Effects of Medications on Heat Loss Capacity in Chronic Disease Patients: Health Implications Amidst Global Warming.

IF 19.3 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pharmacological Reviews Pub Date : 2023-11-01 Epub Date: 2023-06-16 DOI:10.1124/pharmrev.122.000782
Jericho Wee, Xiang Ren Tan, Samuel H Gunther, Mohammed Ihsan, Melvin Khee Shing Leow, Doreen Su-Yin Tan, Johan G Eriksson, Jason Kai Wei Lee
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Abstract

Pharmacological agents used to treat or manage diseases can modify the level of heat strain experienced by chronically ill and elderly patients via different mechanistic pathways. Human thermoregulation is a crucial homeostatic process that maintains body temperature within a narrow range during heat stress through dry (i.e., increasing skin blood flow) and evaporative (i.e., sweating) heat loss, as well as active inhibition of thermogenesis, which is crucial to avoid overheating. Medications can independently and synergistically interact with aging and chronic disease to alter homeostatic responses to rising body temperature during heat stress. This review focuses on the physiologic changes, with specific emphasis on thermolytic processes, associated with medication use during heat stress. The review begins by providing readers with a background of the global chronic disease burden. Human thermoregulation and aging effects are then summarized to give an understanding of the unique physiologic changes faced by older adults. The effects of common chronic diseases on temperature regulation are outlined in the main sections. Physiologic impacts of common medications used to treat these diseases are reviewed in detail, with emphasis on the mechanisms by which these medications alter thermolysis during heat stress. The review concludes by providing perspectives on the need to understand the effects of medication use in hot environments, as well as a summary table of all clinical considerations and research needs of the medications included in this review. SIGNIFICANCE STATEMENT: Long-term medications modulate thermoregulatory function, resulting in excess physiological strain and predisposing patients to adverse health outcomes during prolonged exposures to extreme heat during rest and physical work (e.g., exercise). Understanding the medication-specific mechanisms of altered thermoregulation has importance in both clinical and research settings, paving the way for work toward refining current medication prescription recommendations and formulating mitigation strategies for adverse drug effects in the heat in chronically ill patients.

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药物对慢性病患者热损失能力的影响:全球变暖对健康的影响。
用于治疗或管理疾病的药物可以通过不同的机制途径改变慢性病患者和老年患者所经历的热应激水平。人体体温调节是一个至关重要的稳态过程,在热应激期间,通过干燥(即增加皮肤血流量)和蒸发(即出汗)的热量损失,以及积极抑制产热,将体温保持在狭窄范围内,这对避免过热至关重要。药物可以与衰老和慢性病独立协同作用,改变热应激期间对体温升高的稳态反应。这篇综述的重点是热应激期间与药物使用相关的生理变化,特别是热解过程。这篇综述首先为读者提供了全球慢性病负担的背景。然后总结了人类的体温调节和衰老效应,以了解老年人面临的独特生理变化。常见慢性疾病对体温调节的影响在主要章节中概述。详细回顾了用于治疗这些疾病的常见药物的生理影响,重点介绍了这些药物在热应激期间改变热解的机制。该综述最后提供了了解在高温环境中使用药物影响的必要性的观点,以及本综述中包括的药物的所有临床考虑因素和研究需求的汇总表。意义声明:长期药物调节体温调节功能,导致过度的生理压力,并使患者在休息和体力劳动(如锻炼)期间长时间暴露在极端高温下,容易产生不良健康后果。了解体温调节改变的药物特异性机制在临床和研究环境中都很重要,为完善当前的药物处方建议和制定慢性病患者高温下药物不良反应的缓解策略铺平了道路。
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来源期刊
Pharmacological Reviews
Pharmacological Reviews 医学-药学
CiteScore
34.70
自引率
0.50%
发文量
40
期刊介绍: Pharmacological Reviews is a highly popular and well-received journal that has a long and rich history of success. It was first published in 1949 and is currently published bimonthly online by the American Society for Pharmacology and Experimental Therapeutics. The journal is indexed or abstracted by various databases, including Biological Abstracts, BIOSIS Previews Database, Biosciences Information Service, Current Contents/Life Sciences, EMBASE/Excerpta Medica, Index Medicus, Index to Scientific Reviews, Medical Documentation Service, Reference Update, Research Alerts, Science Citation Index, and SciSearch. Pharmacological Reviews offers comprehensive reviews of new pharmacological fields and is able to stay up-to-date with published content. Overall, it is highly regarded by scholars.
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