period.

    • Main Results:

    • Eight patients were admitted for heat stroke, with daily temperatures exceeding 33.3°C (91.9°F).
    • Medications known to induce or worsen hyperthermia were implicated in 75% of cases, with cocaine being the most common.
    • Rhabdomyolysis occurred in 75% of patients, with 3 also developing disseminated intravascular coagulation.
    • The mortality rate was 25% (2 deaths).

    Conclusions:

    • Medications can significantly contribute to the development and severity of heat stroke, even with moderate temperatures.
    • Drugs such as cocaine, diphenhydramine, tricyclic antidepressants, and phenothiazines should be considered in patients presenting with heat stroke.
    • Increased awareness and screening for drug-induced hyperthermia are crucial for managing heat stroke patients effectively.