MDS Alert

Check Section O of the MDS 2.0 to see if a resident is taking these 2 types of drugs.

All elderly residents are at risk for heat stress, dehydration, and sunburn during warm-weather outdoor activities. Some of them may be even higher risk than you might think, and a quick med review can identify them.

For one, watch out for drugs with an anticholinergic effect, as these can affect a person's thermoregulatory system, says Judy Beizer, PharmD, a professor at St. John's University in Queens, N.Y. "Thus, the person doesn't sweat and may not realize she is getting overheated."

Resource: For a list of common anticholinergic medications, which include Benadryl and medications used to treat urinary incontinence, go to www.empr.com/medications-withsignificant-anticholinergic-properties/article/123667/.

Diuretics also pose a potential problem because "many older people take diuretics for hypertension or heart failure, and may limit how much they drink in order to avoid having to go to the bathroom," cautions Beizer.

"Lithium, which not many people take anymore, can be very dangerous if people get dehydrated, as their Lithium levels go up," says Beizer. Residents taking drugs that can cause hypotension (such as the alpha blockers) who get dehydrated will be more likely to experience dizziness and/or fainting, Beizer cautions. Other drugs heighten the risk of sunburn. "Some of the antipsychotics can do this, as well as amiodarone (an antiarrhythmic drug). Tetracycline can also cause this problem," says Beizer.

Bottom line: While "it makes sense to pay closer attention to people who are higher risk" for hyperthermia, dehydration, or sunburn, make sure all residents going out in warm weather wear hats, use sunscreen -- "and drink [fluids] until their urine is clear." Beizer says.