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Drug-associated non-pyrogenic hyperthermia: a narrative review

Bongers, K, Salahudeen, MS ORCID: 0000-0001-9131-7465 and Peterson, GM ORCID: 0000-0002-6764-3882 2019 , 'Drug-associated non-pyrogenic hyperthermia: a narrative review' , European Journal of Clinical Pharmacology , doi: 10.1007/s00228-019-02763-5.

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Purpose: Hyperthermia occurs when heat accumulation surpasses the body’s ability for heat dissipation. Many drugs may affectthermoregulation. This narrative review aimed to provide an overview of the current literature concerning reports of drugassociated non-pyrogenic hyperthermia.Methods: A comprehensive search was performed across 5 databases covering the period of inception to March 2019, forpublications that reported hyperthermia associated with drug use. Studies that reported potential drug association with hyperthermia due to altered thermoregulatory mechanisms were included. Case reports of less than 3 cases were excluded, as well ashyperthermia due to other causes, such as hypersensitivity, malignant hyperthermia and neuroleptic malignant syndrome. Theprimary outcomes of interest were hospitalisation and mortality.Results: The literature search initially identified a total of 2609 records. Based on full-text analysis, 11 articles met the inclusioncriteria, of which there were 5 case-control studies, 2 case series and 4 retrospective analyses. Studies reported heat-relatedhospitalisations or emergency department presentations associated with the use of psychotropics (antipsychotics, antidepressantsand anxiolytics), anticholinergics, antihistamines, diuretics, cardiovascular agents, non-steroidal anti-inflammatory drugs andanticoagulants. Psychotropic drugs were reported to be associated with increased heat-related mortality, other than throughneuroleptic malignant syndrome, but findings varied among the studies.Conclusion: Given the relative lack of publications, more research is necessary to study specific effects of drugs on bodytemperature and the likelihood of inducing non-pyrogenic hyperthermia. In particular, psychotropics, anticholinergics, diureticsand cardiovascular agents are of interest for future studies.

Item Type: Article
Authors/Creators:Bongers, K and Salahudeen, MS and Peterson, GM
Keywords: hyperthermia, non-pyrogenic, heat stroke, heat exhaustion, thermoregulation, drug-associated, adverse drug reactions, hospitalisation
Journal or Publication Title: European Journal of Clinical Pharmacology
Publisher: Springer-Verlag
ISSN: 0031-6970
DOI / ID Number: 10.1007/s00228-019-02763-5
Copyright Information:

Copyright 2019 Springer-Verlag GmbH Germany, part of Springer Nature

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